If ever I am faced with a medical emergency that requires paramedics, I believe that my mind will immediately flash to scenes from Shannon Burke's Black Flies, an interesting novel (though more like a memoir, I think) of life as a rookie paramedic in 1990s drug-infested, poverty ridden, racially charged Harlem. The protagonist, a young midwestern middle-class white guy hoping to get accepted into medical school and eager for hands-on experience while preparing to improve his MCAT scores, gets swept up in learning his craft while dealing with seemingly burnt-out and angry (though efficient and skilled) senior medics who try to show the new guy the ropes. Ollie Cross tries to fit in with his colleagues and maintain his morality as he comes face-to-face with the depression, violence, senselessness, cruelty that is life in a large poor urban war zone. The system seems to reward and respect individuals who maintain a cold detachment and make calculated choices, mostly based on the possibility of survival; medics who go out of their way to provide compassionate care or go beyond what their more cynical colleagues fell is acceptable treatment, are often scorned and ridiculed, if not actually run out of the job. Some paramedics (especially those with the most experience), however, like playing God and doling out justice for victims they do not feel deserve extraordinary measures (they are called skels) of treatment. Burke reveals the seemier side to emergency services, detailing how the pressure and stress can break down idealism and morality. Like many close-knit service professions, the insiders cover each other's back. Some of the morbid humor fits nicely with what I have experienced among police and corrections officers I have known. And although some of the medics come off as sociopaths, the real bad guys in the story to me seem to be the police. It is easy to see how some EMS personnel might not take kindly to thei volume, might even be insensed after reading it.
The books is a pretty quick read, and keeps one's attention. I think the relationship between Ollie and his more successful, driven medschool girlfriend, was weak. The story seemed a bit disjointed at times. A few editorial errors (such as making Rut's name Turkovsky in one passage). Where were the female medics? The hispanic ones?