In her stunning debut novel The Application of Pressure, Adelaide author Rachael Mead takes readers to the front lines of South Australia’s emergency services. Here, Rachael shares how she crafted the novel to dig beneath the grit and gore and reveal the humanity of paramedics and their patients.

The Application of Pressure is the story of two paramedics, Tash and Joel, who work side-by-side saving lives on Adelaide’s medical front lines. As paramedics, their regular workday is a supercut of the worst moments of other people’s lives, and Tash and Joel maintain their sanity through a friendship that is built on a bedrock of black humour and mutual respect. But the constant exposure to trauma begins to take its toll – on both of them in different ways – and the story follows their struggles to stave off burn out and preserve both their mental health and their relationships in the face of ever-mounting pressure.

I’ve been married to a paramedic since he started work with the South Australian Ambulance Service 23 years ago. He loves his job: the challenge and variety of both medical case work and people he meets as patients; the excitement of lights and sirens work; his colleagues and their characteristic dry, black humour.

People are fascinated by paramedics – everything about the job seems to inspire curiosity. And it’s not just the lurid appeal of gory cases like gunshot wounds or vehicle accidents. It’s the fact that paramedics get to see inside homes and other places that remain hidden from the rest of us. So, being a writer married to a paramedic, writing about his work was an obvious choice.

But I didn’t want to write a book that just gratified the natural voyeur in all of us. Being the partner of a paramedic also meant that I was very aware of the toll that constant exposure to trauma can take. I wanted to write a book that asked how paramedics cope with this part of their working life.

An important part of dealing with trauma is being able to talk about it.  As someone who can’t even watch a horror film, I’d make a terrible paramedic, so being married to one, I’ve had to harden up and find some inner mettle. Learning how to ask open questions that really dig into what my husband is thinking and feeling on the job turned out to be a very useful skill. After years of practice, all those debriefing sessions allowed me to imagine myself into his headspace and eventually write a novel that I hope will immerse readers in the often brutal realities of paramedic work.

Many of the stories that make up The Application of Pressure are based on real-life situations that I’ve fictionalised by changing names, genders, cultural heritage, locations and dates. With each chapter revolving around an emergency in or around Adelaide – some grisly, some heart-breaking, some simply bizarre– The Application of Pressure digs beneath the surface of the gore and grit of ambulance work to lay bare the unique culture of the emergency services, and the binding and supportive friendships that can develop from shared adversity.

As the stories unfold and intertwine, the reader gathers fragments of information about Tash and Joel’s lives and relationships away from work. Much of this occurs off-stage, in the spaces between the stories, so that the reader is much like another paramedic, seeing Tash and Joel in short bursts of intense interaction over the years rather than living with them constantly and knowing them deeply over the long-term as a life-partner would.

While readers flesh out portraits of Tash and Joel over the years, the patients they treat are all fleeting characters. So again, readers are put in the headspace of paramedics – they have short but intense interactions with these momentary characters, but these stories end with the delivery of the patient to the emergency department. Neither the paramedic nor the reader ever knows the fate of each patient’s story.

With The Application of Pressure out in the world in this strange time of Covid-19, I think it’s more important than ever to consider and appreciate the amazing work that paramedics and other emergency service and health workers do, every day.