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San Francisco Chronicle
27-06-2025
- Health
- San Francisco Chronicle
Joanna Sokol's ‘A Real Emergency' looks under the hood of a broken emergency response system
Growing up in Oakland in the late 1990s and early 2000s, Joanna Sokol felt adrift and uncertain, a school-averse black sheep among her academically inclined family. Eventually, she found her calling as a paramedic, spending a decade serving the communities of Reno, Santa Cruz and San Francisco. She started to make sense of her experience writing essays for Reader's Digest, Epoca and Hazlitt. Her revelatory book 'A Real Emergency: Stories from the Ambulance' details her painful, abusive love affair with driving an ambulance. It's a mordant, sometimes stomach-churning immersion into the world of first responders dealing with ailing bodies, drug-addled minds, bean-counting bureaucracies and eventually a pandemic that pushed the system to the breaking point. Q: During your early days working as a medic at concerts and festivals, did you notice any patterns between styles of music and emergencies? A: There were certain patterns in drug use — you're going to get more alcohol at a metal concert, more psychedelics for a jam band, more MDMA variants at a rave. But you'd be surprised how much overlap we saw. Like — sir, why are you using ecstasy at a hardcore show? You are on the wrong drug, my friend! And I would say even more than the genre, we noticed differences between the overall energy levels at an event. A late morning reggae set at a festival I would expect maybe dehydration or bee sting allergies, whereas a 4 a.m. heavy electronica warehouse rave; well, you can imagine. A: I had some amazing mentors as a new EMT. This sounds trivial, but I would jump on the floor and teach young me some core strength exercises. When you're first getting into the job, everyone says 'take care of your back,' but no one really explains exactly what that means. It's actually less about lifting heavy patients and more about poor working conditions. Most ambulance workers don't get their own stations to rest or stretch in between calls the way that firefighters do. Instead, we are in the ambulance driving around for 12 or 16 hours a day. Q: Along those lines, 'A Real Emergency' shows how poor work conditions make the job so much more difficult than it needs to be. What are the biggest hurdles EMTs face in organizing for better work policies? A: This is really layered, and there is some fascinating history behind it. But the short answer is that ambulance systems are run by a wide variety of entities in the United States. Some public, some private, some by fire departments. There's no real cohesion on a national level. In many places, the ambulance is very much treated as a steppingstone to a fire engine, so most people don't stick around long enough to see paramedicine as a realistic career. Q: Your descriptions of the early months of COVID-19 while you were working in San Francisco are beyond chilling. What did that period reveal about our emergency and hospital system? A: A lot of us knew for years that the emergency system was falling apart: overcrowded ERs, long wait times for ambulances, never enough staffing. And suddenly the rest of the world was looking at us with this sense of fear and shock, asking us if there were enough resources, and we were thinking, 'No, of course there aren't enough resources.' It felt like we'd been inside a burning house screaming our heads off and suddenly everyone else was saying to each other, 'Oh, no, what if that house catches fire?' Q: In researching the history of ambulance/EMT services, what are some of the challenges that remain unchanged over more than a century? A: The ambulance has never turned a profit. It's generally used by those in poverty, and those with chronic medical and social issues. And there have always been arguments about what constitutes a 'real emergency.' I found records of one of the first ambulance agencies in the country arguing with their local police department about overuse of ambulances for drunks. This was back in the 1800s! The ambulance has always tried to focus on immediate life threats, and it has always ended up as a resource for all of the issues that society can't or won't deal with in other ways. A: More EMS staffing. There are some very cool ways that ambulance crews can get trained and be more involved in these issues, but unfortunately every single one of them starts with having enough of us available to respond to calls.
National Geographic
16-06-2025
- National Geographic
How to spend the perfect day in Cartagena, the Colombian city with a Caribbean heart
This article was produced by National Geographic Traveller (UK). Cartagena — a lively city on Colombia's northern Caribbean coast — has always moved to the rhythm of its own drum. It's where the jaunty beats of cumbia music fill a UNESCO-stamped historical quarter, where innovative cocktail bars and trendy coffeeshops are never too far away and where some of Latin America's most talented chefs use indigenous ingredients to create exquisite Colombian-Caribbean dishes. Throw in ample green space and a live music scene that lasts until the early hours, and you have a fun city break that'll please all the senses. 9am: Fuel up with caffeine There's only one way to start the day in Cartagena: with coffee. At Epoca, an all-day artisanal cafe in Centro Histórico, take a seat by the window and order one of the specialty coffees. Go for local favourite Colonia Coco, grown in the country's Andean region, which has notes of coconut, butter and chocolate. The food menu ranges from the classic arepa de huevo to waffles coated in hollandaise sauce with ham and bacon salt. 11am: Admire arts and crafts Duck into the Museo de Arte Moderno on Plaza de San Pedro Claver — part of the 17th-century former Royal Customs House — to see works by artists from across Colombia and Latin America. Spend an hour here before heading to the nearby Ajá Company; it's a great spot to buy artisanal products, such as handbags made using natural fibres and raw materials. 1.30pm: Have an elevated lunch Jaime Rodriguez creates exquisite contemporary Caribbean dishes at Celele, an upscale restaurant in the neighbourhood of Getsemani. The menu features dishes including buffalo-milk burrata with moringa-plant sorbet and roasted watermelon, and flower salad with pickled cashews. The interior is an eccentric mix of exposed brick and gargantuan murals depicting the people and wildlife of Colombia. 3pm: Get to know Getsemani Mural-swathed Getsemani brims with bars, restaurants and a mishmash of both low-budget and luxury hotels. Yet it's still very much local — the sort of place where Cartageneros sip rum roadside while blasting out African-influenced beats. To explore the area with a snack, book a tour with Foodies. Highlights include popping into a local home to try arepas de huevos and chicha de maíz (a local corn drink). Find dishes like sunflower petals and plum tree leaves in a broth of lemon juice and fish bone at Celele, a contemporary Caribbean restaurant run by chef Jaime Rodriguez. Photograph by Karolina Wiercigroch 6pm: Explore parks and squares Ambling the city's squares and green spaces is a great way to while away the early evening. In Getsemani, Plaza de la Trinidad is home to street music, fast-food vendors and locals sitting kerb-side with a drink. A short walk towards Plaza de los Coches, a lively square just outside the old city walls, will take you through wildlife-rich Parque del Centenario, home to monkeys, sloths and tropical birds. 7.30pm: Dine like a local La Laguna Azul in Getsemani is part restaurant, part liquor shop, and has a mostly Colombian clientele. Start the night in the leafy courtyard and enjoy the live music with a Cartagena Mangle, a local pale ale. Order the ceviche levanta muerto, meaning 'ceviche to raise the dead', with prawns, calamari and octopus served in a fiery bloody mary sauce. Calle de la Media Luna 8 9pm: Listen to live music Café Havana in Getsemani draws crowds with salsa tunes from local stars like Joe Arroyo and a live band that kicks off around 10pm. It can get crowded, so it's best to book a table ahead of time. For something a little more mellow, head to cosy Mientras — a bar and art gallery in Centro Histórico — which has a good mix of drinks, desserts and local DJ sets. 11pm: Sample more nightlife El Barón on Plaza de San Pedro Claver is the ideal cosy, late-night spot for wine, beer or a well-crafted cocktail. It has two indoor spaces as well as a huge courtyard right opposite San Pedro Claver church. There's a menu of Cuban and Colombian rums and cigars, too. Come nightfall, it hosts regular DJ sets from local artists spinning cumbia, hip-hop and disco. Getting there & around Avianca flies from London to Cartagena via Bogotá. Average flight time: Centro Histórico and Getsemani neighbourhoods are a short distance from each other, and easy to explore on foot. For places further afield, taxis or Uber are by far the quickest and most convenient mode of transport. The modern bus system, TransCaribe, operates across the city; cash isn't accepted on board so you must have a pre-purchased card to ride. A single journey costs COP$3,000 (56p). When to go Cartagena has a tropical climate. The best time to visit is during the dry season between December and April, when there is little rainfall and temperatures are pleasantly warm, averaging around 27C. August to the end of November are considered the wettest months, resulting in cheaper hotel and flight prices. Where to stay Hotel Caribe Cartagena. Rooms from COP$687,480 (£128), B&B. Sofitel Santa Clara. Rooms from COP$1,570,544 (£294), B&B. More info The Rough Guide to Colombia, £15.99. How to do it: Journey Latin America has a 15-day highlights trip, with three nights in Cartagena, starting from £4,600 per person. It includes international and domestic flights, transfers, excursions and good-quality hotels on a B&B basis. This story was created with the support of Journey Latin America. Published in the June 2025 issue of National Geographic Traveller (UK). To subscribe to National Geographic Traveller (UK) magazine click here. (Available in select countries only).
