The emergency medical aid was developed by a group of black paramedics: gunshots

dr Nancy Caroline with Paramedic Walt Brown in 1975

The archive of the National EMS Museum


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dr Nancy Caroline with Paramedic Walt Brown in 1975

The archive of the National EMS Museum

Society is unimaginable without the assurance of having qualified, professional paramedics respond to a medical emergency. But before the 1970s, clumsy, indiscriminate care, often by police officers, was the norm for emergencies. According to journalist and former paramedic Kevin Hazzard, negligent ambulance care was responsible for an estimated 1,200 to 2,000 preventable deaths each year in the United States.

In his new book American SirensHazzard tells the eight-year history of the Freedom House Ambulance Service, the all-Black paramedic team that pioneered the profession in Pittsburgh from 1968-1975.

The book documents an untold piece of American history by chronicling how Freedom House saved thousands of lives and influenced the emergence of professional paramedic services in cities across the United States, ultimately setting the gold standard in emergency medical care.

Hazzard begins the book through the eyes of John Moon, a black man who was born into poverty at Grady Hospital in Atlanta but found his calling as a Freedom House recruit. Other prominent Freedom House contributors are dr Peter Safar, the Austrian-born physician who co-founded the Freedom House Ambulance Service shortly after his invention of mouth-to-mouth resuscitation; and dr Nancy Carolinethe first Medical Director of Freedom House, who wrote the groundbreaking text on the emergency medical service Emergency care on the street.

With his professional EMS experience, Hazzard’s writing feels like a paramedic witnessing medical chaos – intubating patients against the clock, confronting terrified patients and their distressed loved ones, and competing with an opposing police force.

Most shocking are the stories of preventable deaths before the advent of EMS, which illustrate the crater-wide void that Freedom House’s ministry filled. Wealthy, white residents of Pittsburgh could afford private ambulances, while residents of the Hill District, the city’s oldest black neighborhood, had little access to basic city services, let alone a chance of surviving a medical emergency.

Paramedics Eugene Key and Harold Brown demonstrate their gear to a guest in 1975.

The archive of the National EMS Museum


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Freedom House provided much-needed medical care to a neglected community. It also provided employment and training opportunities for decent work. Some members of the team were high school dropouts, none had any formal medical training at all. They became skilled paramedics and dispatchers who saved lives.

By 1972, Freedom House employed 35 crew members, received 7,000 calls a year, and its directors had set up the National Register of Paramedics to formalize the field. The crew pioneered several medical developments and technologies, including introducing physicians to ambulance work, allowing medics to transmit EKGs, using air casts to stabilize injured bones and joints, and even administering Narcan to overdose patients.

NPR spoke to Hazzard about the book, the racism faced by the predominantly black team, and how the Freedom House Ambulance Service has changed US society for the better.

This interview has been edited for clarity and length.

The EMS workforce today is mostly white and male, with a proportion of black paramedics around 8%. What most people don’t know now is that this profession has its roots in a black neighborhood in Pittsburgh. Why is it important for this story to be told?

I had this memoir written about my time as a paramedic, and someone emailed me and said, “Hey, you know, have you ever heard that other story?” I realized that not only had I not heard the story, no one had heard it. I found it odd that I was being tutored by people who started their EMS careers in the 1970’s – very close to the emergence of the field – and yet none of them had ever said anything about it.

So when I came across the story, I thought this is the story of something that had a profound impact on my life, and I want to tell that story.

As I began to delve into this, through conversations with the men and women involved, I immediately realized that some people died waiting for this story to be told, and others were waiting for the world to simply witness this incredible feat and acknowledges their ministry to us all.

American Sirens, a book by Kevin Hazzard, traces the history of professional emergency medical services in the United States

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American Sirens, a book by Kevin Hazzard, traces the history of professional emergency medical services in the United States

Hachette books

What was it like sitting down with these people who were so integral to your paramedic training and hearing their stories?

It’s not very often that you get the chance to reach out and touch history. [I spoke with] the surviving members of Freedom House – the doctors are gone, much of the paramedics themselves are gone, but some of them are still there.

That was no small feat. That was a mighty, mighty thing they did. They all say I’m just doing a job, but they knew they were changing the world. That’s why it meant so much to them.

Freedom House forever changed the way the ambulance industry works, right down to the color of the ambulance, the way the ambulance was designed, a lot of the equipment we use and the textbook.

Many people know Nancy Caroline and that she wrote Emergency care on the street. It’s kind of a bible for EMS, but where did this information come from? How did she test these ideas and theories? Where did these teachings come from? They came from the few dozen people [at Freedom House]. On April 4, 1968, they began work that influenced what people did four decades later, and that’s a tremendous legacy. The stamp they have left on the EMS field cannot be underestimated. There are too many innovations that have come out of the Freedom House Ambulance Service.

The destruction of entire Black and Hispanic communities in Los Angeles, Atlanta, and New York City to “revitalize” cities in the 1960s sets the backdrop for the creation of Freedom House. Why did you have to include urban renewal in this story about the first paramedics?

On the surface, urban renewal was a good thing. However, what no one wants to acknowledge is that to build these universities and hospital systems and build highways, someone had to lose. That’s not a very flattering story to tell.

I was born in ’77 so much of it happened before I was born. We tend to say, well, those things are long gone, and we’ve moved away from them. [But] I felt it important to tell the insidious nature of this type of systemic disenfranchisement to an entire group. Without them, there is no way to understand who these 24 people were, how unlikely it was that this situation would arise, how important it is that they be the ones to do it first, and how unsurprising it was that they had all this resistance.

At one point, then Pittsburgh Mayor Robert Flaherty pushed for Freedom House to be defunded, discredited and shut down. He and others considered Freedom House’s services “un-American.” What about providing emergency medical services and saving lives that have earned this label?

The un-American thing was the idea of ​​using public money for what people considered business. There were private companies that felt it might be unconstitutional to get money from the city. The other question that arose was if we say that an ambulance is a public service that has to be paid for with public dollars, what happens to the rest of medicine?

A common bogeyman of the right is this idea of ​​socialized medicine, and suddenly it becomes a slippery slope where everything is public. I found it amazing that people are so afraid of a public health system that they would try to obstruct even an emergency system.

What are some of the challenges facing paramedics today that parallel those faced by Freedom House in the 1970’s?

In many ways, a lot of things haven’t changed at all. You know, I think the last two and a half years have shown that we cannot learn from our mistakes and plan ahead.

So people in an ambulance are fighting for money today. They fight for benefits. How many years did it take New York firefighters to receive benefits for 9/11-related health issues? Here in Georgia, firefighters have been struggling to get various types of on-the-job cancer insurance because that was something they didn’t have.

And they are, for example, the only people other than doctors who can intubate. Emergency rooms are always crowded, and you have this incredible resource that you feel like you can’t tap into because there’s this rigid hierarchy that doesn’t allow it.

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