The U.S. Paramedics provide vital care in emergency situations and are a lifeline for all Americans. The history of emergency medical service (EMS) remains largely unknown.
American Sirens: The Incredible Story of the Black Men Who Became America’s First Paramedics, Kevin Hazzard (a former paramedic) highlights the Black Pittsburgh men who were the pioneers of emergency medical service and created a template that was copied by other cities.
In 1966, the National Academy of Sciences (NAS) published a white paper that was a damning indictment of the nation’s emergency response system. “Essentially, paramedics weren’t plentiful enough to be there when you needed them and then weren’t well trained enough to be of much use when they were there,” Hazzard says.
Ambulances were, in some cases, hearses that were driven by undertakers from the funeral home that would later plan the patient’s funeral. Other situations might see the injured and sick being attended to by volunteers or police officers who are not qualified to give emergency care. The NAS report found that Americans survived a gunshot wound more often in Vietnam War than at home. That’s because the least wounded soldiers were accompanied by qualified medics. “In 1965, 52 million accidental injuries killed 107,000, temporarily disabled over 10 million and permanently impaired 400,000 American citizens at a cost of approximately $18 billion,” the report said. “It is the leading cause of death in the first half of life’s span.”
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Peter Safar (an Austrian-born physician at Pittsburgh) felt the pinch from this lack of emergency treatment. He was a pioneer of CPR and helped create the hospital Intensive Care Unit. He lost his daughter in 1966 to an asthma attack because she didn’t get the right help between her house and the hospital. So he coped with the loss by designing the modern ambulance—including the equipment inside, plus its paint scheme. Perhaps most crucially, he also designed the world’s first comprehensive course to train paramedics.
A group of Black men were the first to enroll in the 1967 course. They were part of Freedom House, a nonprofit that provided work delivering vegetables to low-income Black Americans. Initial plans were to change the delivery service’s focus from food delivery to transportation to hospitals. In eight months, drivers learned how to manage emergencies like heart attacks and seizures. The 1968 uprising that followed the assassination Martin Luther King Jr. saw their first call.
Data showed the training was effective. Freedom House carried out a 1972 study that examined 1,400 patients brought to the area hospital by Freedom House. The results showed that the paramedics provided the best care for critical patients in 89% percent of cases. The study showed that police and volunteers delivered correct care 38% and 13%, respectively. Nancy Caroline (One Freedom House) wrote a textbook about EMS training which became the standard for all EMS courses.
The city ended Freedom House’s success in 1975. Pittsburgh Mayor Peter Flaherty believed that a better system could be created and replaced Freedom House by an all-white paramedic corp. TIME hears from Hazzard that he thinks racism played a role. As he puts it, “What other reason could he have for not wanting this organization, which was so successful and was a model around the country and around the world, other than the fact that they were an almost entirely Black organization.”
The real story “doesn’t make the city look good,” Hazzard says, so that’s why he thinks the story of the nation’s first paramedics is not better known. Hazzard is convinced that there are valuable lessons to be learned from this story for paramedics and all other professions. Many of the Freedom House participants went on to get master’s degrees, Ph.D.s, or medical degrees—or pursued careers in politics or the upper echelons of police, EMS, and fire departments.
“These were really successful people who came from nowhere and where it all began was an opportunity in 1967,” Hazzard says. “All it took for a group of young men that the world had written off was one opportunity, and they never looked back from that point. You can rise to great heights. They just simply need a single opportunity.”
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