99% Invisible - 405- Freedom House Ambulance Service

Episode Date: July 8, 2020

One night halfway through a graveyard shift at the hospital, orderly John Moon watched as two young men burst through the doors. They were working desperately to save a dying patient. Maybe today he wouldn’t bat an eye at this scene, but in 1970 nothing about it made sense. The two men weren’t doctors, and they weren’t nurses. And their strange uniforms weren’t hospital issued. Moon was witnessing the birth of a new profession—one that would go on to change the face of emergency medicine.  The two men were some of the worlds first paramedics, and, like Moon, they were Black. This is the story of Freedom House Ambulance Service of Pittsburgh. They were the first paramedics and they changed the way we think about emergency medicine. Freedom House Ambulance Service

This is 99% invisible. I'm Roman Mars. Back in the 1960s and 70s in the city of Pittsburgh, there was a nickname for guys like John Moon, the unemployed. We simply meant that no matter where you went for a job, nobody would hire you. Moon grew up in Pittsburgh's largely black and economically depressed hill district. In better times, the hill had its own neuro-league baseball team, and jazz clubs that hosted Duke Hellington and Louis Armstrong. But by the time Moon was graduating high school in the late 1960s, there was no escaping the neighborhoods, unemployable stigma.

The reputation was there, but I don't want to go to the hill because you may get beat up. You have drug addicts and alcoholics, and that same label was placed on myself, and I understood that. But just because that was your thought doesn't necessarily mean that I had to live up to it. So Moon was glad to land a well-paying job right at a school at the local steel mill, only to discover that the hours weren't as reliable as he had hoped. Next, he was in orderly at Pittsburgh's Presbyterian University Hospital, which provided steady employment, but not much else.

All I was doing was making beds and taking people back and forth to the operating room and lifting and stuff like that, mechanical things where you didn't have to think. For a while, Moon tried his best to find meaning in the work. But there was a part of me that said there has to be something more that I can do. Then one night, halfway through the graveyard shift, Moon watched as two men burst through the doors of the hospital. They were working desperately to save a dying patient. And as they rushed by, Moon stood

pressed against the wall and wondered, who are these people? What are they doing? How do they get to be able to do that? Maybe today he wouldn't bet an eye at this scene, but in 1970 nothing about it made sense. The two men weren't doctors and they weren't nurses, and their strange white uniforms weren't hospital issue. But these guys came in with a certain type of confidence that was just shocking to me from the very point that they came into the room. And they had an emblem on their breasts that just picked my interests.

The emblem was the two snake to caduceus, the traditional sign of medicine and healing. But just below the familiar symbol was a word John Moon had never seen before, paramedic. Moon wasn't familiar with the term paramedic, because back then, no one was. That's reporter Kevin Hazard. Moon was witnessing a birth of a new profession, one that would go on to change the face of emergency medicine. But to Moon, perhaps the most striking thing of all, was that these first ever paramedics looked like him.

I'm standing here looking at these two guys and I'm saying to myself, my God, these are black guys. Never before had moonsing young African-American men performing that kind of work. These were two guys that had afros in Beards and the staff on the floor gave them a level of respect that amazed me. And there's something I never really mentioned to anyone. I actually snuck off of the floor, and I actually followed them out to the vehicle. Because I wanted to see what prompted them to show such proudness and boldness. Once I looked at that vehicle, pull off,

it was almost like, there goes my job. There goes my career. That's what I wanna do. Moonbelt right then halfway through his long night shift to become a paramedic. Whatever that was. And in Pittsburgh in 1970, the only place to do that was an organization called Freedom

House Ambient Service. So I went and applied to get a job with him and the rest is history. But that history about how a group of young black men from Pittsburgh became the world's first paramedics is still largely unknown. I'm a former paramedic myself. I did this job for ten years, and you'd think the profession's origin story would be a big deal. But the truth is, most of the EMTs I've talked to have never heard of the Freedom House paramedics,

or understand what we owe them. Today, it's easy to take what paramedics do for granted. Call 911 and they'll arrive with cardiac monitors, airway equipment, and an array of pharmaceuticals to treat anything from heart attacks to gunshots to premature births. But for a long time, emergency medical service, or what today is called EMS, didn't provide anything resembling that. In the early days of what we would view as EMS, it really wasn't the equivalent of what we see today.

They would do whatever it was they knew to do, but, you know, were they doing the right thing? Who knows? That's Richard Clinchy, he's the president of the EMS Museum and the trained paramedic. Clinchy says that when he started and emergency care in the late 50s, emergency services didn't provide treatment at the scene, or even necessarily on a way to the hospital. They were just about getting you to the hospital as quickly as possible. Which kind of makes sense in a way it is after all where the doctors are.

But as a result, it often wasn't clear whose responsibility possible. Which kind of makes sense in a way it is after all where the doctors are. But as a result, it often wasn't clear whose responsibility it was to rush to the scene of an accident. Before the evolution of the MS, who did you call? Well, I was a paid firefighter back in the 60s and sometimes we got the call. If somebody needed a fire truck and they see it in New York, there were fireboxes everywhere. You'd pull the handle and fire person will look fire-quip would show up. In other areas, the responsibility for transporting patients often fell to local funeral homes. So imagine that you're having a massive heart attack, your life's in the balance, and who rolls up to save you, two more titions in a hurry. In many major cities, this crucial task fell to another municipal service that probably

had even less business responding to medical emergencies. The police. In the area where I was a firefighter, we had a police department that had a 57 Chevrolet wagon. That was an emergency response vehicle. So the idea, the general public was faced with was more less what I would call swoop and scoop, which simply meant that you'd call the police that rushed the person out there to you and then they'd pick you up,

put you in the back and rush you back down to the hospital. With minimal training and equipment, John Moon's police departments could do little more than offer patients basic first aid, a canvas stretcher, a half empty oxygen tank, and a pillow. Which more often than not, only serve to choke off the patient's airway. And on top of that, both individual, meaning police officers, got up front and left you back there by yourself. So if you stop breathing by the time you arrived, you were perhaps DOA because no one had done anything for you.

The police simply didn't have the tools, the training, or the disposition to save people in a medical emergency. But in the absence of a dedicated emergency medical service, the job was being left to them by default. And perhaps nowhere was the problem of relying on the police for help, more vividly illustrated than in Pittsburgh's largely black hill district. Moon says the city's mostly white police force was often slow to respond to emergencies in the hill, or the black residents, for their part, were reluctant to even call the place

to begin with. Because there was a trust issue with the police, primarily because there were no constraints. I mean, they could do whatever they wanted, and there was no repercussion, consequences for their actions. No one wanted to get into the exact same police van that the cops had threatened to throw them in the day before. So there was issues all the way around. Do I really want to call the police?

Chances are they're going to take their time getting here number one and if I wait too long Then chances are a cap won't come to my neighborhood primarily because of fear of being robbed of what the case says so the options were very limited Doing that time and the same was true to varying degrees in the rest of the country committed, doing that time. And the same was true to varying degrees in the rest of the country. Whether in neighborhood was served by the police, or the fire department, or the local funeral home, so long as the priority was transportation, as opposed to treatment, no one even realized that there was a job that needed doing.

But then, in the mid-60s, something happened which flipped the paradigm for emergency care on its head and laid the groundwork for the invention of paramedicin. In 1966, the federal government published a white paper that would prove so influential that even now in EMS circles it is simply called the white paper. Basically, it told us we were killing over 50,000 people a year on the highways and doing so unnecessarily that there was a way to intervene and save those people.

But we didn't have the people, nor the resources, nor the training to do a whole lot about it. Techniques practiced by combat medics overseas had been largely ignored by the medical community. With the result that a person was more likely to die of a gunshot wound in America than on a battlefield in Vietnam. The white paper shamed the government into providing money for EMS development on the local level. And government officials and local community leaders began searching for solutions, including a community organizer in Pittsburgh named Phil Hallen. Oh my god, why do I do this?

Hallen is a former ambulance attendant who came to Pittsburgh in the early 60s and yes, he hates being interviewed. Okay, how long are we going to be going on this? I can't, I don't last very long at age 90. Alan ran a civil rights organization called the Maurice Falk Medical Fund which examined health disparities due to institutional racism, and he immediately focused his eye on the city's pitiful emergency services. What was your impression of the level of care that was available in Pittsburgh?

Well, it wasn't my impression of it. It was the way it was. There was a netly level of care. There was no such thing as emergency medicine or any of the things we now look back on it. I think what the hell was going on. No, there was nothing. I mean nobody was straight. Especially the cops. He could see that what was going on was effectively a public health crisis that was disproportionately affecting black neighborhoods. But then one day, Helen came across an article in the local paper about a black operated jobs training program based in the Hill District called Freedom House. The article described how Freedom House had rolled out a kind of mobile grocery store for black neighborhoods using trucks to bring fresh vegetables to people's doors. And, well, healthcare is terrible in the Hill District. We have to do

something. If we could run a grocery van around, why can't we run a medical van around or something like that? Helen wasn't envisioning anything like modern emergency medical services. At first, he just thought Freedom House's trucks could help transport people and underserved neighborhoods to the hospital and that they could hire people from the Hill District to drive them. But that's what I got the director of the University Hospital on this group as well. And you know before the first meeting was over he said oh my God we have to go immediately to SAFER. The experimental study you are about to see is one of 18 similar studies during which we

compared various methods of artificial respiration. Dr. Peter SAFER was a head of anesthesiology at University of Pittsburgh, and by that time he was already famous in medical circles. Saffer was a pure scientist and a very precise and impatient Austrian. We simulated field conditions by selecting as subjects men and women of various body types. This is a film of Saffer from 1951 demonstrating a new technique he developed for resuscitation. What today we call CPR. To help orient you, we have made a diagram of the experimental set up. SAFER understood that, to be effective, resuscitation needed to be started immediately by the first

person on the scene, but he faced heavy resistance from the medical community, which felt the general public couldn't be trusted with such specialized knowledge. So, SAFER performed an experiment. By anesthetizing and curing these subjects, we simulated LIMP asphyxia victims. SAFER paralyzed a group of volunteers using a chemical compound from the Amazon, normally used on poison dip deros. This is the same medical testing has changed a lot. Once the volunteers could no longer breathe on their own, SAFER had untrained lay people use CPR to keep those volunteers alive.

And when I say untrained lay people, I mean children. This boy scout will perform mouth-to-airway breathing. Ultimately, SAFER's views would be vindicated, and for his effort, he'd forever be known as the father of CPR. Helen already knew some of this when he walked into Peter's saffer's office in 1966, but nothing could have prepared him for what actually happened. Within seconds of greeting Helen and the Freedom House team,

the wiry and energetic energetic safer began to unleash a torrent of ideas. Basically, he said, you are just what I'm looking for. I've been trying to figure out how to take rescue breathing and the rest out on the street and to train people how to do that. You got the people.

But safer didn't stop there. He wasn't content to just teach some van driver CPR. I said, let's go beyond that. Let's train them to be professionals as well. Professionals who could provide high quality medical care before the person was even taken to the hospital. It was not go to the scene, pick up a patient, transport to a hospital, and then start carrying

it was emergency treatment right there on the paper. Instead of repurposed cargo spaces, SAFER argued that ambulances should be mobile intensive care units staffed by professionals trained to use cardiac monitors, administer medication, and anything else that might keep a patient alive. Halen and the others could barely keep up. Safer wasn't proposing a simple update to the existing system,

but to change the whole culture of pre-hospital care. And he wanted to do it using Freedom House. I think somebody said, well, how big? What are we talking about here? He said, I can teach, I can remember this. I can instruct 40 people and you know, inside of a half an hour, we realized that there was something going on here which was way beyond anything that we had thought of.

Saffer said about designing advanced ambulances and an intense 300 hour course whose graduates would be the world's first comprehensively trained first responders. This wasn't just the birth of a profession, but of a whole new branch of medicine. It would become a vital link in the chain with a subculture all its own. And the world's first fully trained barometics would be stabbed exclusively with young black men from the Hill District of Pittsburgh. And the people that worked there all were labeled unemployable.

Freedom House recruited many of its first students right off the street, most of whom were just happy to land a good job, even if they were a little fuzzy on the details. John Moon wasn't part of that first class. He signed up a little later. But even he admits that as incredible as he thought the opportunity was, he didn't fully understand what he was getting into. On some level, he was just excited

to finally be wearing the uniform with the cool emblem that he saw on the first night. I'll put it this way. If someone bought you a thousand dollars suit and just gave it to you and Said just walk up and down the street in it. How would you feel? That's the way I felt I was at the point where okay, I got this uniform That's all it takes to help people and boy was I wrong It took a little bit more than that Um, that's how it takes to help people. And boy was our wrong.

It took a little bit more than that. After they signed up, moon and the others underwent a battery of psychological evaluations and interviews with medical professionals. They learned anatomy, physiology, CPR, advanced first aid, nursing and defensive driving at first under SAFER, but later under freedom houses first medical director, a 30-year-old white doctor with no previous ambulance experience named Nancy Caroline. And we look at her with skepticism because you have to remember she's not black, but once we found out that her heart was with us, that was really nothing she could do wrong.

In everywhere she went, she took us with her. Caroline got the trainees access to almost every department of the hospital. She had them work in the morgue, the anesthesiology, suite, and the maternity ward. And of course, if they were going to bring the ICU to the street, they had to master everything that happened in an ICU. So that included spinal immobilization, cervical immobilization, IV insertion, and the advantages of classroom training for us at that particular time is we would learn a procedure in class or she would teach it to us.

And then we would go out a half hour, 45 minutes later after we got out of class and perform that procedure on the person. In Freedom House Paramedics, we're often the first people to perform that procedure outside of hospital. They were among the first to use narcan to reverse an overdose, and the first to save a patient by shocking their heart in the field. Moon told me that the biggest first he personally experienced came in a call where Nancy Caroline was riding along. It was a patient having trouble breathing. He was unconscious.

So Moon started calling it in, but then Nancy Caroline stopped him. And, lo and behold, she said, start and I be an interbait, this patient. And I said, repeat that, since it's start and I be an interbait, this patient. Moon thinks he was the first paramedic who has ever asked to intubate someone in the field. I wasn't able to confirm that, but intubation, the subtle, but critical art of snaking a breathing tube into a patient's trachea

is an incredibly difficult procedure. I've gone through the training. It's not easy, even in a hospital setting. And here they were doing it on the sidewalk. Moon says he was scared to setting. And here they were doing it on the sidewalk. Moon says you've scared to death. And once I gathered my nerves together and remembered how she had taught us in the anatomy lab, I went ahead and did it.

And once I interviewed the person and took him to the emergency room, I had to deal with the ER doctor saying, well, who, who, who, who caused them to be interpreted? And I said, I did. And you are. I said, well, my name is John Moon and I'm a paramedic at Friedman San Francisco. But it wasn't enough for Moon and the other paramedics to simply master the techniques required for emergency medical care. Freedom house personnel faced an even bigger challenge from the moment

they got the call. The city had contracted with Freedom House to handle calls in Pittsburgh's mostly black neighborhoods in the downtown area, but the Pittsburgh police dispatchers often refused to send them. Because the police looked at us as someone taking their jobs away, but Freedom House looked at the police as being a threat to the patient. And one of the things that we had to put in place is we used a police scanner. And we would monitor the calls, and we

would subsequently try to get to the scene before they did. Moon recalls getting to the scene just seconds after the police arrived and seeing them try to drag patients out of wreck cars. And here we are saying, no you can't do this, let's put them on a spine board and put a cervical collar on them. But remember, these were a bunch of black guys from the hill lecturing mostly white cops. You know, and we're yelling at them. And they're cussing us out. Sometimes the police would relent. But other times they would threaten the paramedics with a rest unless they backed off.

And you know, the only thing you can do is just stand back and say, okay, and then you watch them drag the individual out of the car and put them in the back of a paddy wagon and both guys get up front and they race off to the hospital. So those were oftentimes battles that you were not going to win. And it wasn't just the cops who didn't understand. Patients couldn't fathom why Moon was using a cardiac monitor and starting IVs in their house instead of herring them to a doctor. Their idea was let's call the ambulance.

The ambulance comes and pick you up and take you to the hospital. That's all they knew. And it wasn't the easiest thing in the world to explain to a family member that we have brought the emergency room to the person. Trying to convince white patients to submit to treatment was especially difficult. Some wouldn't even let the black paramedics touch them. That was found upon on more than one occasion, where they would say, no, do you have to really do this? I would prefer that you not do it. And it's something that we had to endure, because the problem

was not with us. The problem was with the patient. It was their belief or their preconceived notion about the individuals that were touching them. The same went for doctors and nurses at any hospital not directly affiliated with SAFER and the Freedom House program. Moon remembers trying to read a patient's vital signs, only to have a nurse laugh in his face as if he was pretending to play doctor. Other Freedom House paramedics were mistaken for orderlies and asked to mop the floor. But despite all the struggle, Freedom House's reputation was growing.

People were beginning to recognize that something really different was going on here. This wasn't just called the ambulance. Phil Hallen says stories started to spread about an ambulance service that could perform miraculous life-saving procedures at the scene of horrific accidents. Perhaps the most influential story was about a kid on his bike who was hit head on by a car. The accident was in Squirrel Hill, one of the city's most affluent neighborhoods, and one that Freedom House had never been allowed to enter. So initially, the dispatcher sent the police, but the cops panicked.

The kid was bleeding out in front of them and they had no idea what to do. And somebody said, get freedom house up here. And they did a miraculous activity, which nobody had ever seen, and they'd take place on the street before. People watched it happen. And that was a basic turning point. By this time, Freedom House's five ambulances were running nearly 6,000 calls a year and providing demonstrably better care. At a City Council meeting, SAFER presented data showing that as many as

1,200 people a year had been dying needlessly while in the care of other emergency services. Freedom House paramedics, by contrast, had saved 200 lives in the first year alone. Doctors and medical directors from around the country flocked to Pittsburgh. Freedom House medics were invited to conferences as far away as Germany. Everyone wanted to see what they were doing and learn how they could copy it. In 1975, the federal government chose Freedom House to field test the first standardized training curriculum

for EMS providers. And Nancy Caroline was asked to write the textbook. But Freedom House's growing reputation would ultimately prove to be its greatest liability. The more successes they chalked up, the more certain residents and city officials wanted to see Freedom House gone. And according to John Moon, it was for a simple reason.

How dare you have an EMS system or an ambulance service, this good serving the Black economically deprived community or as society says those people. And we don't have anything like that. And perhaps no one did more to punish freedom house for this transgression than Pittsburgh's mayor. Elected in 1969, 45-year-old Pete Flairity was a fiscally conservative Democrat. Tall and broad-shouldered, he went into office already believing programs using taxpayer money should be managed entirely by the city But ask Phil Hallen and he'll tell you he believes that the mayor's beef with freedom house went beyond issues of fiscal or bureaucratic turf What was his opinion of freedom house?

Well, I didn't like it particularly because it was it was doing too well. That was black And you think that's why's why he felt that way? I think so. Was it your opinion that he was racist? Yes. When Flarity took office, he slashed Freedom House's operating budget in half. This didn't leave enough money to cover even routine

maintenance on the ambulances. Caroline repeatedly wrote frustrated missives to Freedom House's board complaining about breaks and steering that locked up, doors that fell from the hinges and seats that toppled over. Once, according to Caroline, an engine caught fire while transporting a patient. Flirty passed an ordinance that banned ambulances from using their sirens in certain neighborhoods, which significantly slowed their response times. And I first I'll say you can't use a siren downtown because people are complaining about it.

Unfortunately, people look in the vehicle to see who's driving it and then they complain. So we're going on the call downtown and you have to blow your horn to tell the car to get out of the way. And they're looking at you like you're crazy. Rumors were spread that Freedom House paramedics were selling drugs and running dice games from the ambulances and that thousands of dollars had

been stolen from headquarters. And it became a struggle after struggle after struggle and eventually, you know, it's it's almost like a patient struggling to breathe and eventually the heart gets tired and it stops beating and the person stops breathing and that's exactly what happened. In 1975 Flerdy struck a final devastating blow. He announced that the city would roll out its own brand-new paramedic service. Not announced that the city would roll out its own brand new paramedic service.

Not only was the new service showered with the resources Freedom House had long been denied, its recruits were all white. The city needed Caroline to serve as its medical director, and she used that leverage to make one demand that the Freedom House crews be hired on. Flaherty relented. Sort of. Because the city was required to bring the employees over, but they were not required to keep them. So they found a way to get rid of them. So, you know, that's how the city system ended up being 98% it. White when the first EMS system in this country was African-American. Within a few years of being replaced by the city's EMS service, Freedom House was more less forgotten. In part because, like all good things, Paramedics were soon taken for granted. Today, it never occurs to anyone to ask where paramedicine came from. But to Phil Hallen that's the true measure of freedom

house's legacy. Paramedicine is just there. You know do you know anybody that doesn't take this for granted at this point in any American city or even in the American countryside? I mean that nobody would even think of a time when somebody would not survive because they couldn't, that somebody didn't know how to do CPR. It's unthinkable anywhere in the United States. The model of care created at Freedom House ended up being adopted by countless other paramedics programs across the country, very often with the help of Freedom House veterans. Peter Safr, helped to develop a paramedic program in Baltimore.

Mitchell Brown, another Freedom House alum, became the EMS Commissioner for the City of Cleveland and later its director of public safety. In Nancy Caroline, founded the first ever EMS service in Israel. Her textbook, titled Emergency Care in the Streets, ended up setting the first ever EMS service in Israel. Her textbook titled Emergency Care in the Streets ended up setting the standard and EMS instruction for decades. As for Moon, he stayed with Pittsburgh EMS and retired in 2009 as an assistant chief. How does he feel about it all now? When he looks back on the days when a handful of young men from the Hill made history. It's something that I'm extremely, extremely proud to have been a part of.

And every time I see an EMS unit going down the street, I wonder, do they have any idea that's where it all began, because it all getting there. Kevin and I discuss what lessons the surprisingly recent history of paramedicine might offer people contemplating a different role for police in our public safety infrastructure today. After this. Okay, so I'm now talking with Kevin Hazard who reported that story for us and you are a paramedic. I think that's interesting to know. How did you get into being a paramedic? Basically, after 9-11, I was working as a reporter

and a lot of my friends had been in the military and they had these crazy stories that they would tell. One of them was among the first Marines to enter into Iraq. And he's cruising along, talking about rockets, being fired from a helicopter so closely, he could feel a heat off of them. And I'm sitting in city council meetings and you know reporting on like the whether or not they should put speed bumps and various

sub urban streets and I was just frustrated and bored and in one night I got sent by my editor to cover a tunnel collapse They were doing this huge infrastructure project in Atlanta and You know there were six guys on a scaffolding that dropped 250 feet into the earth, and we sat outside with the families and waited. And there were a group of paramedics that went down there, the sort of high-angle rescue team, and they were pelt down into the darkness, and we're all waiting and waiting and waiting. And finally, they emerged.

And, you know, of course, the news is as bad as we anticipated it to be. But there was something in those guys and the way that they carried themselves and whatever it was that they saw once they disappeared into darkness of that whole, I just thought, whatever version of the truth that I'm looking for, I think those guys are carrying it somewhere within them. And so I just signed up for an EMT class completely on a lock and no idea if I even could finish it. And next thing, I'm sitting on an ambulance and I'm my way to some ridiculous call. It all happens somewhat accidentally. Yeah. I mean, it sounds pretty similar to the story that John Moon says. Of C's, someone being inspired of that as being in a vocation and that speaking to you in some way.

Did that story have particular resonance with you because of your own experience? Yeah, it did. I mean, if you get to the heart of John's story, you know, really he's a young guy who's looking for a way to prove himself in a world, you know, a particular two world that has ignored him. You know, and obviously my experience in life is vastly different from John's. But to me, I saw this group of people who were doing something that I thought that I could do. It didn't feel like an unattainable goal, but it felt like this incredible opportunity

to do this sort of thing that I never anticipated, to have the opportunity to do. And, you know, so there was a lot in John's story that always felt, that always rang true to me. And what part of your career did you learn about this history about, you know, the first paramedics being black men from an underserved neighborhood in Pittsburgh, and this whole orchid story. No part. I think that's probably the the reason that you know John sits up at night, you know, filing his teeth and his his his Pittsburgh home. Nobody knows this when when I went to paramedic school, my instructor was one of the first six medics in the state of Georgia. And he was telling us these stories of the early days when he was riding a horse, you know, coming out of the funeral homes and they would embom bodies one night and then transport the next. And, you know, he did get a call and he sweep the flower petals out of the back of the horse and you rush off.

So when you say sweeping out petals in the horse, he was one of those people sent by the funeral home to be an EMS person. Is that what you mean? Yeah, and much of Atlanta, the only people who are capable of transporting a body with a funeral home, right? They have how many people have something like a horse. And so he was a funeral home employee. And one night a week he would embomb bodies.

And then the next night he would be responsible for responding to emergency calls. And this was, you know, before there was any notion of a paramedic. So these guys had, you know, maybe 10 hours of first-aid training. And they're sitting down, you know, in the basement of the funeral home. Call comes in, they rush out, you know, again, they yank out, the casket sweep out the flower petals, slide in some sort of a stretcher, and then race the streets in a hearse which you know with these old Cadillac hearse and he said that if you got going too fast the brakes would soften up and you couldn't stop. So they're

screaming this hearse with a purple light on its roof screaming through the city of Atlanta with no brakes. Flower pedals trailing out of the back window. Oh my goodness. That sounds like a totally different world. It's amazing that that's within our lifetimes. That's just amazing. It's not that long ago at all. Yeah. Yeah. And so hearing these stories of the early days when they carried a credit card machine with them and before they dropped a patient off the hospital, they'd slide it in front of them and say, Kess, check or charge. This really sort of wild west era in which nobody really knew what they were doing. But that was all I knew about it.

It started out in a very, you know, slip shot sort of way and then slowly became serious. It wasn't until after my book came out that somebody said to me, you know, hey, there's another story, another EMS story, if you're ever looking for one, and it was said in Pittsburgh. And so I started googling it, and the only thing I could find were a handful of, you know, local press accounts, you know, of these, these, you know, young men and women who had done this thing in the late 60s and early 70s, and I started digging into it, and all of a sudden just the reality of what it was that had happened that nobody knew, you know. I know a paramedic from Pittsburgh who has no idea that this was the start of it all. And for no one to know that, it was shocking to me, particularly someone who

did it for a year and wrote about it. And that's when I got in touch with John and I said, how does nobody know this? And he just screamed, I know! Nobody knows! Oh, I'm so glad that we get to tell a story because it's amazing to me. And it's pretty resonant today. And particularly the role of police in both the story that you told and what's happening right now, there's this history there that we presented.

That is, you know, the police were the kind of default person to be called in this type of emergency, even though they had, you know, no skills or inclination to do the job that was required. And we're looking at what policing means today. And what does it mean that a person potentially armed like a soldier is brought to a situation where someone had a stroke, for example, and maybe that isn't the right thing to do. And we had this discussion, or we, people had this discussion in the late 60s and 70s, too.

So when you think about the story you told in your experience, and you think about what the discussions are happening today, how do you take in the moment and reconcile it with this history that we told in this story? Yeah, you know, what's crazy about that is when I began researching this story, I was coming across quotes that really got to the heart of a conversation we're just now having today. And these are things that I was reading in the fall and spring of 2018 and 2019. The early medics who were out there saying,

hey, if you want this police truck to show up at your house, you have to understand that last night, that was a truck that showed up to arrest your neighbor. Tomorrow night might be the truck to show up to arrest you. If you really think people are going to be comfortable calling that guy to arrive tonight, then you don't think you understand the situation we're living in. And there was a lot of pushback from, you know, the city of Pittsburgh, Allegating County about changing this system because it was the system that had always been and people thought it was works. And somebody was able to come along and prove that no, this isn't working and these guys aren't suited for this task. No, but I think what is valuable about these lessons of history, it's so recent that paramedics

were invented. It's so surprisingly recent that it should free your mind to think of the possibilities of what infrastructure of public safety could be today if we didn't all want its arrest on the police and wanted to try something different. I would agree. I understand the resistance to it. I understand the fear that people feel when you say something like defund the police, it sounds like a really radical term.

But if you can sit down and realize how often the police are called out because there's a psych patient who hasn't taken his medicine and his 76-year-old parents aren't certain what to do with him. And this police officer shows up, not saying to a hammer, everything looks like a nail. Well, unfortunately, the police really kind of, they're limited in terms of what they can do.

And one of the things I learned very quickly in doing that job was that the police can't lose a fight. You know, by the nature of their profession, they are back as against the wall. And once they arrive, they have to keep pushing forward. And oftentimes, that led to a situation that didn't need to happen. What could have been a situation that we had de-escalated, wound up escalating because the person that arrived with someone who had essentially,

if they didn't get cooperation, they only had one avenue that they could venture down. It's amazing to me to think, you know, when John Moon saw the paramedics for the first time, he'd never heard the word paramedic, you know? And it was completely novel to most people. And I'm thinking today about how we're thinking about the police and maybe how to sort of, you know, defund them or divest them of some of these activities,

which they're not suited towards. I think it's kind of interesting to imagine that there could be a word, you know, that is like a rapid response, social worker, mental health worker that is going to be sent out to people that will be a word like paramedic in 50 years. I mean, you thought about that? It feels like I have it. It feels like we're on the cusp of that moment. There's no doubt that people are looking for a new way for police to respond. It's something different to come out.

The number of instances we've had in which these situations have gone wrong, how often it has been someone who's called out for a mental health issue or something that didn't initially appear to be a crime in progress. And you have to think that somebody out there and amidst all these, you know, defund the police conversation, someone must be saying, well, how else can we deploy these resources?

Who else can we bring to bear in these situations that can bring a better outcome? And there's probably a new job title, a new role, a whole new group of people that are sitting out there that not too long from now, we're all going to look back and say, well, of course, it's so obvious, naturally those guys are there, naturally those people are responding. How in earth did we live without them? And I think we're sort of at the moment where these things are born.

Well, I think it's really interesting, and I'm so glad we're able to share this story. So thanks so much for talking with us and for reporting. That's been great. Thank you. It's really great to be here. 99% Invisible was produced this week by Kevin Hazard, edited by Joe Rosenberg, mixed-in tech production by Sarah McCarthy, and Sri Vyusev, music by Sean Real. Kurt Coleset is the digital director of the rest of the team, a senior editor to Lany Hall, Katie Mangle, Emmett Fitzgerald, Vivian Leigh, Chris Baroube, Abby Madon, Sophia Klatsker, and me Roman Mars. Many thanks to the atavist for sharing Kevin's original story with us. If you want to learn

more about the history of Freedom House, you should check out that article. If you want to learn more about Kevin's career as a paramedic, you should go read his memoir, it's called A Thousand Naked Strangers, bovelling to both on a website. We are a project of 91.7 K.A.L.W. in San Francisco, and produced on Radio Row, which is distributed in multiple locations around North America, and in our hearts it will always be. In beautiful downtown Oakland, California. We are a proud member of Radio Topia from PRX, a fiercely independent collective of the most innovative listeners supported 100% artist-owned podcasts in the world. Find us and support us all at radiotopia.fm, just like these fine people did, Emilio Martinez, Ashley Travers, Bill Worthin, Alison Myers, Elizabeth Camero, and John and Jen, who just

got married. Congratulations, and thanks, everybody, for your support. You can tweet me at Roman Mars in the show at 99pi Oregon, or on Instagram and write it too. But our true home on the internet is 99pi.org. Radio tapio. From PRX.