Criminal - The Paramedics

Episode Date: June 9, 2023

As recently as 1965, if you had a medical emergency, the people who showed up at your door would be volunteer firefighters, police officers, or undertakers with a hearse. Today, the story of how a group of Black men from Pittsburgh changed that.  Kevin Hazzard’s book is American Sirens: The Incredible Story of the Black Men Who Became America's First Paramedics. Say hello on Twitter, Facebook and Instagram. Sign up for our occasional newsletter, The Accomplice. Follow the show and review us on Apple Podcasts: iTunes.com/CriminalShow. Listen back through our archives at youtube.com/criminalpodcast.  We also make This is Love and Phoebe Reads a Mystery. Artwork by Julienne Alexander. Episode transcripts are posted on our website. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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That's BotoxCosmetic.com. That's BotoxCosmetic.com. Believe it or not, when I finished high school, I wanted to be a police officer. I had no idea on how to pursue that goal because at that time, individuals that looked like me were not really noticeable on the police force at that time. John Moon grew up in Pittsburgh in the 1960s, in a predominantly black neighborhood called the Hill District. At one time, it was the home of the nation's largest black newspaper, had jazz clubs where

Ella Fitzgerald and Louis Armstrong performed and had its own baseball team. But by the time John graduated from high school, things had changed. The businesses dissolved, and the community itself, from my opinion, became one of neglect and underserved. And there was a lack of jobs, a lot of unemployment. John says that sometimes people who lived in the Hill District were called unemployables. John found a job working at a hospital.

I was an orderly at the hospital, and orderlies at that time were kind of one step up from housekeeping, if you get my drift. And so it was more or less a job that was at the bottom of the rung. John says that at the time, almost all of the orderlies in the hospital were black, and almost all of the nurses and doctors were white. One night in 1971, after John had been working at the hospital for a couple of years, he saw something he hadn't seen before. These two black gentlemen came in with white uniforms and afros and beards because that was the style back in that time. The men went into a patient's room and began to lift the patient onto a stretcher.

And it was something about these two guys that just kept me in awe. I didn't know what it was at that time. I just kept looking at him. John remembers that the nurse in the room, who had only ever acknowledged him when she needed him to change a bedpan or move a patient, nodded to the men in the white uniforms when they left. It was something that really caught me by surprise that they commanded the presence of that environment in the room.

And to the point that I said, wow, what do I have to do to be like them? And I, at that time, didn't know who they were, where they had come from, until I happened to see a patch on their left breast, and it said Freedom House Ambulance Service. I'm Phoebe Judge. This is Criminal. The Freedom House Ambulance Service was formed in 1967.

It was made up of a group of black men from the Hill District who would respond to emergencies. They could deliver babies, treat a seizure or a gunshot, and get you to a hospital. It's widely acknowledged as the first paramedic program in the country. Paramedics are an ambulance care period. It's one of those innovations. It's like the country. Paramedics are an ambulance care period. It's one of those innovations. It's like the Internet.

You know, the moment it arrived, nobody could remember a world in which it didn't exist. But as recently as 1965, if you had an emergency, the people who showed up at your door were going to be two volunteer firefighters, two police officers, or maybe two undertakers in a hearse, which is, you know, maybe the scariest of all moments.

You know, if you're thinking you might die and you look up and you see this hearse pull up in front of your house, that's what it was. Author and former paramedic, Kevin Hazard. And regardless of who these people were that showed up, nobody, none of them had much training. They were less trained than the lifeguard at your public pool. They also had very little equipment, if any. They tried to transport the patient to the hospital as quickly as possible. It was sometimes called scoop and run. So basically, if you could survive in the time it took you to get to the hospital,

you might have a chance. Yeah, but you think of emergencies like a stroke or a heart attack where every second matters. In the 60s, a hospital could be a long way from your house. Imagine 30 minutes where your brain is not getting oxygen. There are well-documented cases of people who, in the middle of a city, dropped from a stroke, were immediately whisked off to the hospital, but because care was so poor, by the time they got there, they were brain dead. And that was care across the United States. And it had been that way for quite some time. And, you know, people were dying because of it.

Kevin Hazard says there had been some attempts at an ambulance service. During the Civil War, a wagon force was created, sometimes with a doctor on board, to get injured soldiers off the battlefield. But one doctor later complained to Congress that the drivers were drunk. After the war, Bellevue Hospital in New York began to send doctors out in horse-drawn wagons. This was before telephones, so the hospital heard about emergencies through a complicated system. When a police officer on the street heard about a medical emergency, he would send a telegraph to the 18th Police Precinct, which was the closest one to Bellevue Hospital. Then someone from the precinct would run to the hospitalth Police Precinct, which was the closest one to Bellevue Hospital. Then someone from the precinct

would run to the hospital with the message, and a wagon was sent out to pick up the patient. The wagon had a stretcher, some splints and bandages, and a flask of brandy. And they had a gong mounted at the front to let people know to get out of the way. These were physicians. They were able to deliver care. That continues to improve through World War I. And then World War II hits, which is such a vortex that all hospitals,

they didn't have a single Band-Aid to spare. So they jettison their ambulance services because they just can't support them anymore. And they wind up with volunteer fire services. They wind up with police departments. They wind up with civil defense forces. And the standard of care just goes down and down and down and down. And so, you know, by the mid-50s and into the 60s, the standard of care is pretty much non-existent. In 1966, the National Academy of Sciences released a report saying that an American was more likely to survive a gunshot in Vietnam than at home because soldiers in Vietnam had emergency medical care.

And then, a couple of months after it was published, something happened in Pittsburgh that brought emergency medical care to the city's attention. There's a gubernatorial election that is coming down to the wire. The final weekend before this election is going to happen, the state's Democratic Party gets together and they throw this huge rally in Pittsburgh. And all the powerful people are there, And among them is this guy named David Lawrence, who at that time in the state of Pennsylvania, he was as powerful a man as existed. He was a former mayor of Pittsburgh. He was a former governor of the state. He was sort

of the old lion of Pennsylvania democratic politics. And so he was the main speaker. So all these people are together. Thousands of people are in this huge auditorium and everyone's giving these rousing speeches and the crowd is on their feet and they're screaming. And then in walks David Lawrence. This is the moment, you know, his entire political life has led to this moment right here where he's going to, you know, carry this crowd into Tuesday and then, you know, carry their guy into office. And Lawrence steps up in front of the lectern, and he gets about three words into his speech, and he tilts back, and then boom,

falls face first on the floor. And you can hear a pin drop in this auditorium. And everybody immediately jumps up, and they rush forward. And two things happen. One is that there happens to be a nurse there named Karen McGuire. She drops to her knees and begins CPR. The second thing is that someone in the audience calls for help. And that call for help in the city of Pittsburgh alerted two aging police officers in a paddy wagon. And they start on their way. So there's Karen McGuire, a nurse, a professional. She's doing CPR.

The police-borne ambulance service arrives. They come running in with this canvas stretcher. They have an oxygen tank with them that's either broken or empty, but either way, it's able to deliver no oxygen. They drop down next to Lawrence, and they essentially just nudge Karen McGuire out of the way. They pick up Lawrence. He's a large man. He's not of the way. They pick up Lawrence. He's a large man.

He's not easy to carry. They pick him up. They put him on their stretcher, and they begin running out. And Karen McGuire's trying to say, hey, hold on. This critical care is needed in this moment. But they run out the door. She follows them, and she sees that they've got the back doors of their wagon open, and they're loading their stretcher, and they're closing it,

and they're going to leave him alone. And so she forces her way into the back of this ambulance. The doors close, and they take off. Now, she's got six minutes until they arrive at the hospital. Imagine you're in the back of a U-Haul truck, and you're trying to do anything. You wouldn't be able to know when it's going to turn, when it's going to speed up, when it's going to slow.

So you wouldn't be able to anticipate these things. You'd just get tossed around. Well, that's what's happening to her in the back. She's able to deliver no care. So they arrive at the hospital. The door's open. You know, doctors have been prepared. Hey, the most powerful man in the state is on the way.

They are ready. The door's open. They grab him. They bring him into the ER, they get a pulse on him, they get a blood pressure back, but they're unable to save him because he's brain dead. So even though when he hit the ground, he had a trained professional there and CPR started almost immediately. That six minutes from when he was picked up and put in the ambulance until he arrived at the hospital was fatal. The doctor who treated him was a man named Peter Saffer,

who was very interested in what could be done to help someone in the minutes before they arrive at a hospital. Peter Saffer had grown up in Austria. He was a teenager during World War II and had avoided fighting for the German army by covering himself with a chemical that made it look like he had a skin condition. After the war was over, he immigrated to the United States to study medicine and became an anesthesiologist, which was still a developing field at the time. And it's while he's working as an anesthesiologist that he witnesses what then passed for rescue breathing, which was you have someone who's not breathing, you flip them face down, you press on their shoulders, and you flap their arms. And the idea is that if you move them

around enough that the lungs surely will open and close and oxygen will sort of make its way in there almost by accident. Saffra doesn't believe this is true. But at the same time, he has encountered a study that says expired air holds enough oxygen to keep people alive. So he marries these two ideas. One, this bad idea, and two, this new study that says that breathing into someone's mouth could save them. And so he conducts a series of studies, 49 of them,

over the course of about a year in which he sedates and paralyzes volunteers and records what happens when he does the old method on them, which of course, rather than bring oxygen in, it forces it out. And then he brings in untrained, ordinary people, housewives, accountants, secretaries, and he gives themwives, accountants, secretaries. And he gives them this sort of 15, 20-second crash course on how to do rescue breathing and then backs up. And he records them, keeping these people alive through his experimental means. That seems incredibly – I mean, I don't think I'd sign up for that study. No, it's literally the world's worst sales pitch.

You know, this is a 35-year-old man who's never conducted a study and whose specialty is so brand new that most cities around the country don't do it. You know, anesthesiology does not exist in many hospitals at that point. So there's nothing to make you, on the surface, follow this guy and allow him to sedate you and paralyze you so that you're unconscious and not breathing and keep you alive with untrained, ordinary people off the street other than your belief that this man is smarter than everybody else around you. that he had to take these dramatic risks to prove that it worked, or he couldn't start to change the general opinion about what it takes to breathe for someone else. Yes, and the main reason for that is medicine at that point really believes that the ordinary person cannot practice it, that medicine is such a complicated art that only those who have, you know, the sort of benighted few are able to make it happen.

He partnered with Walter Reed Hospital, and they were going to make a video because, you know, he wanted to bring this everywhere. In his mind, the whole world needed to know this skill, not just the few people that he could reach personally. And so he needed the most dramatic moment possible to really put a fine point on what was happening. And so what he does, and it's really a remarkable thing to watch, what he does is he gets his volunteer, and he sedates and paralyzes them. And so there's this volunteer lying on the floor of this operating room.

And he brings in a trained professional. He brings in a Baltimore fire chief. And he says, okay, go ahead and do the old method. So they lay this person face down. They do the pressing on the back and the flopping of the arms. And everything is being measured and recorded. And so you see this person's oxygen level drifting down from the upper 90s to the low 90s, from the upper 80s to the mid-80s, down to the low 80s,

which is a point at which any emergency physician in any city anywhere in America would immediately spring to action. So this is someone who's really on the verge of spiraling. So he's brought them to a critical level, and then he says, Okay, stop. And they roll the person back over. And he then brings in this 11-year-old boy who walks up, who's significantly smaller than the man on the floor.

And he says, okay, here's how you do it. And so the child gets down, and he pinches the guy's nose, and he lifts the chin, and he breathes, and nothing happens. He can't get the oxygen in. So Saffir says, okay, reposition. So the child repositions the head and deep breath, breathes in and you see the chest rise. And then the kid keeps going.

And then those oxygen levels go from the low 80s to the mid to the upper. All of a sudden they're back up in the upper 90s. It's an incredibly dramatic moment because you've just watched this small child bring back a full-grown man who was teetering on the verge of death. Today, Peter Saffer is known as the father of CPR. One night in June 1966,

Peter and his wife were away from home when they heard that their 11-year-old daughter was having a severe asthma attack and was on her way to the hospital. And he and his wife rushed to the hospital, and by the time they get there, she's in full cardiac arrest. She's not breathing. Her heart is not beating. And I cannot imagine this but staffer actually personally takes over care so he's now working on his own child and he's able to get a respiratory rate he's able to get a heart rate but again she's brain dead and

the reason for that is because from the moment that she stopped breathing until she arrived at hospital and began to get real care, she was getting nothing at all and, you know, the brain couldn't support it. And so, you know, he looks at this, you know, as he's removing his own child from life support, he, you know, he's got a very, very close, very personal look at the consequences of our lack of pre-hospital medicine. He wanted to find a way to bring the emergency room out into the world. In his mind, there was no reason that you couldn't train somebody to take all that equipment and all those medications and deliver them right there where they were needed. Why wait? If somebody's dying, why wait?

And so, five months later, in November 1966, when the politician David Lawrence arrived at Peter Saffer's hospital in Pittsburgh and couldn't be saved because of the six minutes that he didn't receive care on the way to the hospital, Saffer made his case. It's Peter Saffer who's explaining to the people of Pittsburgh that, hey, this man that you've known your entire lives, he's going to die, and the reason he's going to die

is that six minutes. So Saffer's in the middle of that, in the city, staring at the death of David Lawrence, finally says to him, okay, you have this idea. Go ahead. Go ahead and do it. We'll be right back. Support for Criminal comes from Apple Podcasts.

Each month, Apple Podcasts highlights one series worth your attention, and they call these series essentials. This month, they recommend Wondery's Ghost Story, a seven-part series that follows journalist Tristan Redman as he tries to get to the bottom of a ghostly presence in his childhood home. His investigation takes him on a journey involving homicide detectives, ghost hunters, and even psychic mediums, and leads him to a dark secret about his own family. Check out Ghost Story, a series essential pick, completely ad-free on Apple Podcasts. What software do you use at work? The answer to that question is probably more complicated than you want it to be. The

average U.S. company deploys more than 100 apps, and ideas about the work we do can be radically changed by the tools we use to do it. So what is enterprise software anyway? What is productivity software? How will AI affect both? And how are these tools changing the way we use our computers to make stuff, communicate, and plan for the future? In this three-part special series, Decoder is surveying the IT landscape presented by AWS. Check it out wherever you get your podcasts. At the same time that Peter Saffer was trying to find a way to train ordinary people in

emergency medicine, an organization in Pittsburgh run by a man named James McCoy was trying to help people find work. That organization was called Freedom House. The idea is they're going to create job training opportunities for people living in the Hill District. But this is a predominantly African-American neighborhood, and you just can't get anything of value. One day, a man named Phil Hallin walked in.

He ran a medical nonprofit and focused on improving medical services for people in black communities. And he recognizes that the Hill is a place where people have scant, if any, access to health care. It was really a blighted area at that time. John Moon. If you had just a doctor's appointment, because a cab wouldn't come to that area,

you had trouble getting back and forth to your doctor's appointments. There were invalids, basically, that needed assistance getting out of their residence to get to their doctor's appointments, and none of that stuff was available at the time. Phil Hallin saw that Freedom House had a vegetable delivery truck, and he got an idea. And he says, well, you can deliver vegetables, you can probably deliver people. Why don't we just create this little ambulance service where you can take people to and from appointments? They started asking around about how to coordinate it. And they were told almost immediately that the person they needed to talk to was an anesthesiologist

named Peter Saffer. And Saffer lays out this idea he has for what is the modern paramedic training program. And it's going to be nine months long, incredibly intense. And then these trainees are going to go to the OR, they're going to go to the ER, they're going to go to OB, they're going to go to the ICU, they're going to go nine months long, incredibly intense. And then these trainees are going to go to the OR, they're going to go to the ER, they're going to go to OB, they're going to go to the ICU, they're going to go to the morgue to watch autopsies. There's no way to overstate how big a revolution this is. And they're excited, they're impressed, they're blown away by what's being said, but they're also under the impression that there's no way this revolution includes them,

that they've got people who are under or unemployed, people who did not finish high school. They don't think that there's any way that Saffer will allow, you know, his first class to be all people from the hill. And they tell him this, and of course Saffer says, no, no, you don't understand. I need ordinary people. I need to prove that this idea is replicable across cities all across the country. And so they say, all right, great.

We have tons of that. But everybody who you recruit for this program, they have to come from the Hill and they have to be black. And Saffer says, yes. And in that conversation, not only is the world's first paramedic training class born, but so is the idea that the world's first medics will be black men from the Hill District of Pittsburgh. Not only would the men going through all this training be from the Hill District, they would be working in the Hill District,

a place where the emergency medical services were, by all accounts, very bad. Kevin Hazard told us a story about a teenager named Mitch Brown, whose mother collapsed in their house. He called for help, and two white police officers arrived. And, you know, Mitch is frantic, and he says, Hey, you know, something's wrong with my mother. I don't know what's going on. You've got to help her. And they look at him, and they say, No, no, she's just drunk. We're not carrying her.

We'll take her to the hospital, but we're not going to carry her. He says, no, she doesn't drink. You know, there's something really wrong. And they said, no, trust me, we know she's drunk. And so they walk out the door and Mitch has to pick up his own mother. And ultimately, we'll find out that she's having a stroke. He has to pick up his own mother, carry her out, lay her down in this ambulance. The cops are already sitting up front and shut the doors. And that's the last time he sees his mother alive. That's pretty emblematic of what medical care existed or consisted of if you lived in the hill. This was a neighborhood that couldn't get a taxi.

And it was certainly not going to get any sort of medical care that you would call as such. Years later, Mitch Brown went on to become a Freedom House paramedic. After months of training, the first class of Freedom House trainees went through the hospital to see real patients. So they get to the ER and the idea is, hey, you guys have learned all these things, heart attacks and strokes and seizures and hemorrhages and broken limbs and broken necks. Now you're going to go and see how it's done. And they get there. And the first thing that happens is nurses hand them mops because the

presumption is black men in the hospital, they must be orderlies. And then they go to the OB wing to deliver babies and the nurses bar the doors. They're not going to allow them in. So they have to learn how to deliver babies by reel-to-reel tape. But nonetheless, they do all these things and they go through all this training and they emerge on the other side with this full-spectrum education of emergency care, which has never been done outside of a physician. Near the end of the training, they heard the news that Martin Luther King Jr. had been assassinated. There were riots all over the country, and the Freedom House trainees went to work. And so their first calls are in the Hill District during the, what's called the Holy Week Uprising in Pittsburgh. And they just keep the lights on in the cab of their trucks so that people can see, oh hey, you're from here, you're one of us.

And they let them in, and that's where they begin their work. The patients begin to see, wait a minute, these are people that we've known our whole lives who are doing this incredible thing and they take very personally the care that they're delivering to a neighborhood that has never had any kind of care and to a neighborhood of which they are members. During their first year of operation, Freedom House responded to almost 6,000 calls and was credited with saving at least 200 lives in the Hill District and the next neighborhood over, Oakland. The next year, Freedom House expanded and started answering calls in downtown Pittsburgh. And so, you know, this was not proving something to themselves,

but proving something to the outside world, that, hey, you wrote us off, and look what we're doing now. In 1971, John Moon saw the two Freedom House paramedics in the hospital, where he was working as an orderly. After they left, he started researching Freedom House and found out their offices were right across the street. In my mind, I'm thinking, wow, I'm an orderly in a hospital. I've been doing this for four or five years.

How hard could their job be? So I'm ready. So I go up there and apply and walked into the office and the gentleman looked at me and I said, I'm here to apply for a job. And he said, okay, well if I showed you a picture of the heart, would you be able to diagram the chambers or diagram the circulatory system of that picture if I showed you? No. Okay. If I showed you a picture of the lungs, would you be able to label the respiratory components? No. Okay. Well, you're not qualified to work here. And my heart just sank at that time.

And in the back of my mind, my mind kept telling me, well, John, you wanted that job. You wanted to do that, so it's up to you to find out how to get that job. John says he went home and looked through the Yellow Pages to find some sort of medical training class he could take to qualify. And I was the only person who look like me in the class. And I got my certificate in the mail, and I went back to Freedom House and was hired there on the spot. They sent me from Freedom House's office directly to the uniform store to get my uniforms.

So in the scheme of the big things, I had arrived. And so it became, if you will, it became my calling. And it was a calling that I didn't know was there until I had got hired by Freedom House. We'll be right back. Thank you. And to help us out, we are joined by Kylie Robeson, the senior AI reporter for The Verge, to give you a primer on how to integrate AI into your life. So tune into AI Basics, How and When to Use AI, a special series from Pivot sponsored by AWS, wherever you get your podcasts. Are you looking to eat healthier but you still find yourself occasionally rebounding with junk food and empty calories? You don't need to wait for the new year to start fresh. New year, new me? How about same year, new me? You just need a different approach. According to Noom, losing weight has less to do with discipline and more to do with psychology. Noom is the weight loss management program that

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Sign up for your trial today at Noom.com. Tell me about your first shift. Were you nervous? Absolutely. Absolutely. We got a call for an unconscious gentleman. And we get in the vehicle and we race down the streets with lights and sirens wailing. And, you know, my heart heart is beating 100 times a minute.

And my partner looked over, and he says, do you know CPR, or have you ever done it? So when he said that, the adrenaline kicked in. So I started, I want to be ready when I arrive on the scene of this call, and I'm going to have all my equipment ready. So I started opening just about every piece of equipment that I thought I was going to use en route to the call. I opened up bag valve mask and oxygen tubing and IV equipment and airway stuff.

And I had all this stuff open, and we arrived on the scene, and the guy was standing there on the sidewalk. And I said, oh, my goodness. Now, I've opened this equipment. I'm ready to perform CPR on this guy, and he's standing there. And apparently he may have passed out by the time we got there, he was conscious and alert and standing on the street. So that call, in anyone's mind, you should be thankful for. And I was. But the problem with that is I had contaminated all of the sterile equipment that we were going to use on that vehicle. Needless to say, the supervisor at that time was not very happy with me.

He kind of really tore into me and said some choice words that I can't mention on this telecast. But I learned from that. I learned that I had to trust my instincts. I learned to be more confident in whatever abilities that I had that there was no particular situation that I couldn't handle. But I had to be able to survey that once I arrived on the scene. So once that confidence started building up and I felt more prepared to deal with any emergency,

everything else kind of fell in place from that point on. But people were not accustomed to the emergency room being brought to them. They had never experienced that before. So they were somewhat kind of resistant to it until we were able to convince them that the training that we had was the same that would happen to them in a hospital emergency room. It's just that we brought it to them a lot sooner. So you take that along with some unfortunate situations where racism had to rear its ugly head, and we would have white patients that didn't want you to touch them and things of that nature.

Did you ever have a situation like that yourself? Unfortunately, yes. We had a young lady that we responded to that was suffering a heart attack. And once I arrived on the scene and I started to explain to her what I was about to do, and she politely said, I don't want you really doing anything to me. I just want you to take me to the hospital. She was just adamant that she didn't want me to lay a hand on her, not to even take a blood pressure. It was pretty obviously as to the reason why without her actually saying it.

So I had to explain to her, if you don't allow me to utilize the training that I have, the chances of you arriving at the hospital like you are now diminishes with each minute that we stand here and talk to each other. I essentially am bringing the emergency room to you, and the same thing that would happen to you in the emergency room, I'm doing right here in your living room. Because you only had one job, and that was to try to keep her alive. Absolutely. Absolutely. And I had to explain that to her in a professional manner.

And once I started doing that, the environment started to, the tension in the environment started to subside drastically. John Moon says that not only was there tension with patients who might have expected police officers to show up and take them to the hospital, there was also tension between Freedom House and the police themselves. Freedom House somewhat was looked at as a threat to their jobs, number one. And you have to keep in mind that you're in a predominantly black neighborhood and you're having black men provide a service that once police used to do or were still doing, but we were doing it significantly better. And as a result of that, the police dispatchers themselves, which had control of every call

that came in, determined when or if they wanted to utilize Freedom House's EMS system. John Moon says that it wasn't unusual for the police to take calls that should have been handled by Freedom House, or for Freedom House and the police to arrive at a call at the same time. He remembers one time when he was dispatched to a car accident. The driver had crashed into a telephone pole. The police were actually pulling the patient out of the car. And in our way of trying to prevent things from becoming worse, we started saying, no, no, no, no, no, no, don't do that this way.

In that situation, the person was not what I would call immobilized, and to remove the patient from the vehicle without immobilizing them first, you run the risk of doing additional damage that the auto accident itself did not do. So that was the thought process once we arrived on the scene, is that they're doing more harm than good to the patient and I didn't take in consideration that I was talking to a white male with the gun and a nightstick and I was more concerned about the patient So I was politely told in some choice unprofessional words

To get the you know, you can put in any adjective you want, away, back, or I will do anything but shoot you. So we had to kind of relinquish the authority of that patient. But we stood there watching them to make sure nothing drastically happened to the individual. But there were times when the police, instead of becoming an asset, they were a liability, unfortunately. And we had to improvise a way to prevent that from happening. So we bought a scanner and we started monitoring police calls from our dispatch base at Presbyterian Hospital. And when the police were dispatched to a medical call, whether it was a heart attack or a shooting

or automobile accident or what have you, and they didn't call us, we would self-dispatch ourselves. And oftentimes we would arrive at the scene, treat the patient, and be transporting them to the emergency room and pass the police en route to the call. Do you remember a time ever where the police asked you how you got somewhere before them? Yeah. And the answer was always the same. We were in the area. What was the situation like when you would arrive at the hospital with a patient? Well, if you look at what we were doing at that particular time, we were providing a care to patients that were primarily reserved for the emergency room. a patient coming in via an ambulance that perhaps had an IV in them or perhaps had an EKG monitor on them or the paramedics saying, I gave this particular medication or the blood pressure was whatever.

The things that we were actually doing, the hospitals themselves were not accustomed to seeing. I recalled when I did the very first, what we call tracheal intubation in the field. It had never been done before. And we arrived at the hospital, and the first thing the physician wanted to know is, who intubated the person. And I said, I did. And he said, well, and who are you? I said, I'm John Moon, and I work at Freedom House Ambulance Service. I learned that procedure through Dr. Peter Saffer in an actual operating room setting,

which was amazing in itself because if I can kind of draw you this picture, I was told one day to report to the 10th floor of Presbyterian Hospital to meet with Dr. Peter Saffer. So I get there, and they tell me to put on operating room attire, the mask, the hat, the shoes, and all of this stuff. And I followed him into the operating room. And when we opened the door to go into the operating room. I walked in with him and there was complete silence. Everyone turned to look over to see who was this person. The anesthesiologist at the person's head,

he stopped doing what he was doing. The OR technician stopped doing what they were doing. The nurses stopped doing what they were doing, the nurses stopped doing what they were doing, total silence in the room. And the reason for that is that the only time that you would see someone that looks like me that comes into an operating room is with a mop and a bucket. But I didn't have that. So once I arrived there,

Dr. Saffer, in his professional manner, simply tells the anesthesiologist, he just simply said, get up. And he said, you sit down and intubate that patient. Now, they had already given the patient a medication that stopped them from breathing. In the operating room, there's also an amphitheater

where you have medical residents or medical students peering down, watching this surgical procedure that's scheduled to be gone. And at the head of this patient, you have John Moon sitting there who didn't have an MD behind his name, who didn't have an MPH or any other list of initials that you would normally be required to have to enter that area. So I sat there, and I knew all these people were there, but I didn't see them.

So I politely got the equipment and intubated the person on the very first time. And once they confirmed that the tube was in the right place, and we went from room to room doing the same thing. And little did I know shortly after that that I would be doing that same procedure out into the field. What were some of the other things that Freedom House was doing on calls that had only been done in a hospital before. Freedom House administered Narcan to drug overdoses back in 1972. It had never been done before. It was primarily reserved for either the emergency room or the operating room to bring people out for anesthesia.

But we took that drug and took it out into the field to reverse the effects of narcotic overdoses. Freedom House paramedics were also some of the first people to use devices that are now commonly used by paramedics. And their ambulance design, which was set up to be a mobile intensive care unit rather than just a ride to the hospital, also provided the template for ambulances today. Doctors and public health administrators from around the country started paying attention to what Freedom House was doing.

They'd visit Pittsburgh to spend a day riding on a Freedom House ambulance and study the training program and the equipment, and then bring what they learned back home. What is the reaction in Pittsburgh to how well Freedom House is doing? What does the city say about this? There are a lot of city council members who see what's happening and can't applaud loud enough. And they say, hey, you know, we need to be expanding this program. We have a groundbreaking service. Problem is the people who are in charge vehemently disagree.

And, you know, he's not alone, but the mayor ultimately, you know, he becomes a very loud voice of dissent. You know, he fights it at every turn. at every turn, and people who were there at the time, some of his allies, people within Freedom House, people without Freedom House, they begin to say, there's no way that the objections to the service have anything to do with anything other than who's doing it. It's not what's happening in these ambulances, but who's doing it in these ambulances. And of course, the who is Black men.

And the city is suddenly being represented on a national stage by 24 guys from a neighborhood that the city really wishes wasn't there. So they don't allow it to expand. Freedom House is in three neighborhoods, and they want to expand to other neighborhoods, particularly the wealthier areas, which of course are white. The city will not allow that to happen. the hill, the city's poorest neighborhood, are getting state-of-the-art, world-class medical care. And people in a place like Squirrel Hill, which is wealthy and white, are getting tossed in the back of an ambulance by two police officers and riding by themselves to the hospital with no care at all. John Moon remembers one time when a child in a wealthy neighborhood was hit by a bus

and very badly hurt. And the police arrived on the scene and were overwhelmed by the injuries that this child has sustained. So they called in to the dispatcher and said, could you send Freedom House? And the dispatcher politely told them, I can't send them because it's not their district. And keep in mind, we're monitoring the police radio at that time. And the police officer, once the dispatcher said, I can't send them, he responded, well, you need to send someone out here who knows what the hell they're doing.

We responded to the call. We were able to stabilize him and transport him to the hospital. In 1975, Freedom House was chosen as the model for the nation's first standardized paramedic training program. That same year, Freedom House was shut down. Pittsburgh created its own emergency medical system, and many of the men who worked at Freedom House were able to get jobs with the city, including John Moon.

I wasn't allowed to do anything. I was the third person on a two-person crew. I couldn't examine the patients. I wasn't allowed to talk on the radio. I wasn't allowed to do anything. I was the third person on a two-person crew. I couldn't examine the patients. I wasn't allowed to talk on the radio. I wasn't allowed to drive the vehicle, just to sit there as an observer. In addition to that, we were constantly put through different testing scenarios. And if you didn't pass those tests or you didn't pass those tests, you didn't achieve a certain score, you were terminated. So the goal was to frustrate the individuals to the point where they would say, okay, look, I don't need to deal with all this hassle.

I'm sorry. I'm out of here. And it was very successful. It worked very good. But John Moon says he decided to stay. I had to put myself out there that, hey, I got this job. I know what I'm doing, and I'm not about to allow anyone to prove to me that I can't do it. And I was able to maintain that type of character throughout my career with Pittsburgh EMS. John Moon would eventually become assistant chief of Pittsburgh EMS. He retired in 2009.

The medical director of Freedom House, a doctor named Nancy Caroline, wrote a textbook on emergency medicine that's still the national standard. We were able to accomplish or create a system that's emulated around the country today. And we did that despite enormous odds, despite setbacks, despite broken promises. And I want this country to really know that the legacy of Freedom House was created in the Hill District by a group of black individuals that nobody ever thought would amount to anything. Criminal is created by Lauren Spohr and me. Nadia Wilson is our senior producer.

Katie Bishop is our supervising producer. Our producers are Susanna Robertson, Jackie Sajico, Lily Clark, Lena Sillison, and Megan Kinane. Our technical director is Rob Byers. Engineering by Russ Henry. Julian Alexander makes original illustrations for each episode of Criminal. You can see them at thisiscriminal.com, where we'll also have a link to Kevin Hazard's book, American Sirens,

the incredible story of the black men who became America's first paramedics. If you like the show, tell a friend or leave us a review. It means a lot. We're on Facebook and Twitter at Criminal Show, and we're also on YouTube at youtube.com slash criminal podcast. Criminal is recorded in the studios of North Carolina Public Radio, WUNC. We're part of the Vox Media Podcast Network. Discover more great shows at podcast.voxmedia.com.

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