EMS World Q&A: Kevin Hazzard, Author and Paramedic

When most folks think about the pioneers of EMS and paramedics, luminaries such as Eugene Nagel (Miami), Dr. Frank Pantridge (Ireland), and James O. Page often come to mind. NBC brought paramedics to America’s living rooms through the TV Show “Emergency” in the 1970s.

But what most people don’t know is that some of the earliest EMS paramedics didn’t look like John Gage and Roy DeSoto. The men and women of Freedom House Enterprises in Pittsburgh, Pennsylvania, predominantly African Americans, were among the first paramedic ambulance services in the United States in the late 1960s. The newly released book American Sirens: The Incredible Story of the Black Men Who Became America's First Paramedics (Hachette Books, 2022), by Kevin Hazzard, brings to light these EMS pioneers’ place in medical history.

Freedom House Enterprises was a government-funded non-profit organization that provided employment and social services to African American neighborhoods in Pittsburgh starting in 1966. EMS in Pittsburgh had previously been comprised of vans from the Pittsburgh police, where care consisted of officers who would put victims in the back, get up front, and drive fast to the hospital—truly “scoop and run." Responses to the racially divided neighborhoods of the time were sporadic and limited at best.

Peter Safar, the “father of CPR” and an attending anesthesiologist, trained a group of 40 men from Freedom House in CPR, advanced cardiac life support, defibrillation, intravenous administration, intubation, and trauma care. These first paramedics were provided with custom-built ambulances and provided emergency response to the “Hill” and other predominantly African American neighborhoods in Pittsburgh under the direction of Safar and Dr. Nancy Caroline, who later authored the first paramedic textbook.

After achieving a remarkable CPR save rate and being lauded for excellent care, even out of their primary response area, Freedom House Ambulance was shut down by the city of Pittsburgh in 1975 when the mayor created Pittsburgh Emergency Medical Services. Many of the Freedom House paramedics went to work for the city, including John Moon, whose story is a primary focus of the book.

American Sirens is a mix of biography, historical chronology, medical developments, and social commentary on both the city of Pittsburgh, EMS, civil rights, and political drama from 1967–1975 and beyond. If you came into EMS thinking that Squad 51 or the Miami paramedics started modern paramedic services, this is a great book to read to broaden your historical perspective as well as give the founders and medics of Freedom House their due place in medical history.

Below is an exclusive EMS World Q&A with Kevin Hazzard.

EMS World: Your last book, A Thousand Naked Strangers, was a fascinating account of your experiences as a paramedic in Atlanta. What interested you in this story?

Hazzard: A couple things. First, I was shocked that I’d worked ten years as a medic and had never heard this part of our history. Most of us learned about Napoleon on night one, because he’d been the first to use triage and transport from the battlefield, but not this crucial part of our story. I wanted to fix that. Second, I’m fascinated by 20th century American history, so this just hit me where it mattered. And finally, it’s just a damn good story. I was hooked from the very start—and it just kept getting better.

As a writer, was it hard to switch from writing a memoir to telling someone else's story?

No. I actually found it easier. I didn’t love telling my story. I was self-conscious about all the I/me/my on the page. When you tell your own story, at least in my experience, there’s this constant need to justify why you’re telling it. Because I wasn’t at the heart of American Sirens, I could look at it objectively and say yes, this is a good story and trust that I would be justified in writing it.

This story takes place in the 1970s. How did you manage the research and what resources did you use?

I used a ton of newspaper accounts from the era. I also spent a lot of time in various archives in Pittsburgh and also at Harvard. I read books about the cities and people depicted and did a fair amount of online research as well. All that and I was lucky enough to be able to interview many of the people involved.

What is the lasting legacy of people like John Moon and Freedom House? How about Peter Safar and Nancy Caroline?

The legacy of Freedom House is its people. We could point to the design of the ambulance, the training manual, the introduction of Narcan, a thousand things. But what made Freedom House special was that the people who upended their lives to train for a job that didn’t exist did so because they’d been marginalized by society and they saw paramedicine as a way to make their mark on the world. They invented the job one shift at a time, while working under incredibly difficult conditions and immense pressure. And they did it with tremendous grace. And when it was over, they continued to live their lives with grace. That’s the legacy. As for Safar and Caroline, they were absolute hurricanes. Safar was a certifiable genius. The man invented CPR, the paramedic, designed the modern ambulance, helped create the modern ICU, was a pioneer in the budding field of anesthesiology, and led the world’s research efforts—until the day he died—in resuscitative medicine. He was nominated three times for the Nobel Prize in Medicine. Truly remarkable. Nancy was, too, but in her own unique way. After writing the medic textbook, she started Israel’s EMS service and, later, its hospice program. She served for a number of years as a flying doctor with AMREF in east Africa where she started a food program. She had no agricultural experience, but just like she had no EMS experience when she took over one of the best services in the U.S., she just grabbed the challenge and wrestled it to the ground. Sometimes there’s a personality that comes along and changes the world. She was one of them. Period.

How did your previous experience as a paramedic help you write this story?

When someone talked about running a call or I read an account of Freedom House running a call, I knew what it felt like. I knew the nerves and challenges, the neighborhoods, the fun, the terror. All of it. It made it remarkably easy to breathe life into the story. Plus, it gave me a certain amount of credit with people I was trying to interview. They knew that I knew and also that we shared the bond.

Do you miss your days as a paramedic with Grady? If so, what do you miss?

I miss those nights, you know the nights, where you’re partnered with your best friend and running around a city gone wild. I miss that feeling. I miss helping people, even in the tiniest ways. As you know all too well, not every call is blood and guts and those quiet calls are often the most rewarding. I miss the bond you have with the community.

What advice would you give to someone starting out in EMS today?

Know what the hell you’re doing. Study the material, learn from people who do it the right way, give good care. But also be a good human. The hard part of the job isn’t treating gunshot wounds. The hard part is treating everyone, even the difficult ones—especially the difficult ones—with dignity. That’s the job. It’s often not easy but when done well, and for the right reasons, it’s the most rewarding thing you can do.

Are you working on another book?

I am. Still getting my arms around the story but it’s set in the 50s and 60s involves both medicine and crime. It’s early days, but I’m excited about it.