EMS World Hall of Fame: Freedom House

The short history of EMS has been driven by the wisdom, foresight, and innovation of countless individuals. As the field ages into its second half-century and its origins fade to the past, it’s worth commemorating the greatest pioneers of prehospital emergency medical services. This series honors these trailblazers. 

As in so many U.S. communities, the residents of inner-city neighborhoods in late-1960s Pittsburgh lacked a lot of basics. Two of the most important were quality emergency care and job and career opportunities. The legendary Freedom House Ambulance program provided a solution to both and brought America’s first paramedics to the field. 

Founded in 1967 to serve the city’s predominantly Black Hill District, Freedom House trained its mostly Black workforce to unprecedented levels beyond the first aid then delivered in the field. It began with former ambulance driver Phillip Hallen, the president of a local charity, the Maurice Falk Medical Fund, and a desire to create jobs and improve some of the shortfalls in EMS care then delivered to such neighborhoods by police, fire departments, and funeral homes. Hallen proposed that Freedom House Enterprises, a local nonprofit that assisted Black citizens, expand its job training to ambulance work. Freedom House Enterprises boss Jim McCoy agreed. 

Hallen then pitched the idea to Edward Norian, an administrator at Presbyterian University Hospital, who connected him with resuscitation legend Peter Safar. The “father of CPR,” Safar was then working on ambulance design. Safar envisioned a new level of care to be provided by the new ambulance service and agreed, in conjunction with Jerry Esposito and his Citizens’ Ambulance, to train its new recruits. 

With funding from Hallen’s group, President Lyndon Johnson’s War on Poverty, and Pittsburgh Mayor Joseph Barr, the program was created. Students came from some tough backgrounds and the streets they’d be serving but received elite education through giants like Safar and Nancy Caroline. The first cohort consisted of 25 men recruited from the Hill District, some recruited off the street by Esposito. Half hadn’t graduated high school; some had criminal records. Safar put them through a 32-week, 300-hour course that included anatomy, physiology, CPR, advanced first aid, nursing, and defensive driving. Also involving Drs. Ron Stewart, Paul Paris, and later Caroline, the curriculum would help define paramedicine across the country and world. 

Based at Presbyterian and Mercy Hospitals, Freedom House Ambulance Service began operating in 1968. It won a city contract to serve the downtown and some largely Black neighborhoods. Crews quickly became known for their quality care and arrived much quicker than police. Freedom House Ambulance responded to almost 5,800 calls in its first year. 

Caroline became medical director in 1975 and trained providers in intubation, cardiac care, and IV drug administration. This became the core of the first paramedic curriculum and was adopted by the federal government that same year. 

The medics of Freedom House continued to face racism even with such accomplishments, sometimes having their care refused by White patients or being mistaken for orderlies at hospitals. Peter Flaherty, who became mayor in 1970, opposed the program and denied it access to more affluent and profitable neighborhoods, instead slashing the city’s contribution to its budget. He eventually ended the Freedom House contract in 1975, and the organization folded that year. 

Caroline became medical director for the city’s new service that replaced it under the condition the Freedom House paramedics and dispatchers also be hired and their crews kept together. The medics were hired, but the city reneged on keeping crews together and instead fired those with criminal records, dismissed others for failing exams on new materials they hadn’t been taught, and shifted others to nonmedical positions. Ultimately only five of 26 Freedom House employees who joined the city ambulance service stayed. 

John Erich is the senior editor of EMS World. Reach him at john.erich@emsworld.com.