Guest Editorial: We Need a New Metaphor

It’s often a sore point among paramedics and EMTs that the public thinks of EMS professionals as mere “ambulance drivers.” To counter this outdated image, we need a new metaphor. We need to replace the old idea of “driver” with a different mental picture. This will take some work, but it can be done. And the place to start is with the ambulance. 

Let me back up a step. A metaphor is a figure of speech in which a known word or phrase is applied to something else, usually less well known. For example, a relatively recent metaphor that has come into popular use is feed. In social media a feed is the way information is organized. So when you receive breaking news headlines on your news feed, the word feed isn’t being used literally. 

Back when automobiles were new, the metaphor of the “horseless carriage” emerged. It drew on an object with which people were familiar and used it to describe something new. The metaphor of the horseless carriage was eventually adopted by all the major automakers. 

Today the role of the car in our lives is fundamentally changing. Self-driving cars will transform society and require a new metaphor. What is the most useful metaphor for a self-driving car? Some in the auto industry see the future of the automobile through the metaphor of a workspace, not a carriage. It will be a combination office and lounge where the goal isn’t just moving from one place to another as efficiently as possible but rather productivity. So the metaphor of a carriage won’t work with a self-driving car. 

Now think about the ambulance. The word ambulance comes from the Latin ambulare, which means to walk. To ambulate is to move from one place to another. Ambulances are sometimes referred to as rigs or trucks. Trucks are used to move things from one place to another. The people who work in them may therefore reasonably be thought of as drivers.

Maybe that worked 60 years ago, but it doesn’t reflect today’s reality. An ambulance in the year 2022 is no more a truck than a car is a carriage. Today’s ambulance is an emergency room on wheels. And the EMTs and paramedics who work in them are highly skilled professionals. 

I haven’t come up with a new metaphor to replace the outdated and inaccurate mental picture of “ambulance driver.” But to change the public understanding of who we are and what we do, we might start with changing the metaphor for the ambulance itself. 

What else might we call an ambulance? Something descriptive—a figure of speech using something people already understand, applied to that ER on wheels. For purposes of this discussion, I’ll propose rebranding the ambulance as a “mobile emergency department.”

Now picture yourself on the highway in your car, following a large vehicle. Bold letters on the sides and back of that vehicle spell the words mobile emergency department. How does that change your mental picture of the purpose of that vehicle? It’s no longer just an “ambulance,” the goal of which is to solely to move people from one place to another. Now you see it for what it truly is: an emergency room on wheels. 

Then, when that mobile emergency department arrives at a scene and its doors open, the people who step out aren’t just drivers—they are highly skilled medical professionals. 

We owe it to the public and ourselves to find some new metaphors. 

Russell Myers is chaplain for Allina Health EMS, based in Minneapolis, MN. He is board-certified by the Association of Professional Chaplains.