Unsung Heroes
They set the standard. They were the first. They were innovators. And you’ve probably never heard of them.
I’m referring to the twenty-five Black men of the Freedom House Ambulance Service who, in 1967, became the first fully trained paramedics in United States history. In the eight years they operated, the men of the FHAS revolutionized how emergency medicine functioned in America. Ambulances weren’t a thing back in the 1960s, not like they are today. In Pittsburgh, if you called for emergency medical care and lived in the suburbs, a hearse from the local funeral home would show up. If you lived in the city, the police would arrive for transport. And that’s if anyone showed up at all. Neither option was medically trained for emergencies, but there was no other standardized emergency service in America at the time.
As you can imagine, this way was dangerous, and people were dying. A study from 1966 illustrates just how big the problem was. Titled, Accidental Death and Disability: The Neglected Disease of Modern Society, the study found that “up to 50,000 deaths each year were the result of inadequate ambulance crews and lack of suitable hospitals within range.”1
For the people of Pittsburgh, Pennsylvania, the absence of proper emergency care hit home when the former mayor of Pittsburgh, David L. Lawrence, suffered a heart attack and had to be transported to the hospital by police. After arriving, he had no brain activity and later died. According to his treating physician, Dr. Peter Safar, his death might have been preventable with adequate pre-hospital care…like the kind a trained squad of paramedics could give.
Safar, an anesthesiologist, was further motivated due to a personal tragedy. His daughter had previously died of an asthma attack — a death that also could have been prevented with proper pre-hospital care. He was determined to set a new standard of care. So, working with Freedom House Enterprises, a local civil rights organization, Safar recruited twenty-five Black men from the Hill District, a predominantly low-income neighborhood. This program also served another purpose. Racial tensions between the community and the police often led to slow response times — or even refusal to provide service at all. Safar and Freedom House reasoned that the members of the community were more likely to trust their own, and so the work began training these volunteers on the ins and outs of emergency medical care.
Most of the recruits came from difficult backgrounds. Many had not graduated high school. Some had criminal records. A few were returning veterans of the Vietnam War. But together, they endured over 300 hours of intense training on anatomy, physiology, CPR — which Safar had helped invent — first aid, nursing, and defensive driving.2
When they emerged, they became the only trained paramedics in the country.
These remarkable men were trailblazers in providing pre-hospital care. In their first year, they responded to almost 5,800 calls and saved over 200 lives.1 A study done of 1,400 patients transported by Freedom House found they were given the correct care 89% of the time. This was an enormous jump compared to the police’s record of 38%, and the 13% rate given by volunteer ambulance services.3 In the beginning the police saw Freedom House as a threat to their job security, but over time law enforcement began to recognize that Ambulance Service was making their job easier. Eventually, officers began calling Freedom House for medical assistance.
Along the way, the Freedom House crew set a number of “firsts.” They were the first in the nation to intubate a patient on the street. The first to deliver an electric shock to a patient’s heart in the field. The first to read and send EKG while en route and use Narcan to reverse an overdose. The groundbreaking training they received from Safar became not only the world’s first comprehensive paramedic training course; it became the basis for all paramedic training in the country.
Unfortunately, despite their immense success and support from the community, they faced several hurdles. For one thing, the paramedics faced almost constant racism. Hospital staff assumed they were in janitorial positions and ordered them to mop the floor. When responding to calls in other neighborhoods, surprised patients often refused to be touched by them. Many who lived in affluent suburbs were upset that poorer neighborhoods were getting better care than they were, so they began contacting the mayor with noise complaints due to the ambulance sirens.
Racial tensions eventually lead to Freedom House being shut down in 1975. The mayor cancelled the contract between the city and Freedom House and instead started a city of Pittsburgh EMS with a completely new all-white staff. But while the Freedom House Ambulance Service came to an end, the example they set has never faded.
Today, their legacy lives on through our emergency medical services. The ambulances people see driving through the streets today all trace back to the Freedom House program. Their story is a testament to the spirit of those who fought against the inadequacies of the past — not just in emergency medicine but across society as a whole. Despite the obstacles they faced, the contribution of those twenty-five Black paramedics laid the foundation of care that we often take for granted today. They are pioneers for those who would follow after them.
Not many know their story, so let’s take time to honor their resilience, their dedication, and their innovation as we continue to strive for a more caring future.
*Content Provided By Bill Good
1 “Freedom House Ambulance Service,” 99percent Invisible, https://99percentinvisible.org/episode/freedom-house-ambulance-service/
2 “Freedom House Ambulance Service, Wikipedia, https://en.wikipedia.org/wiki/Freedom_House_Ambulance_Service
3 “The Little-Known History of the Black Men Who Became America’s First Paramedics,” Time, https://time.com/6215072/first-paramedics-black-men-history/
