Esther, daughter of a native healer who has some familiarity with and respect for Western medicine, envies and longs for Antonia’s Western training and attaches herself to her as a disciple. In her encounters with patients, Esther finds that she has an inexplicable gift for healing which baffles her as well as Antonia and complicates their already tenuous relationship. Esther’s gift forces Antonia to reexamine some of her most basic assumptions about what constitutes healing. 

The novel raises complex questions about the cultural, religious, and institutional contexts of medicine in a delicately drawn portrayal of relationships among characters whose divergent frames of reference complicate trust and understanding. One of the questions the novel addresses is not only how to heal the body, but how to heal the breach between cultures. In the development of the friendship between the American doctor and the African healer these questions are worked out in concrete particulars that fully honor both the pain and the hope involved in authentic cross-cultural dialogue. 

Antonia Saw the Oryx First
Maria Thomas 
Soho Press, New York 2007: 296 pages 

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database.  
Web image by medhum.org.

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Before the late 1960s, when someone had a medical emergency, their best hope was a “swoop and scoop” rescue. A police van or a hearse—if one appeared at all—would load up and drive the patient, unattended, unrestrained, to a hospital emergency department. On arrival, there was often little that could be done. In American Sirens, journalist Kevin Hazzard, himself a paramedic, reveals the story of the first fully trained paramedics who practiced life-saving medicine beyond hospital walls. Celebrated in Hazzard’s account are the Black men from the segregated Hill District of Pittsburgh that the visionary physician Peter Safar, inventor of CPR, recruited and trained. 

Safar’s 1967 project to train and hire unemployed men from a community organization known as Freedom House was initially met with derision. How, his colleagues asked, could he trust people with a high school education, or less, to endure intensive medical training and perform it flawlessly? The training included fifty instruction hours in anatomy and physiology, more time learning CPR, advanced first aid, defensive driving, and medical ethics. Trainees also learned how to treat cardiac conditions, diabetic emergencies, bleeds, spinal and pelvic fractures, and overdoses. Most controversially, they were taught how to intubate patients. While only 24 participants in Safar’s first class of 44 succeeded, those who did provided evidence that paramedics were fully capable of saving lives. According to Hazzard, Safar’s emergency response project became the national standard. 

Hazzard folds the project’s success into the stories of the men—all men at first—who took pride in contributing their life-saving skills to their community. Many of their lives changed direction in the process. Primary among them was John Moon, whose biography and dedication engagingly move the narrative forward. However, Hazzard also recounts how the project’s success met opposition from White residents wary of Black paramedics, a city government reluctant to fund them, and medically untrained police who felt upstaged. The final chapters recount the unravelling of the Freedom House first responders by the mayor of Pittsburgh. By 1975, political forces defunded the Freedom House crews and created a city-sponsored EMS run by the police. Only a few of the Freedom House paramedics chose to join or remain on the city ambulances. Most notable was John Moon, who rose in the ranks, recruited paramedics from low-income neighborhoods, and continues to keep the legacy of Freedom House alive. 

In addition to introducing readers to the Freedom House crews, Hazzard also suspensefully recounts the vicissitudes of several determined physicians who defended their project against professional and political resistance. He briefly pauses that narrative to sketch the fascinating history of emergency care through the last two millennia: from early Christian religious orders through nineteenth-century cities and twentieth-century European and American wars. Hazzard skillfully constructs his coherent narrative of Freedom House from a patchwork of source materials: principally, extensive interviews with John Moon; interviews with Freedom House founder Philip Hallen; the records of Freedom House; contemporaneous news reports; histories of medicine; medical journals; the memoir of Peter Safar; and the meticulous diaries and papers of his colleague, Nancy L. Caroline. She also trained the paramedics, rode ambulances with them, and wrote the first and still standard textbook, National Training Course, Emergency Medical Technician, Paramedic: Course Guide. 

Overall, American Sirens offers a detailed and comprehensive account of a little-known moment in the history of medicine that’s had enduring consequences. By reviving that story, Kevin Hazzard begins to rectify the racial injustice that the first paramedics experienced in their lives and again when their achievements were nearly forgotten. 

Readers interested in meeting John Moon and others central to the Freedom House story, can view the excellent PBS documentary from WQED Pittsburgh, Freedom House Ambulance: The First Responders (first aired January 2023). In a little less than 30 minutes, it underscores the political and economic conditions in which Freedom House was founded to serve the severely neglected Hill community. Interviewed residents recall incidents when police refused, on flimsy grounds, to transport community residents to hospitals. Most of all, the documentary confirms the pride, dedication, and dignity of the first of the first responders. Their story deserves to be known: https://www.pbs.org/video/freedom-house-ambulance-the-first-responders-nl3kcq/ 

Fans of the series The Pitt might remember a patient in Episode 8 who was one of the Freedom House paramedics. 

American Sirens: The Incredible Story of the Black Men Who Became America’s First Paramedics 
Kevin Hazzard 
Grand Central Publishing 2022: 336 pages 


A previous version of this review was published in the NYU Literature, Arts, and Medicine Database (Litmed). 
Web image from Heinz History Center