The Ambulance: A History (review)

As Ryan Bell correctly notes, the centuries-long development of the ambulance (both as form and function) has not lacked for histories that analyze either the military or more recent paramedic services. Bell deliberately limits his history to the civilian world except for “referring to the battlefield only when necessary to understand developments on the boulevard.” (2) To be sure, he gives needed coverage to Civil War ambulance services, a precursor to much that developed in the late 1860s and 1870s in urban America. Left untold, however, is the considerable history of the ambulance in World Wars I and II, Korea, Vietnam, and Iraq, that made valuable additions to our understanding of the ambulance system.

Of particular interest in this book is the author’s focus on the initial use of urban ambulance squads to transport smallpox and fever cases; the evolving nature and design of specialty wagons; the transitioning from telegraphic alarms to telephone call boxes; the debate over the use of the siren and other alarm devices; the development of satellites for the relief of crowded hospitals; and the often regaled history of medical school interns on ambulances. Bell gives a thorough description of the combined funeral home and ambulance service, particularly in the smaller towns and cities of the South, and the novel approach to emergency medical aid known as the Night Medical Service which derived from France and was designed to reduce death and morbidity among the city’s poor. The author also devotes ample time to the impact of the interstate highway system on changes in ambulance services.

As Bell explains, America’s emergency ambulance service resulted from the nexus of inspired innovators (many of whom were ex-soldiers), forward-thinking mayors and civic leaders, creatively bundled services, and the rapid pace of industrialization and urbanization. Woven throughout the book is the role of police-operated emergency responders whose services wax and wane until the onset of large-scale private providers. In addition, Bell provides poignant comment on the numerous men and women whose careers were tied to civilian ambulance services. They include: Dr. Benjamin Howard, who founded England’s ambulance service; Dr. Edward Dalton, whose flying wagons interdicted the cholera epidemic in New York in 1867; Dr. Emily Dunning, who became the first woman ambulance surgeon in 1903; Mary Carter, who drove an ambulance during World War I; and Phil Hallen, who was responsible for the redesign of ambulance services for the city of Pittsburgh.

The transition from horse-drawn ambulances to the motor age and the adoption of the rubber tire receives special attention by Bell. Starting in 1899 with the first electric motor-powered ambulance acquired by the Michael Reese Hospital in Chicago and spreading to St. Vincent’s, Manhattan’s Roosevelt, and Presbyterian in New York City, the era of the motor age moved with dispatch to steamers and finally to gasoline-powered ambulances. The motor age was a hygienically welcomed change from the estimated 2.4 million pounds of manure that cluttered the streets of New York City and the 300,000 quarts of horse urine flushed through its drains each day. With the materialization of assembly line prices, especially of the Model-T Ford, the gasoline ambulance quickly became a permanent fixture in the American landscape. From the Marmon and Scully-Walton, to the Miller-Meteor, Riddle Coach and Hearse, Superior, Hess and Eisenhardt, and Swab, ambulances chassis were a common sight connecting victim and hospital. Besides the more traditional ambulance systems, a number of special disaster cars combined rescue with first-aid. They included cars designed by the Bureau of Mines, New York City’s Rescue Squad 1, which was designed and built around specific technology, the Roanoke Life Saving and First Aid Crew for water rescue, the Baker First Aid Car, which carried a complete surgical kit, and the Jay W. Stevens Disaster Unit designed for heavy-rescue response.

For those anticipating a definitive history of the ambulance, we must wait a...