Book Review: A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back

During my residency training as an emergency physician, part of the curriculum was to learn how to direct the care provided by paramedics in the field.  In Philadelphia, the provision of emergency medical services was handled by specially trained professionals who were part of the Philadelphia Fire Department.  To discover what was really happening in the field, each resident was assigned to a ride-along with an EMS crew.

I had absolutely no idea what kind of gritty world I would be introduced to when I was assigned to a crew based in West Philadelphia.  This was not the area of the Liberty Bell, or Society Hill, or South Street, the center of happening night life. In the 1980’s West Philadelphia was a dilapidated neighborhood of endless row homes, poverty, and litter lining the streets. Nice little middle-class girls like me were rarely seen in these neighborhoods and, truthfully, before this assignment, I had no idea this biosphere even existed.

One call had us attending to an elderly man who we found passed out on the living room floor of an old shabby row house. I helped carry some of the equipment up the front stairs while the paramedics tried to get some useful information from the family member who had called 9-1-1. That person, it turns out, knew next to nothing.  We were on our own.

The man was splayed out on a section of dirty carpeting between sofa and coffee table. I tried but failed to tune out the scene around me:  trash, clutter, pill bottles, the odor of decaying food. The dichotomy between assessing and treating a person squeezed between furniture in a living room in shambles, as compared to the relative order and cleanliness of a hospital emergency department, was striking.  We had no space, no light, poor positioning, and little information to work with.  Although the paramedics initial thought may have been to just get the guy out of there, scoop and run, as they say, they did not. These seasoned professionals knew what treatments could and should be started at the scene and they made sure to follow their protocol. I watched them do their thing with admiration. Just getting the fellow onto the stretcher and out of the row house was an amazing feat in my mind.

When I read Kevin Hazzard’s A Thousand Naked Strangers: A Paramedics Wild Ride to the Edge and Back, I was transported back in time, decades ago, to that day in West Philadelphia. A Thousand Naked Strangers depicts the author’s startling and disturbing account of ten years as a paramedic serving inner-city Atlanta. His personal and professional journey is told through nearly forty chapters of first-person accounts. If you cannot go on an actual EMS ride-along, reading this book is the next best thing.

While libraries are full of memoirs that chronicle the considerable trials of physicians and nurses detailing their clinical experiences, those narratives often pale compared to the drama unfolding at the scene of an accident or when a patient must be stabilized by paramedics while working in a space that is crammed between commode and bathtub and often in a chaotic household.

Television has already discovered the treasure trove of excitement and drama that can be mined from the stories of emergency medical service personnel. In the 1970’s, NBC aired Emergency, a show that followed two LA paramedics. Even today, the major networks carry series dramatizing the heroics of firefighters and paramedics who are the first to arrive on the scene of a disaster.

In an unusual decision for a young man who trained as journalist and writer, Kevin Hazzard decided in 2002 to make a radical career change and to become an emergency medical technician (EMT). Hazzard was looking to challenge himself; to find a life of meaning. For ten years, he served with various ambulance services in the metropolitan Atlanta area, including the vaunted EMS service at Grady Hospital.

Hazzard began as a wide-eyed, bewildered and frightened rookie. Fortunately, he was partnered with an experienced paramedic named Chris who molded him into a capable professional and a “true believer.” In much the same way as a religious invocation, Hazzard heeds the call of the ill and injured patients he is confronted with and finds his purpose in applying his skill to those in dire need.

As an aspiring writer, I suspect Hazzard must have kept a journal and made detailed entries in the downtime between chaotic night shifts and sleepless days. In vivid detail, Hazzard brings us along on dozens of calls to the scenes of tragic accidents, takes us inside the squalor of crack houses and through the hallways of depressing nursing homes housing badly neglected patients.  His experiences are chilling

Hazzard, like so many of his fellow paramedics, seem to thrive on the chaos, excitement, and challenge of prehospital medical care. And we should all be so thankful that they do. Like chameleons, they adjust to the roving shifts, the danger, and the unpredictability of paramedic life. These naked strangers, as the title implies, are baring not only their bodies, but their souls to these remarkable professionals.  In doing so, they are putting their lives into very capable hands.  I would highly recommend A Thousand Naked Strangers, not only for a good read, but to appreciate what it takes to get our patients through the front doors of our emergency rooms where we stand waiting to accept them.