A Real Emergency: Stories from the Ambulance

by Joanna Sokol

Introspective, complicated, and surprising, A Real Emergency is a love letter from a paramedic to the best and worst parts of her career.

For fifteen years, Joanna Sokol filled private notebooks with her confusion, humor, and anger about the strange world of American street medicine. As her career progressed, she found herself taking notes on scraps of paper, backs of gloves, and margins of EKG printouts. She read about the history that brought ambulances into their current role as the caretakers of society’s forgotten, and spoke to her colleagues about their own experiences and perspectives.

Those reflections are collected here, in a series of raw, powerful essays about the state of American medicine.

Sokol’s life as a paramedic took her to three different the casinos and trailer parks of the Nevada desert, the cozy beach town of Santa Cruz, and eventually the crowded tenements of San Francisco’s Tenderloin district. There are no clear villains or heroes in Sokol’s world, only a group of patients and medics who are doing their best in a deeply broken system. Sokol combines impactful research and the strong voices of her fellow paramedics to take the reader deep into the crumbling reality of the modern American ambulance.

Genres: Nonfiction, Memoir, Audiobook, Medicine, Biography, Medical, Biography Memoir

464 pages, Paperback

First published June 1, 2025

Reviews

[midori]

This was recommended to me by a work friend and I’m so glad I took the suggestion. Such a unique, fun, and often deeply depressing memoir on a profession that everyone respects, yet immensely takes for granted. From a policy standpoint, there are many what-the-fuck inducing anecdotes: the lack of wage and overtime oversight, absence of synergy between paramedicine and emergency departments, and what “options” marginalized folks truly have when there’s no place for them to go due to a lack of appropriate social infrastructure. To the paramedics out there — you are braver than the marines and God’s bravest soldiers. Bless 🙏

[Rachel Martin]

I laughed. I cried. My heart broke and then was repaired again. I felt angry and frustrated. Sokol not only writes a deeply engaging memoir (she narrates the audiobook which was incredible) but she brings a massive spotlight to the gross politics and capitalism that goes and has gone on for years, puppeteered by greedy people without the least bit of compassion for EMTs, paramedics, really all those in the medical field. It all becomes a web, a trickle down effect that is damaging to all except the corrupt people with all the money.

Oof, like I said, parts of this made my blood boil. Most of it was incredibly fucking touching and insightful. Human. Since I listened to the audiobook, it felt like she was talking to me if that makes sense. Living in the area she worked in made me feel more connected to the story having felt like just maybe we passed one another.

One of my favorite reads, I think ever.

[CatReader]

Joanna Sokol is an American paramedic; her 2025 memoir, A Real Emergency, recounts her decade-plus work experience in Nevada and California, brief vignettes from many of her colleagues, and historical perspectives on paramedics.

Sokol grew up in Northern California in a family of academics, though by college she realized that a traditional academic path wasn't for her; instead, she thrived in hands-on, action-packed, fast-paced activities, so becoming a paramedic was a natural career fit. While her career forged and dictated most of her identity for many years, she writes about how it's also extremely challenging physically, emotionally, and mentally, particularly when dealing with complex social issues, power dynamics in healthcare, and the recent global pandemic. In recent years, Sokol has struggled with physical injuries stemming from her paramedic work, as well as burnout that's common across the health professions. This was an interesting, thoughtfully-written memoir.

Further reading:
American Sirens: The Incredible Story of the Black Men Who Became America's First Paramedics by Kevin Hazzard - Sokol cites this book extensively; I've also read and would recommend it; see my review here
The Beauty in Breaking by Michele Harper, MD - a memoir by an emergency medicine physician that touches on many similar themes

My statistics:
Book 305 for 2025
Book 2231 cumulatively

[Kathrin Passig]

Ich hoffe, das ist in Deutschland nicht ganz so ein dystopischer Beruf wie in den USA. Ich habe eher wenig über Notfallmedizin erfahren und viel darüber, wie Arbeit aussieht, wenn es keinerlei Gewerkschaft, Rechte oder Arbeitsschutz gibt.

[Emily Burt]

Parts of this memoir are moving with strong commentary on the intersection of healthcare with social welfare issues, but it is repetitive and the essay structure feels disjointed. I'm left feeling a bit underwhelmed and frustrated that it didn't pack the emotional punch that it could have.

[Shannon]

A passionate memoir told in anecdotes about the life of an EMT and the tolls that ambulance work takes both on the body and mind. I really enjoyed this well written defence of the importance of emergency responders and the need for greater government support. There were so many uplifting and tragic stories and the period during COVID was also a big eye-opener. Sprinkled throughout are stories from other front line responders like fellow EMTs, fire fighters and others, which I found strengthened the author's argument and made for a richer narrative. Great on audio and a must read/listen for anyone wanting to better understand what a toll this noble profession takes on its workers who provide an essential service for society.

[Cameron Stanish]

Emotionally riveting - ambulances are the caretakers of last resort and Sokol takes us through the trials of being societies medical backstop. From Santa Cruz, to Reno, to San Francisco, from mundane calls to lifesaving medicine, Sokol brings us stories that elicit equal parts compassion and frustration.

[Abbey]

eye opening, highly recommend!

[Kiera LeBlanc]

I absolutely loved this book! what a powerful, entertaining memoir. I will think of these stories every time I see or hear an ambulance. What an incredible story.,

[Jeffrey McDowell]

One of the most realistic representations of life on the front lines during covid. Does contain coarse language.

[jac]

vianne doesn’t miss!

[Shelby Pitts]

4.5 rounded up
I don't really know what I expected from this book but I know I didn't expect to love it as much as I did.
The author did such a great job of conveying the wide range of emotions that would come with a career in emergency services.
I really appreciated the way she sprinkled the history of the job throughout the book in a way that was really engaging and relevant to her own personal story.. the history of emergency medicine isn't something I thought I'd be interested in but she had me hooked.

At some point in the book, Joanna mentions not resonating with the military types often associated with emergency services and I think that's what made this book so enjoyable for me. Honestly, before reading this, I also kind of viewed people in the field that way. Joanna is compassionate and empathetic and understands the systemic flaws of society in a way that I think is crucial for people working in these positions. I only wish everyone in this field was a little more like Joanna 😊.

[CJ Opal]

3.5 stars, rounded up. Sokol's memoir is full of dark humor and sincere hope for the world of emergency medical services. It's clear that she's done the work, both internally and externally, to try and present a full picture of how her decade of service was shaped by all that came before her. Interspersed with stories from other EMS providers, Sokol maps out not just her career, but her path to understanding the history of the ambulance in the USA. It would be a five star read, but the structure wasn't consistent and it was often confusing to remember where the story was taking place. It would probably be easier to take in on paper, I'm not sure I would recommend the audiobook. It's a good read for anyone interested in EMS history, and it's full of references to other books about the subject.

[Irene]

I can't tell you how much I loved this book. I listened to it on audio (thank you Libro.fm!), but I can tell this is one I would have enjoyed reading traditionally too. Gut wrenching, poignant, and at times laugh out loud funny, I would recommend "A Real Emergency" to anyone who loves medical nonfiction or nonfiction with a political/humanitarian leaning. "A Real Emergency" has that expanding your mind quality of the best nonfiction while also being easy to connect to. I have a deeper understanding for what EMTs do and certainly greater empathy, but I also came away from reading this feeling things had shifted in my heart. Can't recommend this enough!

[Cara]

I've found I love a deep dive in a niche subject, this book being the life of a paramedic.
The incredible work medics do made this all the more incredible to read.

It was interesting and heartbreaking to hear about the folks EMS continually encounter - the seeming hopelessness that comes from drug use & homelessness. There are no easy answers. Thanks to all medical professionals who keep our communities going.

[Rachel Mueller]

Oh I LOVED this.

If I could sum this book up in one sentence I would say it's a jarring, funny, heartfelt, and eye-opening look into the world of US poverty, mistreatment of the labor force, and broken medical system from the lens of frontline medical workers.

Definitely a book where I know my life will be different because I've read it. It was a little disjointed at parts and probably a little longer than it needed to be, but WELL worth it - this is a must-read.

[Chloe]

I lovedddd this. Eye opening and well researched. You get to know the writer as well as hear stories about other EMS providers. I love that she discusses patient experiences as well as sheds light on issues within healthcare

[Michelle Rittenhouse]

Fantastic read that so many healthcare workers and first responders will relate to. The author clearly outlines current gaps and problems with the EMS system, and the fatigue anyone dealing with the general public can relate to. While the language is pervasive, it feels authentic to the experience. And a few sections had me laughing out loud.

[Alex Bowman]

Incredible. The story telling was encapsulating and very informative. It really makes you appreciate the EMTs, Paramedics, and healthcare providers even more.

[Melissa Murdock]

“And that overwhelmed feeling? That feeling that nothing we are doing is working, that this battle is bigger than us, that we are very small and looking out at a very large fight? That’s just a normal day at work.”
Brutal and funny and so real

[Alison Kat]

This was so, so good. Everyone should read this.

[Kanika]

What an amazing insight in to this life!

[Carly Burns]

Amazing! Every healthcare worker should read this. Its hilarious, tells real world stories, and sheds light on the issues of emergency medicine

[Julia Morris]

Sokol writes in such an easy to follow, conversational style that this was an engaging read that felt more like listening to a friend. With a frankness that might make some uncomfortable and uncensored language (that makes the experience of this book much more genuine) you learn so much about what it’s really like to be behind the wheel of an ambulance and to work within a broken EMS system in a society that values productivity and exponential wealth over the quality of life of healthcare workers (specifically paramedics and EMT’s) and the people within it. It was mind blowing to begin to understand the toll this career takes on one’s mental health but also all the amazing things she experiences and beautiful connections she made throughout her experiences. She writes a captivating, engaging, thought-provoking, educational, and quite disturbing story that is well researched with little sprinkles of POV’s from other professionals within her field. This is such an impactful read that I would recommend to most, but especially those in healthcare or interested in nonfiction.

[Kate Granstrom]

Highly recommend wow! Entertaining, informative, critical, compassionate, heartbreaking stories from the front lines of the 911 response system

[Isabella Laurens]

“Would he nod, half asleep in the fog? Would he pass the pipe?”
“When elephants fight, it’s the grass that suffers”
“I followed protocols as well as I could. I think I did my job. My mask is itchy.”

[Keith]

70% rants, 20% personal ambulance stories of the author, 5% medical fun facts, 5% commentaries from other paramedics

I got this recommendation from BookTok, and I had the impression that it was a compilation of remarkable ambulance stories, but most of it was just the author hating her job. I mean, I get her point, that 911 is often abused, as are its responders but I just couldn’t deal with all her complaints. Honestly, all jobs have pros and cons.

[Micaela Comerford]

Very insightful into the personal & professional realm of a paramedic that so often goes unseen. Not only did this grow my respect for all health care workers (despite already thinking they had my full account) but the trauma they go through on a daily basis in which gets normalized is unfathomable. A true masterpiece that also gives recognition to the failures of society to appropriate support all people.

[Mark]

My goodness.

When my niece was a paramedic, I would tell people "My niece is a paramedic" and didn't think much more about it. She didn't talk much about her work, but I remember her saying she used to run out of air for the air horn by leaning on it trying to get idiots out of her way, which both did and did not surprise me.

I have a good friend who has been a paramedic for 22 years so I knew a little bit about the job, but I really had no idea what Joanna went through. This shocking memoir exposes the often flabby, scabby, infected, reeking underbelly of emergency healthcare in Santa Cruz, Reno and SF as seen through the compassionate eye of a paramedic. It's foul, infuriating, hair-raising and PTSD-inducing, filled with the kinds of things you just don't think about, or want to, and a firsthand, non-academic assessment/indictment of a broken system in an increasingly broken country.

The book raises important issues of class, poverty, loneliness and systemic dysfunction in a capitalist society that hasn't figured out how to adequately take care of everyone.

It was only when I was about half way through that I finally understood the title and its double meaning.
Following a reading she did at a local bookstore, I texted my sister saying that for-profit healthcare is of itself a sickness (she did not disagree). It is also very well written, and the dark poetry evoked for me Celine and Burroughs. Who knew that she was such a writer?

I have no idea how many books have been written on the subject but I am convinced this is not only an important contribution to the canon but a very accessible one, deserving of a wider audience. Through her skill as a writer, she turns a depressing subject no one wants to think about into something engrossing. But, gentle reader, be warned: a lot of what happens in this book is gross. There are many parts of this book that are hard to take and will make your head spin, but that's a good thing.

But it flows, well. I gotta say that I soon as typed that I thought of the steady flow of blood, urine, feces and vomit from her many patients. (If I think I have minor PTSD from reading this book, imagine what she went through.)

This is an honest and unflinching work written by, dare I say it, a kind and caring person who genuinely wanted to help people and who, probably like many paramedics, had a love-hate (or like-dislike) relationship with the work. But reading her book, you come to understand why. And when you understand why, it should make you as mad as it made her.

I am obsessed with Utopia (or at least a better world) and this book is in many ways dystopian in nature. It's an example of how things should -not- be. Like Joanna, I would love to see a healthcare system (emergency or otherwise) that is adequately funded so that no one has to wait for treatment or shelter, either immediate, short term or long term. I would also like to see an end to poverty, homelessness, substance abuse and isolation/loneliness, all of which factor into this fine work. This country is fucked up, and I believe it's only going to get worse.

Patients (especially the indigent) and paramedics alike need a vast improvement in how they are treated. This book should be required reading by the heads of every public or private emergency health care entity in the country: ambulance, hospital, shelter, treatment facility, Department of Health etc. The entire system needs an overhaul 'cause it clearly ain't workin'.

What also isn't working are the socioeconomic conditions and drugs like Fentanyl and meth that break and destroy people, causing them to
abuse the system (and paramedics).

A copy of this book should be also be inserted into the rectums of the CEOs of AMR and other private ambulance companies who go through EMTs and paramedics like disposable razors (see p. 354).

Perhaps I am biased but I think this should be on the New York Times bestseller list.

Truly eye-opening and very well done.

[Malise]

this book had a lot of ups and downs for me... I found it difficult at first to get into and would find myself leaving huge chunks of time in between listening sessions with little desire to dive back into the book but eventually we got into chapters surrounding COVID which I found so so so interesting! I'm so glad she included it or otherwise I think I'd have ended up rating about the two star mark, especially as this suffered just being too long in general