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: Memoir, Nonfiction, Audiobook, Adult, Medical, Biography, Autobiography

464 pages, Paperback

Published June 3, 2025

Reviews

[midori · Rating 5 out of 5]

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 🙏

[CatReader · Rating 4 out of 5]

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

[Rachel Martin · Rating 5 out of 5]

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.

[Kiera LeBlanc · Rating 5 out of 5]

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.,

[jac]

vianne doesn’t miss!

[Shelby Pitts · Rating 5 out of 5]

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 · Rating 4 out of 5]

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 · Rating 5 out of 5]

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!

[Chloe · Rating 5 out of 5]

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

[Alex Bowman · Rating 5 out of 5]

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

[Melissa Murdock · Rating 5 out of 5]

“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 C · Rating 4 out of 5]

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

[Kate Granstrom · Rating 5 out of 5]

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

[Mark · Rating 5 out of 5]

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.

[Zibby Owens · Rating 5 out of 5]

This memoir is both introspective and hopeful, exploring the ups and downs of the author's career as a paramedic. She provides insights into the realities of 911 calls, the flawed systems behind emergency medical services, and the emotional burnout and low pay that affect the profession. Despite these challenges, a consistent sense of hope, humor, and camaraderie prevails, highlighting the bonds forged in crisis and the humanity shared during the most vulnerable moments.

I appreciate how the author invites readers into the back of the ambulance, revealing the often-overlooked world of emergency medical services. This book is not just a behind-the-scenes look at emergency medicine; it's a tribute to the resilience of first responders and a call to confront the issues that leave these workers vulnerable, overworked, and underpaid. Most importantly, it serves as a powerful call to action, urging us to examine the broken systems that neglect the emotional and physical sacrifices of these individuals. It challenges us to ask a fundamental question: How can we better support those who dedicate their lives to caring for us during our most urgent and life-altering moments?

To listen to my interview with the author, visit my podcast at:
https://shows.acast.com/moms-dont-hav...

[jess e 🪐🎱 · Rating 5 out of 5]

this was a stellar book, I picked it up on sheer morbid curiosity in the way that one would love reading about true crime. Sokol’s work delves into her 15 odd years in the field of paramedicine. I enjoy the quote that she gives

“you don’t actually require a true emergency to dial the phone. All you need, really, is a situation that you can’t handle by yourself.” Sokol provides a paint on paramedics that almost describe them to a liminal quality - they are the ones who will help, at all costs.

Her mini essay styled book is full of the aching raw parts of the field, the dingy sides that most people don’t think about. The PTSD, the mental health side effects of being in an emergency profession, etc. it also covers the aspects that most people don’t think twice about, about how a large portion of society treats unhoused, “invisible” or patients struggling heavily with substance abuse.

I found myself tearing up in some points (especially the chapters covering elderly care and patients), and snorting with laughter in others (the patient they had who didn’t have pants was a favourite of this laugh).

As a non-American, the chapters delving into the history of the American health care system were well done and intriguing to read from a providers side of the line, and one who wrote with compassion and grit to the f*ckery that is the system and its bureaucracies.

[Tiffany · Rating 4 out of 5]

I can't remember where I heard about this book but I'm so glad I put it on my to-read list. Sokol is an excellent storyteller who brings deep empathy (and humour and appropriate frustration) to the story of working as an EMT and paramedic. I appreciated her insights on the realities of this work, the explainers about its history, and the personal reflection she offers from the field (and from the effects of a rewarding and physically- and emotionally-demanding job). This is an important read, both for its compelling depictions of the everyday work and the people she encounters and for its ability to offer a bird's eye view of the state of the system (her story is a window on what happens when emergency response is allowed to be guided by profit rather than patient care or decent working conditions). Highly recommend.

[Kelsey Pope · Rating 5 out of 5]

Without a doubt, the most impactful book I have ever read. I wish I could meet Sokol and thank her for writing this book. As a medic that is so overwhelmingly burnt out, this book felt like a heart to heart with a loving big sister who GETS IT. So incredibly well written with so many angles incorporated so well. The history of EMS that makes the current system make sense. The emotional toll of being a woman in a male dominated field. The political aspect and capitalism. The Poverty. Drugs. Alcohol. Mental Health. Homelessness. Whose responsibility is it to “deal” with all that? Society? Community? EMS? Hospitals? Family?

What do you do when you love a job that is slowly destroying you?

We’re not monsters. We are human.

“I have no regrets choosing this line of work, but I am not sure I have what it takes it continue. I will return to the field when my leave ends, but I know it’s time to start looking for a way out.”

[Stacey · Rating 5 out of 5]

Absolutely loved this memoir. Read it on the recommendation of a friend who is an EMT and has worked with the author and wow. Highly recommended reading for everyone. I knew folks working in EMS had it rough, but damn. The memoir tackles issues like homelessness, addiction, mental health, and all the ways in which our systems are overburdened and stretched too thin and absolutely failing human beings and society. The author did a really good job tackling such big, overlapping issues, and highlighting how they’re connected. Especially important read for folks living in San Francisco or other places facing similar issues around poverty and additional and mental health. Or if you know anyone working in EMS, it will help you get a clearer picture of their struggles.

[Mary Beth · Rating 5 out of 5]

I loved listening to Sokol read her book. She opened my eyes to the parts of our world that are broken. Her love and heartache for her job reminded me so much of my own thoughts and feelings teaching at Provo Canyon School. I appreciated her curiosity at the history of paramedics and how these broken systems came to be. She sees and points out flaws while wishing she could place all her blame on one evil thing. But she understands that society is too complex to blame one thing. While she writes about heavy topics she doesn’t leave you feeling hopeless and I appreciated her view and hope that small improvements can continually make our world better.

[Lynn · Rating 4 out of 5]

Thank you to Penguin for my advance copy (although it arrived after the publish date! [crying emoji]). Nevertheless, it provided great insight to the struggles that emergency medical professionals have to deal with, as well as the frustrations they face when it seems bureaucracy and policies seem to actually impede them from doing their jobs properly.

Here's a link to my full review:
https://www.theepochtimes.com/bright/...

[Bailey Marie · Rating 5 out of 5]

I really enjoyed this and what I learned from it. It’s a really interesting look at the day-to-day lives and experiences of medical first responders as told by a paramedic. There was also some history of emergency medicine sprinkled throughout to help us see how the current ambulance/911 system developed. I found her stories of her time on the crisis response team to be especially interesting. The author does a fantastic job with the narration, so I highly recommend listening to this one on audio.

[Charlotte · Rating 4 out of 5]

I wanted to read a non-fiction book, and this was a great dive back into the genre. Sokol's memoir feels deeply thoughtful, focusing upon the reality of working on an ambulance and the cracks in the emergency medicine system. She does have her share of wild stories, but maintains ethical boundaries and it doesn't feel like she's exaggerating or exploiting her patients. Great and quick read, and serves as a well-packaged call for EMS reform.

[Cheryl R. · Rating 5 out of 5]

Full of humor, empathy, pathos, honesty and frustration, this book gives you a clear view of the life of a paramedic/EMT. It shows the failures of our health system and how it might be improved. But at it's best, it shows you the real people who show up when you call 911. It shows them doing the job that they love, hate, and can't do without.

[Kristen Beauchamp · Rating 4 out of 5]

very good first person perspective of a very difficult and miss represented field of work along with other perspectives to round of the over arching message of a system that abuses those who we need most at our greatest time of need. It also highlights the lack of systemized care required for homeless, struggling, and disabled people.

[Stephanie Griest · Rating 5 out of 5]

A REAL EMERGENCY is a five-alarm firestorm of a book that we should all swerve over to read. Keenly observed and gorgeously composed, it is a testament to both the brutality of our medical industrial complex and the humanity of the paramedics frantically trying to save us from it. A page-turning, soul-enraging act of narrative justice that will haunt you to the core.

[Abbie Correll · Rating 5 out of 5]

I really liked this, and also it was good for me to read. Some days I needed to put it down and be like this is too much, and some days it made me and my experiences feel really seen. Anyway great book.

[Darlene Acero · Rating 3 out of 5]

PA school finals week kinda put a damper on me giving this audiobook my full attention, but I think I enjoyed it over all.

I am not a first responder, so it was cool to see a glance into the life of a paramedic. It was surprisingly more personal than about the job itself!

[Shana Z · Rating 5 out of 5]

The structure/organization of this book didn’t always work for me, and yet this was so brilliantly written and told from a place of truth and empathy. I actually loved this book and will be thinking about it for a long time.

[Tfalcone · Rating 3 out of 5]

Totally not what you see on TV shows. Rough reality.