Paramedic: On the Front Lines of Medicine

by Peter Canning

In this unforgettable, dramatic account of one man's experience as an EMT, Peter Canning relives the nerve-racking seconds that can mean the difference between a patient's death and survival, as Canning struggles to make the right call, dispense the right medication, or keep a patient's heart beating long enough to reach the hospital. As Canning tells his graphic, gripping war stories--of the lives he saved and lost; of the fear, the nightmares, and the constant adrenaline-pumping thrill of action--we come away with an unforgettable portrait of what it means to be a hero.

Genres: Nonfiction, Medical, Medicine, Health Care, Memoir, True Story

351 pages, Mass Market Paperback

First published January 1, 1997

Reviews

[Perkimom · Rating 3 out of 5]

Enjoyed it though a bit self-absorbed and not nearly as real-feeling as I see on the front lines of my job.

[BookAmbler · Rating 5 out of 5]

Hey, I loved this book! Although working 'across the Pond' from Peter (and at least 6 months short of getting my paramedic registration) I can relate to so much of what he says. He would feel very much at home in LAS (London Ambulance Service) - short journey times/ short runs to hospital/ large ethnic minority population. But I was surprised to read that they suffer from 'the rubbish' (he calls them BS jobs) as much as we do... I thought the private health care system would sort that out.

I loved the way he explains his anxieties, triumphs and tribulations. Especially his anxieties because I have them too! The way he describes jobs in the 'first person - present tense' - normally something I dislike - seems to work well here. I also think he interspersed tales from his former work (campaigning/ political speech writer) very nicely.

Some interesting similarities and differences from the UK;Cardiac drugs - they have dopamine for cardiogenic shock (we have atropine) and adenosine (we have amiodarone). No lidocaine (lignocaine), bretylium, procainamide or sodium bicarb here. Epinephrine = adrenaline. Lasix = furosemide. UK paramedics give morphine for pain relief, no permission required. Why only baby aspirin? - think these are 75mg each - we can give 300mg (=1 adult tablet) for suspected cardiac chest pain to over 16s. UK Paramedics are more reserved about giving fluids/ IV access and don't take bloods for the hospital (in Essex). Not sure why they are so reluctant to give 'nitro' tablets; we don't have IV nitro but use glyceryl trinitrate (GTN) spray relatively freely, as long as the systolic BP is ok.

Allergic reaction - benadryl = chlorphenamine/ piriton. Seizures - UK paramedics do not need to get authority to give diazemuls (Valium) - and they can also give it rectally as diazepam. Unresponsive - no ammonia inhalants here. Hospitals are not responsible for paramedics' actions here, and we do the 'EMT to Paramedic' progression differently.

Manual handling - every front line vehicle in Essex has a tail lift so no manually lifting the stretcher into the vehicle. Think this has been true for at least 5 years.

Same handover woes - he sums it up in a nutshell (can't find that page again) - A&E nurses mostly don't listen here either :(

Not many shootings and stabbings here in Essex, though they do happen.

We don't got 'Stork pins' :(

I feel both relief and letdown. I want action, but I also fear it.

[Beth Cato · Rating 5 out of 5]

I read the sequel to Paramedic about two months ago, and this first book is much of the same. This is part of my continued research for my novel. I've been reading so much about EMS that it's starting to creep into my dreams.[return][return]Peter Canning was a speechwriter with powerful connections throughout the northeast and Washington D.C. However, he gave up his big paycheck and nice office to go and work on the streets of Hartford, Connecticut, as a paramedic. He sees many of the same drunks day to day, is frustrated with the system, and every now and then makes a big save that makes everything worthwhile. For my selfish purposes, I wish he had gone into more details about some of the mundane details of dispatches and paperwork, but it still provides me with many ideas.

[Sara · Rating 4 out of 5]

I thoroughly enjoyed the stories of real-life ambulance work. A good portion of the book also touches on Canning's work as an aide to the governor, and that didn't interest me as much. He does an excellent job of decribing exactly how things are done on the ambulance; that was my favorite part.

[Salma Par · Rating 5 out of 5]

This was one of the most (if not the most) authentic and honest biography I have ever read! Peter Canning takes us on a journey across his life, exposing his triumphs and vulnerabilities. What I appreciate most is how self reflective he is, and how he isn't afraid to show his human side (both good, and not so good). He talks about his station in life, reflecting on the choices he has made that got him to where he is, and takes accountability for his actions. In particular, he talks about: 1) his "white privilege" and how he sees the impacts of it on the streets everyday; 2) his advantageous upbringing and how that contrasts with his pursuing his passion as a paramedic, which is well below his original socio-economic status; 3) his realization of racism within himself and within his work environment, and how that contrasts with his personal relationship with someone of color; 4) his tug and pull with knowing that he could have easily lived a more comfortable life in policy, or even just moving on in the medical field, yet he so wants to prove his worth as a paramedic; 5) the inner conflicts of what loyalty means (how he was completely loyal to Senator Weicker with no real return on investment, yet his comrades in the paramedic field show complete loyalty every day (even if it is on the side of unethical, such as when he drove the ambulance car knowing that paramedics were beating up on a violent patient in the back)); 6) his search for meaning in life which I believe he finds in connectedness and service to people in his city every single day; 7) the inequity between what paramedics sacrifice everyday compared to the lack of respect and feeling of disempowerment; 7) the realization that ultimately we are all the same in that we all just want connectedness, the feeling of belonging, and respect; and 8) a philosophical dialogue throughout the book about what does it mean to be happy.

What Mr. Canning does and experiences within the time periods constrained in this book far outweighs what most people do in a lifetime. He speaks about his numerous professions apart from being a paramedic (including: government, meat packing, cab driving, factory working, and EMT), and what he loved so much about them contrasted with how society views him in these professions. The wisdom I gleaned from this book was enormous, and I am truly a better person after reading this book.

My one criticism is that the reality that Mr. Canning speaks about is very much limited to the United States, and particularly to the Conneticut area. Paramedics across the border in Canada make a great deal more money and are respected members of society (60K to 100K annually). I find it appalling how inequitable the salaries are when comparing these two countries, and how it requires advocates like Canning to make Americans realize that this profession requires safety, security (both physical and financial), respect, and need to be empowered - aspects that are enjoyed and taken for granted in so many other equally important occupations that are the pulse of our society such as doctors, police officers, and even sanitary workers.

I really am so honored to have read this book, and will try to work towards the goals I have now put on myself based on the wisdom gleaned. Thank you Mr. Canning!!

[John Parken · Rating 3 out of 5]

Canning is best in this book at catching and clearly expressing some of the impressions that EMTs and Medics feel about the job. The sentiments that we commonly experience. In that, his work is among the best and this is something that requires someone with extensive street experience, sharp perception, and excellent writing skill. In the first few chapters, I developed high expectations for the book as a whole.

Those high initial expectations probably set me up for an ultimately disappointing read. And to that, I really believe that it was my early expectations rather than Canning's writing skills that are the primary contributors.

For me, there are way too many pages devoted to the relationship between Weicker and Canning and that the do not contribute to EMS part of the story. Of course, if the intended story is more broad than what appealed to me, then the "fault" is not Canning's so much as that of the marketing of the book. I was a trial lawyer for 20 years (a less than satisfying career) and then an EMS provider and Paramedic for another 20+ year career which I loved and for which I shall always be grateful. I do not admire politicians and am not at all interested in reading about their careers. So, again, my disappointment in this book is on me. But I felt that the EMS components were brief and somewhat shallow and added mostly as "seasoning" to spice up the author's other activities and accomplishments. For me, this feeling is heightened by the episodic nature of the brief patient encounters. As I write this, it becomes clear that this too is an inherent part of field EMS, so in a very real sense my observation can be seen as a credit to the writer's ability to generate accurately the very feeling of which I complain. That is ironic but not "fair."

[Trent · Rating 3 out of 5]

I enjoyed the discussions and descriptions of clinical practice and the way he analyses the CT emergency healthcare system to show it's faults, but boooy oh boy does he spend a lot of time talking about his time working in politics. It should really be called "Politician: Who Then Did a bit of Paramedicine". About 20% of his politics talking is as it relates to emergency medicine, the struggles in fixing it's faults, the rest is honestly just him daydreaming about his old job as a speech-writer or generally rambling. Which perhaps you could look at as part of Paramedicine, questioning his decision to enter it as it's emotionally and physically draining. Doesn't make for a great experience as a reader, however.

The amount of times he brings up that Senator Weicker... mate. C'mon. I genuinely know more about Senator Weicker than I do about the author.

Also it's clear that he's a great paramedic clinically but he's often an awful communicator, has no awareness of that, and that's a foundational fault that will always make for poor practice. He's like that nutty friend of yours that's telling you a story about how unfairly they got treated in a given situation and you sit there listening to their story thinking "Ok yeah you were clearly the one at fault there..." but instead you just nod and agree with them like "Yeeeah, that other person does sound awful, poor you."

Anyway, I will give it some props for being one of the first books of it's kind written by a Paramedic. So good on him. I think his later books improve so I'll actually try those as well despite this scathing review here.

[Ben Savage · Rating 4 out of 5]

" If we are to learn, we must study that was written before us. There is more lost knowledge in these once standard texts than we can hope to obtain. Why reinvent the wheel when these who came before us had laid it out for us"

I forgot who said something like this but it applies to this book. Shocking to think I worked 30-45 miles from this place.
Simultaneously makes me wish I did more then but also glad I was very green.

This book should be required reading for aspiring paramedics, maybe burnt out paramedics, and family members of people who are in EMS.

It is STAGGERING the issues that still are big issues from 28 years ago. It is also staggering that in a few asides he predicts the rightward swing of American politics.

This book is a very hard book to like because it was so visceral and real. Definetly has some shock value for green medics and the uninitiated, which is what made it visceral and real. But it definitely opened up a few minor traumatic doors. He waffles between hope for humananity and abject, bleek despair. At the end of the book, heck, at the end of some asides, I worried that this guy was gonna take himself out.

Medically very straightforward and engaging this book is also a love letter to those who worked with him. If he had more I would read it.

[Vanessa Castillo]

Paramedics:On the Front Lines of Medicine was a book that has its ups and down. If you like books where the protagonist overcomes their challenge but life doesn't let them so easily, you should read Paramedics:On the Front Lines of Medicine. The book includes many funny unexpected scenes,such as the incident with grandma and ML. Paramedics:On the Front Lines of Medicine by Peter Canning is a book for those who expect too much of themselves or feel like they're not good enough. One of my favorite lines from Paramedics:On the Front Lines of Medicine was “ While I am excited by the adrenaline rush of the call and having finally gotten to defibrillate someone (something I never want to do again on a conscience person without sedating them), inside I fight the feeling that I failed badly.” I liked this line because it shows how he felt excited because he finally got his first really sick emergency in a long while but he carries the guilt that he didn’t do good enough to be able to save the old man. Was it wrong for him to feel like that? I would recommend this book to most readers because it carries many feelings that the readers can relate to and really shows the ML going through these hard times and overcoming them.I would give this book a 8.5/10.
11/6/22

[Bill · Rating 2 out of 5]

There are sections of Canning's book that I liked and found relatable. He is good at getting across both the isolation and the feeling of power that comes from being in a Paramedicine role. The medicine in the book is often bad, but that was medicine when this was written and I'm not going to hold that against Canning. What I will hold against Canning and the book are the deep undercurrents of racism and classism that litter the book.

Canning wants his cake and to eat it too, he really hits the "I'm just a working man" narrative hard but then spends a lot of pages complaining about working class people calling 911 or making sure to call a woman fat or highlight the race of a patient he doesn't think deserves his treatment. That's where Canning's book loses me, the hypocrisy of positioning himself as a good man while he fails to recognize the systemic issues at play for his patients and instead makes them into villains in his story. Too many folks in Paramedicine have the views of Canning toward those calling 911, it's a failure on the part of our profession much like Canning's work is a failure as a book.

[Kathleen Garber · Rating 4 out of 5]

I enjoyed this book but I do have to put a warning out there. Maybe a few. First of all the book is from 1997 and so has some outdated ways of talking about people. There are many instances where the author or another person from their stories calls people or even children fat. That’s not something that would go well now a days. However if you realize the times and read past those spots, the story itself is intriguing.

I’m reading from the point of view of a person who has has EMS at their house a lot and unfortunately rode the ambulance many times too. It’s interesting to read from the other point of view.

Every story was interesting and I even saw myself in some of the patients who had the same or similar conditions to me. It had my captivated the whole book which was just story after story. I wish it was more up to date and Canadian because when it mentions regulations I have no idea if they are still like that or if Canada is like that. I want to find an EMS memoir that is Canadian and up to date.

However even though it’s dated the book was a good read.

[Alex Bromley · Rating 4 out of 5]

Peter Canning is a paramedic in the states. He became a paramedic later in life after working many jobs, including a speech writer for politicans. This book is a recount of his first year working as a certified parametric. He talks about his anxieties on scenes when he is still learning, he talks about his doubts in his ability and his decision to become a parametric, he describes the pain he feels on the harder cases when he loses people, and the great sense of accomplishment and pride when he is able to help someone. His description is so raw that it makes you feel what it must be like to be a parametric. These people do not get paid enough for the work that they do. The book has kind of a weird, disjointed flow to it that took a little bit to get used to. But I wonder if this was on purpose to mimic what a chaotic day one has as a parametric.

[Jenn · Rating 5 out of 5]

Fascinating insider's look at what it takes to be a paramedic. I actually read Peter Canning's second book first (years ago). Loved it, kept it, remembered it, and pulled it out to read again. This first book gave a good backdrop on how Mr. Canning became a paramedic. Well worth the time it took to read it. Especially during our COVID-19 crisis, reading about first responders gives me a new and deeper appreciation for the critical services they provide.

Great book with stories told sincerely by an amazingly talented, humble, caring, compassionate paramedic. I just love him ~

Now, I am ready for a second run through his next book: Rescue 471!

[Katie · Rating 4 out of 5]

Overall I really enjoyed this one. It was really interesting to see just how far the field of emergency medicine has come from when Canning was working in the field. His stories show so many aspects of the job he does. They truly show the large gamut of calls and patients that the EMS systems deal with. The only reason I gave it 4 stars instead of 5 was that I felt at times the explanations and such given were a bit overdone. Canning needed to trust his reader just a bit more at times but overall I really enjoyed this read.

[Empathy · Rating 4 out of 5]

Peter Canning included his politics which I didn't really like, but that wasn't much of his book and it was part of his life anyway, so I'll allow it. I really loved these stories! I could just sit and read these forever. I forced myself to only read a little at a time as to make the book last as long as possible.

[Gail Johnson, Ph.D · Rating 5 out of 5]

I purchased this book back in 2003, but just now getting a chance to read it. I wish I had read it sooner. This book was like taking the first class of paramedic school. The first 45 pages is a breakdown of paramedic terminology and supplies for the ambulance. The book is a page turner and it's like being on a call with Peter. Will be reading his other books.

[Joseph C Bryson · Rating 5 out of 5]

Awesome

Been a volunteer EMT for six months. I’m about Peters age and have dreams of being a medic. Everyone tells me not to. Can’t think of a better book to read that balances the mix of emotions.

[Taylor Worlton · Rating 5 out of 5]

I absolutely loved this book. It was such an amazing view of what it’s truly like in EMS. I read this when I first entered the field and it really put things into perspective for me. Peter Canning is an incredible author!

[Maureen Sepulveda · Rating 4 out of 5]

Fast paced description of life as a paramedic in Hartford, CT and suburbs in 90’s. Interesting because author worked as an aide to US Senator then Governor and was involved in health department before going to be a paramedic. I just found descriptions of situations he was in fascinating.

[Spencer · Rating 3 out of 5]

Good insight on what his thought process was. Fun to see his reaction to calls and how he dealt with them emotionally

[Nicole · Rating 3 out of 5]

Great stories but lots of swearing

[Barre Kelley · Rating 4 out of 5]

Realistic view of life in EMS

[Danielle Speller · Rating 5 out of 5]

I love this book a lot.

I really love this book. It was awesome. It was a very interesting book and I learned a few things from it. I learned 2 new heart rhythms: Sinus arrhythmia and a rare rhythm called torsades de pointed: abnormal beat of the ventricles that produces a rhythm at first looks like ventricular tachycardia, but isn't. The treatment for it is magnesium and ventricular pacing. If you give the person lidocaine while they're in this rhythm, it will kill them. I also learned that there are 24 drugs that medics use to help bring patients back to life. I thought it was half that number. I'm familiar to most of them from my nursing math course I took. I really loved this book. I'll definitely recommend it all of my friends in the field.

[Marie · Rating 2 out of 5]

So this was written quite a while ago now... and it shows. The stories are interesting, if a bit repetitive. The author is not a compelling narrator and what empathy he shows just seems forced. The theme of his patient interactions seem to be, " I don't know if I'm good enough... at least I got the job done, but I'll do better next time." In summary, his patient-interactions are mostly about HIM and less about the people he is serving at the time. It frustrated me incredibly and made me sad at the same time.

[Ceira · Rating 3 out of 5]

Gave a first hand of the work of a Paramedic, and the various difficulties that must be dealt with to do the work well. Real life stories of people who needed help and those with the courage and skill to give it. Takes a nice closeup hit at the welfare system and it's abusers. It had some foul language and a little other objectionable content, but I suppose that is commonly part of the picture too.

[Hazel McHaffie · Rating 3 out of 5]

An easy read if you want little snippets, or your concentration span is limited for any reason (as mine's been of late). Gives a glimpse into the everyday life of a paramedic in the USA. Canning was previously a speechwriter for a Connecticut Governor and writes thoughtfully on what makes a job worthwhile.

[Laura · Rating 4 out of 5]

Good read about what it is really like to be a paramedic. I love the author's honesty about his feelings and frustrations as an emt/paramedic.

There is a fair amount of swearing in the book but it all makes sense and isn't there just to be there, kwim?

I wonder if Mr.Canning is still a paramedic or if he has burned out?

[Rachel · Rating 5 out of 5]

SO good. I wish he'd write more nonfiction accounts of life as a paramedic. As I'm just starting my journey in the life of emergency medicine, it has been very awesome to see how far the field of EMS has come in the past 20 years and to hear the adventures of those who have come before me. A must read for anyone in the field, for sure.

[Carolyn · Rating 4 out of 5]

Life on the streets as an EMT and then Paramedic. The daily stresses and feelings of being 2nd rate when you bring a patient to the ER. Love of the job, working one on one with people and the feelings of euphoria when you really save someones life. Love Non-Fiction!

[Chris · Rating 4 out of 5]

A good book about what it's really like to be a paramedic. A little dated now, but the basic themes/challenges/experiences still ring true. Some medical knowledge is helpful when reading, as the author uses medical terminology and doesn't always explain what it means.