This year marks half a century since the 1972 debut of the television series “Emergency!” In that time, pre-hospital care has become exponentially more effective at saving lives, in part, due to the series’ influence.
Explore This IssueACEP Now: Vol 41 – No 05 – May 2022
“The show instilled in the public’s mind that paramedic programs needed educational and taxpayer support,” says emergency physician Ronald D. Stewart, MD, FACEP, who served as a consultant on the series and is a professor emeritus in emergency medicine at Dalhousie University in Halifax, Nova Scotia. “When budgets came up, the thought of not funding an outreach program like a paramedic system became unacceptable to the public and any legislative body.”
According to Dr. Stewart, at the time “Emergency!” made its debut, paramedic programs were in their infancy in the U.S., with only about 12 in major U.S. cities, including Los Angeles. When someone called 911 in other parts of the country at that time, firefighters transported them to the hospital if they had been in an accident, had a myocardial infarction, or were on the verge of giving birth, among other emergencies.
In some parts of the country, towns and cities contracted with funeral homes to do these hospital transports and an employee with a first aid certificate and a hearse would show up, since these vehicles could transport people lying down. Consequently, the pre-hospital care many patients in those early years received enroute was little to nothing.
“You pretty much rolled in there with only a cot,” says Rick Murray, director of EMS and Disaster Preparedness at ACEP. “Maybe you had some oxygen if you were lucky.”
Murray’s first job, around the time of the series’ debut, was for a hospital based system that had hired the same person from a funeral home that used to provide patient transportation to run the hospital ambulance so there wasn’t much difference in the level of care. He recalls this man taking blood pressure cuffs and other medical equipment off the ambulances and telling the EMT’s, “Y’all quit playing doctors. Just load them up and drive fast. Quit wasting time taking blood pressures.” It was also not uncommon to hear fire fighters at that time balk that they were trained to fight fires, not deliver babies.
Firefighters weren’t the only ones unhappy with their situation. Dr. Stewart wasn’t thrilled that the consultant role for the television show had been thrust upon him. However, the university had a contract to give medical advice to various medical shows at the time and they made this among Dr. Stewart’s duties. He had come to the University of Southern California to do a residency in Emergency Medicine after practicing family medicine at a 14-bed hospital on rural Cape Breton Island in Neil’s Harbor, Nova Scotia, where he also made house calls.
Within a year of beginning the residency, Dr. Stewart had become medical director of Los Angeles counties’ paramedic training institute, which put him at the center of their rapidly developing program. By day he was busy trying to finish his residency and do research. The only time he was available to be in the streets with the film crew was at night.
“I would spend all of my spare time trying to understand what these paramedics needed to know because there were no textbooks at the time. I had to write one myself and it was really very hard to keep up the pace,” he said.
Worst of all, in his estimation, was that his consulting role also included answering medical fan mail, a task Dr. Stewart described as, “terrible.”
“I quit doing it when I got one note written in pencil from someone in the Midwest saying, ‘I saved my granny from death with that CPR stuff I saw on Emergency! But there was one problem, she kept getting up,’” he says, laughing.
The role did have its upsides, Dr. Stewart would soon learn. One was working with Producer Bob Cinader, a man Dr. Stewart describes as an occasionally brusque but brilliant Hollywood producer who also happened to be crazy about fire engines and loved listening to bagpipe music. “I happen to be a piper,” Dr. Stewart says. “So we got along very nicely and ultimately became quite close. We all thought a lot of him.”
Cinader, who died in 1982, would take Dr. Stewart to bagpipe concerts and encourage the show’s stars, Randy Mantooth, who played Johnny Gage, and Kevin Tighe, who played Roy Desoto to join them. They all had fun and became friends; Dr. Stewart still keeps in touch with the actors and several others from the series.
Dr. Stewart used to downplay the show, thinking it wasn’t really doing anything of value. They couldn’t show blood. They couldn’t show a patient dying. And at that time, in real life, it wasn’t legal for paramedics to run IVs or defibrillate, so in the very early days of the program when a call came in from the dispatcher, the paramedics got on the truck and would have to pick up the coronary care nurse at the hospital to respond to someone having a heart attack. “With that system in the unwitnessed cardiac arrest and without citizen CPR, the survival rate would be zero,” Dr. Stewart says. “All of that changed with legislation.”
That system didn’t last long, however. Bob Cinader influenced one of the county supervisors who became very involved with the program. That supervisor was friends with then California Governor Ronald Reagan, who he convinced to pass a bill into law allowing paramedics to perform medical tasks including defibrillation and IV starts. Improvements in legislation meant medications got to patients more quickly and survival rates dramatically improved.
“It became very humbling,” Dr. Stewart says, “because I couldn’t see how we could affect any change without this happening. I was a very minor player in something that became a very major thing.”
Rick Murray credits the series with inspiring him to become a paramedic, saying that watching “Emergency!” made him realize just how unprepared he was as a young volunteer fire fighter riding in an ambulance. “When I saw the show, I thought, ‘Those paramedics are like mini-doctors. They’ve got all of the right equipment and training.’”
Murray hoped life could somehow imitate Hollywood in this respect. Ultimately, through his work as a paramedic officer for a fire department, and then working with his state’s health department and later with ACEP for 25 years, he had the opportunity to help make that happen. “Emergency!” had inspired him and the timing had been perfect. He says, “I was very fortunate to have been in the right place at the right time in the early years of EMS.”
Renée Bacher is a freelance medical writer located Baton Rouge, Louisiana.