Into the Breach: A Year of Life and Death with EMS Hardcover –

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From Booklist

Karam brings her skills as a journalist and her insider knowledge as an emergency medical technician (EMT) to this compelling look at one year in the operation of the Emergency Medical Service teams in Newark, New Jersey. The gritty urban environment presents a range of crises from gang shootings to crack-house mothers in labor, from a senseless bureaucracy to the lack of adequate equipment. Karam takes the reader along on emergency calls, detailing human dramas of violence and disorder that require a heroic response. Karam also recounts the physical and emotional demands on EMT workers, who are sometimes traumatized by their work, tend to develop an insularity that negatively affects their family relationships, and use humor to ease the tension. She details how EMT training and operations have evolved, the increasing pressure to respond to the crises wrought by the mayhem of modern urban life, and how the lack of adequate social services translates into medical emergencies. A fascinating book that tracks how urban social trends affect medical issues. Vanessa Bush
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This book exposes the reality of EMS in a clear and engaging way. It's worth reading if only for the the fascinating decon operation on 9/11 in the last chapter, but the rest of it is important, too. Too often, EMS is the forgotten segment of the public safety sector- everyone knows about police officers and firefighters, but most people don't even know the proper term for EMTs (no, we are not paramedics!). Everyone should read this book, just to understand what's happening inside those big, shiny boxes with the flashing lights.

About the Author

After witnessing a car hit a bicyclist and going to the victim's aid without real knowledge of how to help, Jana Karam took a community first-aid class and became an emergency medical technician. The bicyclist's near brush with death inspired her to leave her business career behind in favor of reporting and writing, a passion she has had since childhood. She earned her M.S. in journalism from Columbia University. Into the Breach is her first book. She lives with her family in Morris Township, New Jersey.


Into the Breach is the true story of paramedics, emergency medical technicians, and heavy-rescue specialists fighting to control trauma and medical emergencies in one of America's toughest and most violent cities: Newark, New Jersey. A riveting account that hauls readers on a first-hand tour of street medicine today, Into the Breach shows what really happens inside an ambulance and some of the diverse and bizarre places EMS workers tread.

Through authentic accounts, every facet of emergency care is on display-from the first 911 call to patient discharge or death, including an exclusive look at what is perhaps the biggest decontamination operation ever conducted, which crews performed for victims of the September 11, 2001 terrorist attack.

A hybrid profession that blends public safety and public health, EMS attracts careerists and volunteers from all sectors of society-from Boy Scouts and housewives to Fortune 500 vice presidents and work-fare recipients. The men and women that make up the Newark EMS graveyard shift, one of the busiest, full-time teams in the nation, are quintessential EMS workers: intense, irreverent, hard-working action junkies who crave autonomy and the instant gratification of solving critical problems in real-time. This unflinching profile hones in on award-winning EMS workers as well as those who pollute the industry, ironically, sometimes one and the same.

Into the Breach offers an unusual opportunity to bear witness to unimaginable suffering, heroic stoicism, and the inventiveness of American EMS workers fighting to save lives.

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