In this era when terrorism and disasters are very real threats to all of us, we have a new awareness and appreciation for the services provided by emergency medical service (EMS) personnel. Yet for more than 40 years, EMS personnel have toiled diligently to take care of people in their hour of need. One patient at a time, these unsung heroes have placed the interests of others before their own and saved countless lives.

Life and Death on the Streets by Joseph Clark is a testament to the challenges that EMS personnel everywhere face daily. Whether they are assisting a patient who is having difficulty breathing, treating someone’s pain, or merely providing safe transport to the hospital for a psychotic patient, they must always be prepared to help the next person for whom they are summoned. They do this willingly and seldom with any accolades.

Despite the personal rewards that EMS personnel often receive from all of this, their jobs exact an emotional toll—a big one. There is an emotional strain that is often overlooked and rarely discussed for fear that this would be perceived as weakness. Life and Death on the Streets is more than a collection of experiences. It’s more than an accumulation of intense life events that most of us will never encounter. It is a daring and open debriefing session, a necessary unburdening of an emotional weight that would crush most of us.

This book’s bold approach reaches a balance that many books attempt, but few achieve. It is frightening yet humorous, disheartening yet inspirational. These are just a few of the emotions in the complex mix that our EMS personnel are expected to manage every day. Joe Clark was no exception. Now, his shared experiences offer us a peek into the nonstop challenges of this job. His delivery is natural, genuine, and brutally honest.

Prepare yourself for a roller coaster ride of emotions as you enter a world of psychological stress and physical challenge. Some people, such as EMS personnel, will find it liberating to share “war stories” and (finally) openly confess the emotional strain that they, as heroes, have endured for so long. But everyone can learn from the experiences recorded in these pages.

Todd Crocco, MD
Chair, Department of Emergency Medicine
West Virginia University
Morgantown, WV