Presents a unique view of social problems and conflicts over urban
space from the cab of an ambulance.
While we imagine ambulances as a site for critical care, the reality is
far more complicated. Social problems, like homelessness, substance
abuse, and the health consequences of poverty, are encountered every day
by Emergency Medical Services (EMS) workers. Written from the lens of a
sociologist who speaks with the fluency of a former Emergency Medical
Technician (EMT), Medicine at the Margins delves deeply into the world
of EMTs and paramedics in American cities, an understudied element of
our health care system.
Like the public hospital, the EMS system is a key but misunderstood part
of our system of last resort. Medicine at the Margins presents a
unique prism through which urban social problems, the health care
system, and the struggling social safety net refract and intersect in
largely unseen ways. Author Christopher Prener examines the forms of
marginality that capture the reality of urban EMS work and showcases the
unique view EMS providers have of American urban life. The rise of
neighborhood stigma and the consequences it holds for patients who are
assumed by providers to be malingering is critical for understanding not
just the phenomenon of non- or sub-acute patient calls but also why they
matter for all patients. This sense of marginality is a defining feature
of the experience of EMS work and is a statement about the patient
population whom urban EMS providers care for daily. Prener argues that
the pre-hospital health care system needs to embrace its role in the
social safety net and how EMSs' future is in community practice of
paramedicine, a port of a broader mandate of pre-hospital health care.
By leaning into this work, EMS providers are uniquely positioned to
deliver on the promise of community medicine.
At a time when we are considering how to rely less on policing, the EMS
system is already tasked with treating many of the social problems we
think would benefit from less involvement with law involvement.
Medicine at the Margins underscores why the EMS system is so necessary
and the ways in which it can be expanded.
