Book Review: From Last Hope to First Aid

Book Review: From Last Hope to First Aid

By Mike Rubin Jan 12, 2017

Did you know first aid used to cause bleeding instead of stopping it? Or that drowning was treated with positive-pressure tobacco smoke administered rectally? These are just two of the many entertaining, sometimes-startling revelations you’ll find in From Last Hope to First Aid, Francesco Adami’s collection of health-related oddities and discoveries.

The Italian author, who was finishing medical school at the University of Pisa while he wrote this book, handles English fairly well. It’s not hard for readers to overlook his use of antiquated terms like pervious or insufflation because the tone of Last Hope is mostly engaging and informal. And the only Italian you need to know is Roman numerals.

Adami is clearly from the James Patterson school of accommodating short attention spans. With 37 chapters spread over only 218 pages, it’s easy to start and stop reading Last Hope without losing track of a story thread or missing anything other than commercials during football season.

Don’t skip the footnotes; although they’re long and sometimes devolve into streams of consciousness, they contain some of the most interesting observations about eccentrics associated with medical marvels.

Take Dracula. His character was based on Romanian prince Vlad Tepes, known to pierce much more than the veins of his enemies with spears rather than overgrown incisors. In “A Very Special Juice,” Adami’s chapter on blood transfusion, we learn Tepes’s dislike of garlic and sensitivity to light were traits writer Bram Stoker attributed to his fictional vampire.

Adami reminds us Stoker wasn’t the only famous author inspired by the medically macabre. Twenty years after Dr. Charles Kite’s 1778 “Essay on the Recovery of the Apparently Dead” encouraged experimentation with “galvanism” (electric current) as a means of resuscitation, Mary Shelley wrote about a mythical doctor named Frankenstein reanimating a monster composed of stolen body parts. Imagine being on that rotation.

Then there was ophthalmologist Karl Koller, known as “Coca Koller” (I’m not making this up) because he was among the first to use liquid cocaine as an anesthetic during 19th-Century surgical procedures. It’s all there in Chapter XXVI: The Invention of the Hypodermic Syringe, along with inadvertent clinical advice from hockey great Wayne Gretzky about missing 100% of the shots you don’t take. Get it?

If you’re thinking Last Hope is a frivolous work, though, you’re wrong. While the book doesn’t cover ultra-sophisticated equipment or procedures, it’s mostly serious about common tools and techniques now favored by front-line medical practitioners of all educational brackets. As we learn how implementation of these inventions involved all sorts of detours around anecdotal quackery and misunderstood science—the 300-kilogram cardiac monitor, for example, or the prescribing of cigarettes for asthma—it’s helpful to maintain not only a sense of humor, but also a Renaissance man’s or woman’s curiosity about philosophy. How else could you reconcile canned whipped cream still being blended with nitrous oxide, or Resusci Anne’s beatific face modeled after some French chick fished out of the Seine? Basta!

Of Adami’s 37 chapters, 29 cover essential elements of EMS. Here are a few:

  • Chapter XVIII—A Lesson from the Battlegrounds: Discovering Shock. “Shock” has been part of medical literature for over 200 years, but it wasn’t until Dr. Alfred Blaylock defined the term as “inadequate tissue perfusion” that everyone associated with emergency care understood the importance of supporting circulation with blood products and vasoactive agents.
  • Chapter XXII—Medicine in the Time of Cholera: Saline and Fluid Transfusions. When a cholera epidemic hit Britain and Scotland in 1831, Drs. William O’Shaughnessy and Thomas Latta tried rehydrating victims with salt solutions – orally at first, then intravenously. The latter became the standard of care for that disease.
  • Chapter XXX—Witchcraft and Cosmetics: The Discovery of Atropine. The best-known source of atropine is the belladonna plant, so named because “beautiful ladies” were made even more so by dilated pupils, a common side effect of the drug. As for “witchcraft,” atropine was prized for its hallucinogenic properties hundreds of years before doctors were using it to treat bradycardia.

From Last Hope to First Aid is a worthwhile, enjoyable read that makes me wonder how many of today’s practices will be considered witchcraft 50 years from now. Order here.

Continue Reading

Mike Rubin is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at

After a driver rammed his van through the popular street of Las Ramblas in Barcelona, 14 people were killed and 100 others were injured.

A similar second attack that occurred in Cambrils, Spain left one woman dead and four others injured. ISIS has claimed responsibility for both attacks. 

For more on this event, click here.

Police are deeming this event a terrorist attack and have urged residents to remain indoors until the scene is safe.
United Hatzalah volunteer, Gary Friedson, was teaching a local EMS crew about shortening response times when they invited him to a call that came in for a boy having seizures on a plane making an emergency landing nearby.
It will pass across the U.S. on August 21—what are the injury risks?
TXA, which helps clot blood faster, will be issued to EMS agencies to keep trauma patients stable on the way to the emergency department.
In 2016, the United States saw a 19 percent increase in drug overdose deaths from 2015, the biggest annual jump in overdose deaths the country has ever seen.
One county reports about 61 doses of naloxone are used by EMTs and paramedics in 30-day spans.
Methods of fighting the heroin epidemic include providing naloxone to all first responders, educational programs held in schools, and the Safe Passage program, which allows addicts to seek help at police stations.
FOUR Score may be an improvement over GCS, but the fact is, they’re just not that useful.
Can paramedics reliably initiate the new CMS core measure bundle?
Staff will be held to strict limitations on prescribing opioid painkillers to patients in efforts to prevent addiction and enabling current addicts.
EMS Director Carlos Coyle is concerned how publicly accessible Narcan is now being used by addicts at "Narc-Me" parties, where one sober friend has Narcan on hand to revive others' potential overdoses as they experiment with various doses of narcotics.
The van ran through a crowd of people dining outside a restaurant, leaving three in critical condition and four others with non life-threatening injuries.
Statistics show a 37% increase in overdose deaths has occurred since 2016.

Cincinnati firefighters and paramedics believe the laws should be changed to involuntarily commit heroin addicts to rehabilitation facilities to break the cycle of addiction.