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A Career of Firsts: Meet New Hampshire Paramedic Sandy Hillsgrove

It was early 1984, and the Concord (N.H.) Fire Department was looking to hire paramedics. Sandy Hillsgrove heard of the opportunity from a classmate at New Hampshire Technical Institute (NHTI). She’d done some ride time with the department and had once had a memorable altercation there with a colleague.

He was smoking and thought it would be funny to blow smoke in her face. Disgusted by his crudeness, Hillsgrove grabbed him by the front of his shirt and told him, “If you ever do that again, I will take that cigarette and shove it up your ass.” He took a couple of steps back, mouth hanging. His cohorts from work and Hillsgrove’s classmates stood with mouths agape. A moment passed, then in unison: “Way to go, Sandy!”

Hillsgrove was offered a firefighter position and became the first professional female firefighter in the state of New Hampshire. But that was hardly the only first in her historic career. She’d begun working as an EMT nearly a decade earlier and later became the state’s first female paramedic.

Hillsgrove grew up in rural New Hampshire, where her Lithuanian grandparents instilled in her a strong sense of helping others. After seeing an early episode of Emergency!, she told her husband that’s what she was going to do—be a firefighter/paramedic. (She had already nixed the nursing route after learning of bedpan duty.)

In 1975 she got her EMT and joined the Loudon Fire Department as a first responder. During this period there was a collaborative effort by NHTI, Concord Fire, and Concord Hospital to establish a grant-funded associate degree paramedic program at NHTI. Hillsgrove applied for the 1978–79 academic year. On graduating she became the first female paramedic in New Hampshire, holding state license No. 15.

After graduating Hillsgrove went to work for Globe Manufacturing, a purveyor of firefighter bunker gear. She also applied at Frisbie Memorial Hospital in Rochester. Frisbie was creating a hospital-based ambulance service to be dispatched out of its emergency room. Medical director Patrick Lanzetta, MD, hired her at the interview, and she became the hospital’s first paramedic. 

Choose Wisely

Such accomplishments didn’t do much to facilitate an entry into the fire service. There Hillsgrove was the only female at recruit school and had some difficulties. One other recruit in particular kept voicing his displeasure at the idea of women in the fire service. Then, during a rappelling training, he got in trouble and was hanging upside-down. Hillsgrove asked the instructor if she could go down and get him straightened out. The instructor, who’d seen what was going on during class, said yes.

Rappelling down to the stranded recruit, Hillsgrove said, “Well, I guess I found your weakness, huh?” Panicked, he screamed, “Get me out of here!” Hillsgrove did just that, getting him upright and untangled and gently lowering him to the ground. He changed his tune about women in the fire service after that. 

Hillsgrove started her one-year probationary period at Central Station on Rescue 1. One of her first paramedic calls was for difficulty breathing. The patient was in fulminant pulmonary edema, with the classic frothy pink sputum. There were no standing orders at that time; medical control had to be called for all procedures and medication requests. Hillsgrove’s requests for medications were denied. The paramedic lieutenant on the call also tried, but orders were denied again. After a third paramedic was denied, the patient was rapidly transported to the ER amid fears he would code. On arrival the doctor met them at the door and could tell they were all furious with him. When he saw the patient, he immediately ordered exactly what Hillsgrove and her colleagues had requested. After the incident the doctor came to Hillsgrove and told her he would never deny her an order again. The patient survived, and the doctor kept his work. 

Shortly after that Hillsgrove had her first fire—a house fire with smoke pouring out the windows but no significant fire showing. She was sent to the second floor with her partner. It was awfully hot going up the stairs. On instructions from her lieutenant, Hillsgrove was to pull the ceiling down. She drove her pike pole upward and pulled. The whole ceiling came down on her and her partner. Her lieutenant pulled her free and got her outside to safety. One of the other firefighters told her she had nothing to prove, and he knew of some men who would have quit on the spot.

Later Hillsgrove arrived home to find her oldest daughter furious with her. Her family had heard her crew dispatched and the ensuing ceiling collapse and rescue. They were worried something had happened to her. Lesson learned: Call home and check in after difficult calls. 

Hillsgrove has two daughters, Daryl and Dawn. Dawn remembers being 5 or 6 when her mother went into the fire service. They were a single-parent family, but with strong support from the grandparents, there were no noticeable changes in their lives. 

“She was good at her job and didn’t expect any breaks because she was a female,” says Daryl. “Mom worked hard for what she got, including her education. She earned the respect of her peers by being honest and straightforward.”

Hillsgrove rose through the ranks to battalion chief. She was involved in improvements with dispatch, incident critiques, and major events. In 1985 she attended the first Women in the Fire Service conference. It was an eye-opener, as she met female firefighters from all over the country. Hearing so many stories of harassment, discrimination, and lives threatened, she also realized how fortunate she was to be at Concord. The keynote speaker that year said something that’s stuck with Hillsgrove ever since: “Ladies, you will need to pick and choose your battles wisely, because you won’t have the energy to fight them all.” That became her mantra in the fire service. 

‘Aren’t I Worth It?’

Hillsgrove had one more promotion to go: division commander. During those discussions, however, it became evident that she would be paid significantly less money than the other candidate. The personnel director said, “Well, we can’t pay you both $10,000 more a year.” Hillsgrove responded, “Why not? Aren’t I worth it?”

The other candidate made more money than her as battalion chief, which wasn’t a problem—he had more time and was a couple of steps higher in the pay grade. But division commander was a new position, and Hillsgrove more than met all the criteria in the posting. Her argument was that because she had all the educational requirements, they should be starting at the same point in the labor grade established for this position. 

Once the probationary period was over, her colleague was concerned about where they would be placed on the step scale. His concern was that they wouldn’t be earning any overtime and would actually be taking a pay cut if they didn’t get a salary level that would make up for that loss. They both refused to accept the positions in an acting capacity because the administration could have kept them there indefinitely, and they would no longer have fallen under the officers’ union contract.

The personnel director told Hillsgrove, “Well, I suppose you are going to go to the EEOC.” She fired back, “Now that you mention it, that’s a good idea.” This was a battle she was choosing to fight.

She called the Equal Employment Opportunity Commission later that day, explained the situation, and was told she could have a case against the city unless there were other stipulations in the job posting, such as credit for military time, that the other candidate had but she didn’t. Hillsgrove advised the chief of her conversation with EEOC. A few days later the chief called to say she’d be starting at the same salary as the other candidate—would she accept the position? Not until the other issues with the grade step were resolved to both candidates’ satisfaction, she told him. Ultimately the pay issue was resolved, and both candidates moved up to division commander.

Hillsgrove later turned down the chance to be chief of the department. She had a 20-year plan and was at her 20—it was time to retire and enjoy life.

Read more about Hillsgrove and her career at

Mike Kennard, EMT-P, I/C, has been in EMS for more than 41 years. He is a retired paramedic from Frisbie Memorial Hospital in Rochester, N.H.; a retired assistant chief from Nottingham (N.H.) Fire and Rescue; and a part-time instructor for Granite State EMS. He is an avid bicycle rider in support of the National EMS Memorial Bike Ride. He has started a nonprofit, Grumpy K’s Workshop, to fix old and discarded bicycles, sell them online, and donate the proceeds to cancer charities. Contact Mike at


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