It was the earliest days of EMS, five decades ago, and in Oregon the work of Dr. Leonard Rose and the Oregon Coronary Ambulance Project had come to the attention of leaders in Washington. The Department of Defense asked for information on the duties of the ambulance attendants being trained under the project to bring emergency care to cardiac patients in the field. That training included new interventions such as defibrillation, intubation, and IV administration.
It was Decoration Day weekend, offices closed. Rose dictated a response to the DoD’s inquiry as his wife, Beatrice, typed.
Bea Rose was also a physician—George Washington med school, class of 1946—and had fallen into participation in the pioneering EMS project after a fall on vacation.
“Leonard had taken me to Hawaii, and I’d fallen and hurt my leg—I had to be hospitalized and flown back to the mainland,” recalls Bea, who turns 105 this month and lives in a San Diego retirement community (Leonard passed in 2005). “I was convalescing, and Leonard had just started this project. And so he let me watch as he taught the ambulance attendants. He taught, and I took notes and typed up what he’d said—I was sort of preparing a written curriculum for him.”
It struck Bea that ambulance attendants was a bit of a lacking term, given the gravity of the care they’d be providing (and edgy reputation some had developed).
“I said to my husband, ‘We have to change that name. Those boys won’t get any respect!’” she says. “I knew ambulance attendants were known to be fast boys—reckless drivers with no medical knowledge at all.
“He said, ‘Well, what should we call them? I said, ‘Well, you’re teaching them techniques, so they’re technicians.’ And he said, ‘That sounds pretty good. But doesn’t it need to be more specific?’ And I said, ‘Yes, they’re medical technicians!’
“He said, ‘That sounds even better. And because they’re working two at a time at emergencies, why don’t we call them emergency medical technicians?’ I said that was a great idea. So that’s what we put in our report, and the next thing we knew, that’s what the DoD called them: emergency medical technicians.”
That may well be the origin of the term still used today—additional research hasn’t located any earlier references.
That's 'Doctor' to You
Beatrice Rose assisted on a number of her husband’s projects but was a woman of formidable accomplishments of her own. She was the first woman named to the Oregon Board of Health and the first female delegate of the Oregon State Medical Society and the first recipient of the Multnomah County Medical Society’s Award for Service to Public Health.
In her med school class of 82, she was one of four women. “Even some of the professors were sometimes pretty nasty to us,” she says.
Bea met Leonard soon after med school at a pathology conference. An intern friend had invited her. She was tired and didn’t want to go, but “my mother put a guilt trip on me,” Rose recalls. “She told me I’d never get better unless I was really interested, so please go!”
She went. When her friend introduced them, Leonard offered his hand and a polite “How do you do, Miss Carter?”
“I had just gotten my degree, and that kind of ticked me off,” Bea says, laughing. “So I said, ‘Dr. Carter to you—I worked just as hard as you did for my degree!’ And that’s how our courtship started.”
The Oregon Coronary Ambulance Project occurred more than two decades later, so both Roses were well established in their careers. As Leonard pushed it forward, Bea was pursuing her master’s in public health at the University of Washington, where evaluated her husband’s work for her thesis.
“One of our major concerns was that now that the trainees had a very distinctive and dignified label, they needed to live up to that label,” she recalls. “We set out rules of behavior—how they would conduct themselves, when and where they would institute CPR, when and where they would need to take someone to the hospital—in order to make them not only competent but ethical and effective in their behavior.”
It was important that these new providers earn respect—while the doctors were excited about them, Bea remembers, others in healthcare feared intrusion onto their turf.
That consideration shaped the selection of Buck Ambulance to carry out the project. It was one of multiple services in Portland at the time but was family-owned, well-regarded, and had a history of innovation. Its vehicles had carried oxygen since 1943 and two-way radios since 1948. “Fortunately we had a lot of intelligent young men to work with,” Bea says. “They were very good.”
“We didn’t even think about women at first,” Bea laughs. “It was 1970, and women just didn’t do that! But I was happy when they came in. I thought they needed a chance to be there. After all, we were training women to be nurse practitioners, and they would have been physician assistants except that all the men coming back from the wars picked up on what they were doing and they began to proselytize to be called physician assistants.”
Five decades later, time and experience have proven right the Roses and other early EMS pioneers who thought interventions brought to the streets could save more lives. And while their pay and respect levels may not always suggest it, the emergency medical technicians of all levels who deliver them still reflect the levels of quality education, sophisticated performance, and tight professionalism the physician couple who initially used the term hoped for.
Says Bea: “One of the things Leonard and I enjoyed over the years, and I still do, is when we see EMTs performing, we see the dignified, competent way they function. They’re still functioning with that professionalism, and that makes me very happy.”