PITTSBURGH, Pa. — John Moon stands on the 2000 block of Centre Avenue in Pittsburgh's Hill District. He's in front of a building that houses the Hill District Federal Credit Union, but he points to a plaque affixed to the stone façade commemorating the Freedom House ambulance service, widely acknowledged as the first paramedic program in the United States.

A half-century ago, Moon was a Freedom House paramedic, and he remains fiercely proud of it: The service, staffed overwhelmingly by Black men from the neighborhood, revolutionized emergency street medicine on the same blocks where many were underemployed, or even believed to be "unemployable."

"We were considered the least likely to succeed by society's standards," said Moon, who was 22 and a hospital orderly when he started training to join Freedom House. "But one problem I noticed is, no one told us that!"

Today, however, Moon worries that Freedom House is in danger of being forgotten – a victim not just of time, but of the deliberate erasure of its memory.

"Unfortunately, today there are probably people who live here that has never heard of Freedom House ambulance service," he said.

A new book could help.

Their story is committed to the page

"American Sirens" (Hachette Books), by Kevin Hazzard, tells the story of Freedom House, which operated from 1967-75, its historic accomplishments, and its unjust and untimely demise.

Moon, himself, plays a central role. He spent much of his childhood in an Atlanta orphanage before relatives living in the Hill adopted him. As an orderly at Oakland's Montefiore Hospital, he was astonished one night when two Black men entered with a patient on a stretcher, giving orders and clearly in command – a nearly unimaginable thing in those days. Moon learned they were from Freedom House, and he vowed to follow in their footsteps.

Hazzard sketches other key characters. One is Peter Safar, the storied Viennese-born anesthesiologist and Holocaust survivor who invented cardiopulmonary resuscitation, or CPR, in the 1950s, while working in Baltimore. Safar was also interested in emergency street medicine at a time when ambulances were driven by police, volunteer firefighters or even mortuary workers with little to no medical training. For victims of car crashes, heart attacks and gunshots, there was no on-site treatment, only an imperative to get them to the hospital as quickly as possible. Mortality rates were high. In the 1960s, working at Pittsburgh's Presbyterian Hospital, Safar developed a plan to do emergency street medicine, but he had no means to implement it.

Enter Philip Hallen, a former ambulance driver who was now president of the Maurice Falk Medical Fund, a local foundation. Hallen also saw the need for street medicine, especially in the Hill, which was medically underserved. He reached out to James McCoy Jr., a Hill-based entrepreneur who ran a job-training program called Freedom House Enterprises. After connecting with Safar, the men took the unusual step of recruiting their first class of "paramedics" – a job that, technically, did not yet exist – from the Hill itself.

"So, what you end up with was, you know, a number of guys maybe who were fresh back from Vietnam. A number of guys maybe who were fresh out of prison. A number of guys who were in-between jobs, because literally they're picking people up who they see kind of wandering the streets," said Hazzard, an Atlanta-based writer and former paramedic.

The rigorous training paid off, Hazzard writes: Serving just the Hill and Oakland at first, Freedom House saved lives that would have been lost before. Tour the Hill today with Moon, for instance, and stops will include the site of his first call for a heroin overdose, as well as the story of how he became, he believes, the first paramedic to intubate a patient in the field. The latter story involves another key figure in the book, Nancy Caroline, a doctor who in later years was Freedom House's medical director.

Doctors speak of Freedom House's success

"They were the first true paramedic program in the world," said Ronald Stewart, a Canadian expert in emergency medicine who was medical director for Pittsburgh's Public Safety department in the 1970s and '80s.

"It just amazes me, the quality of the program they were able to develop," said Jon Krohmer, a Michigan-based expert in emergency medicine and a board member of the National EMS Museum.

One intangible impact of Freedom House was the community pride it generated: Highly trained technicians – dozens of them, over the years — were saving lives in their own neighborhood, which was often ignored by the rest of the city.

"Often times, when a person would call for assistance, they would say, 'Don't send the police, send Freedom House,' " said Moon.

The flip side: Hazzard recounts that some white patients refused treatment by Freedom House, even though their lives might have been at stake.

Freedom House operated under a city contract – meaning that for years, the Hill had better emergency care than the rest of the city, where ambulances were still driven by police. But, in fact, emergency medicine was in the midst of a revolution sparked in part by "Accidental Death and Disability: The Neglected Disease of Modern Society," a 1966 report by the National Academies of Sciences/National Research Council. In this atmosphere, Freedom House's influence spread nationally, too. Under a contract from the U.S. Department of Transportation, Freedom House director Dr. Caroline wrote the first national curricula on emergency street medicine.

Saving lives gets in the way

But despite such successes, in "American Sirens," Hazzard writes, a new Pittsburgh mayor, Pete Flaherty, began to withhold support from Freedom House. At least one issue was racism: The overwhelmingly white police force saw the work of the overwhelmingly Black paramedics as an incursion onto their turf.

"There are many within Freedom House who eventually came to the conclusion that, you know, the problems that we're having with City Hall are not what we're doing, but rather who's doing it," said Hazzard.

Funding cuts were followed, in 1975, by the absorption of Freedom House into a new citywide EMS department. Many Freedom House paramedics stayed on, but most say they were treated poorly, their years of experience discounted. John Moon recalls being forced to "ride as the third person on a two-person crew."

"I endured a concerted effort to eliminate as many, if not all, of Freedom House employees as humanly possible, and it was very, very successful," he said.

But Moon himself persisted: In 2009, he retired as assistant chief of the department. These days, he is one of the main advocates for keeping the memory of Freedom House alive.

Savoring their memory

Public remembrances include the plaque on Centre Avenue (which was the headquarters of Jim McCoy's Freedom House Enterprises), and another on the site of UPMC Presbyterian, where the Freedom House ambulance service actually operated (though the original building is gone). Heinz History Center also houses a Freedom House display as part of its permanent exhibit "Pittsburgh: A Tradition of Innovation."

Moon hopes "American Sirens" helps spread the word. But in any case, Freedom House lives on in his heart.

"I owe Freedom House a debt that I don't think I will ever be able to repay," he said, "because they're the ones that instilled that motivation and that drive into me that I could do something no matter what it is, no matter what the hurdle, no matter what the barrier."