Skip to main content
University of California Press

About the Book

What is the role of the ambulance in the American city? The prevailing narrative provides a rather simple answer: saving and transporting the critically ill and injured. This is not an incorrect description, but it is incomplete.

Drawing on field observations, medical records, and his own experience as a novice emergency medical technician, sociologist Josh Seim reimagines paramedicine as a frontline institution for governing urban suffering. Bandage, Sort, and Hustle argues that the ambulance is part of a fragmented regime that is focused more on neutralizing hardships (which are disproportionately carried by poor people and people of color) than on eradicating the root causes of agony. Whether by compressing lifeless chests on the streets or by transporting the publicly intoxicated into the hospital, ambulance crews tend to handle suffering bodies near the bottom of the polarized metropolis. 

Seim illustrates how this work puts crews in recurrent, and sometimes tense, contact with the emergency department nurses and police officers who share their clientele. These street-level relations, however, cannot be understood without considering the bureaucratic and capitalistic forces that control and coordinate ambulance labor from above. Beyond the ambulance, this book motivates a labor-centric model for understanding the frontline governance of down-and-out populations. 

About the Author

Josh Seim is Assistant Professor of Sociology at Boston College.

From Our Blog

UC Press May Award Winners

UC Press is proud to publish award-winning authors and books across many disciplines. Bel
Read More

Attend ASA 2022 Book Forums

This year’s American Sociological Association conference is back and in-person in Los Ang
Read More

Ambulance Crews on the Front Lines of Urban Suffering

This blog post originally appeared on the USC Equity Research Institute blog, and it is r
Read More

Table of Contents

List of Illustrations
Preface
Author’s Note
Acknowledgments

Introduction

PART I BANDAGING BODIES: INSIDE THE AMBULANCE
1. People Work
2. Ditch Doctors and Taxi Drivers
3. Feeling the Ambulance

PART II SORTING BODIES: THE AMBULANCE BETWEEN HOSPITALS AND SQUAD CARS
4. The Fix-Up Workers
5. The Cleanup Workers
6. Burden Shuffling

PART III HUSTING BODIES: THE AMBULANCE UNDERNEATH BUREAUCRACY AND CAPITAL
7. The Barn
8. Supervision
9. Payback
Conclusion

Appendix: Notes on Data and Methods
Notes
Reference List
Index

Reviews

"Stunning analysis of the Emergency Medical System (EMS), its frontline workers, and patients . . . . A great source for highlighting how well-intentioned labor processes within seemingly benevolent occupations can further marginalize people and reproduce social inequalities."

British Medical Journal, Medical Humanities
"An exemplar of a kind of ethnographic work that reinvigorates the sociological imagination, connecting the deeply felt personal troubles of patients and the daily joys and frustrations of ambulance crews with the stratification of suffering in urban America."
Symbolic Interaction

“This hard-hitting ethnography takes readers into the working world of ambulance crews, painting a sharp portrait of those charged with picking up the bodies left to writhe in America’s gutters. Weaving fresh theoretical insights with firsthand experience, Josh Seim offers an exciting new lens for understanding urban governance, labor, and inequality.”—Forrest Stuart, author of Down, Out, and Under Arrest: Policing and Everyday Life in Skid Row

“An excellent ethnography focusing on the literal blood, sweat, tears, and neoliberal dollars and cents of the for-profit medical mismanagement of urban poverty and social suffering in the contemporary US city.”—Philippe Bourgois, coauthor of Righteous Dopefiend and author of In Search of Respect: Selling Crack in El Barrio

“A clear and compelling analysis of the role of ambulance care in bandaging the wounds of an unequal society. Seim’s observant-participation as an EMT and ethnographer affords him a clear vantage on the ways that first responders cope with and manage the extraordinary and everyday violence of urban suffering. Gritty and insightful.”—Carolyn Sufrin, author of Jailcare: Finding the Safety Net for Women behind Bars

“A timely investigation into the role that ambulances play in the lives of the most desperate among us. What starts as a study of the American city as seen through the windshield of an ambulance becomes a personal journey when Seim hops into the driver’s seat himself. If you want to know what’s really happening on our streets, then read this book.”—Kevin Hazzard, author of A Thousand Naked Strangers: A Paramedic’s Wild Ride to the Edge and Back

Awards

  • Max Weber Book Award 2023 2023, ASA Section on Occupations, Organizations, and Work

Media

Q&A with Josh Seim: behind the scenes of ambulance work