Nancy Caroline, MD (1944-2002)
Dr. Caroline was one of the first physicians to understand that non-physicians could perform emergency skills traditionally relegated solely to docs. She was mentored by early EMS pioneer, Dr. Peter Safar, and became involved in one of the first paramedic education projects in the United States: training members of the pioneering Freedom House Enterprises Ambulance Service in the Pittsburgh area.
During the late 1970s, spurred by the fact that paramedics had to utilize nursing or medical textbooks that did not take into account EMS’ unique working environments, she authored the now-revered original paramedic textbook, Emergency Care in the Streets. For a decade her book was the only resource available for paramedic care.
Dr. Caroline followed her efforts in the U.S. with work overseas in Israel as the first medical director of Magen David Adom, Israel’s Red Cross equivalent. There she developed a training program that enabled emergency workers to respond to terrorist attacks within minutes. Until the end of her life, Dr. Caroline continued to write books for EMS education, and her first textbook, now in its sixth revision, remains well-known by EMS educators and is venerated by the many paramedics who began their careers through her words.
Obituary: Dr. Nancy Caroline / A leader in preparing non-physicians to provide emergency medical care
Saturday, December 21, 2002
By Anita Srikameswaran, Post-Gazette Staff Writer
A doctor who trained Pittsburgh paramedics in the mid-1970s, and who colleagues later would call “Israel’s Mother Teresa” for her pioneering work with paramedics and in resuscitation and palliative medicine, died of cancer Dec. 12.
Dr. Nancy Caroline was 58. She was buried in Boston, where she grew up.
Dr. Caroline attended Radcliffe College and got her medical degree from Case Western Reserve University in Ohio. In 1973, she came to the University of Pittsburgh for training in critical care medicine under the mentorship of Dr. Peter Safar, renowned for his work in emergency medicine and cardiopulmonary resuscitation.
Safar initiated the Freedom House project, in which people from the Hill District were trained to be ambulance attendants. He delegated much of the work to Dr. Caroline, asking her to teach them to become paramedics. The program was very successful. Among other books, she wrote “Emergency Care in the Streets,” a textbook that was the first and, for a decade, only resource for paramedic care. It is currently in its fifth printing.
“One reason for her great impact was the fact that she is a caring, dynamic, compassionate ‘super doctor,’ a Renaissance woman and an eloquent writer,” said Safar in his 2000 memoir. “The [Freedom House] program gave Caroline the opportunity to demonstrate her exceptional skills in laying hands on victims in emergencies outside the hospital.”
After leaving Pittsburgh in 1976, she became an Israeli citizen and medical director of its organization Magen David Adom, which was responsible for ambulance services throughout the country. Her former assistant, Yehudit Avior, told the Jerusalem Post that at that time, the organization had only basic equipment and ambulances.
“She insisted that mobile intensive care units were needed for serious cases and that every ambulance had to reach the patient within three minutes,” he recalled. “MDA medics thought she was crazy.”
Dr. Caroline then spent five years in East Africa, flying around as a “bush doctor” and again teaching non-physicians to provide medical services. When she returned to Israel, she set up the nonprofit Hospice of Upper Galilee, which delivered end-of-life care to cancer patients. The hospice was taking care of her when she died of multiple myeloma at home in Metulla.
She had maintained her status as a visiting professor in Pitt’s anesthesiology and critical care department. In February, a two-year research fellowship was named in her honor.
Dr. Caroline is survived by her husband, Dr. Lazarus Astrachan, formerly of Cleveland; her mother, Zelda Caroline of Boston; and her brother, Peter Caroline of Green Valley, Ariz.