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Gutter Medicine: Twenty-six Years as a Firefighter Paramedic
"My career as a firefighter/paramedic stretched from 1974 to 2000 when we were inventing EMS as we went along. These are stories from those years on the street. That place I named so long ago, the other reality that exists just outside most people’s everyday lives. It is a place that seems to exist parallel to the normal workaday yet it is only a car accident or cardiac away for any of us. It manifested itself in brushfires, house fires, shootings, stabbings, hangings, accidents with injuries, cardiacs, codes, drownings, and a thousand other emergencies. The street was more than a physical place. It was a place filled with excitement, fear, tragedy, horror, sadness, despair, joy, and laughter. It was a place where routine decisions could have terrible I am going to the grocery store. Or, I will get the wiring fixed next month. Where people died or were maimed. Often, it was terrible place. Or maybe it was reality. It was where all safeguards ended and our job began. There were thousands of cases, but these are the ones etched in my memory. The ones that will never go away." Roger Huder
229 pages, Kindle Edition
Published August 25, 2018
569 people are currently reading
728 people want to read
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Displaying 1 - 30 of 54 reviews
December 22, 2018
One of the good ones
I worked with the author to 18 of his 26 years. I remember many of the stories. I can tell you what he did not....he was not only qualifies to fight death, he treated each patient he encountered with compassion and as a warrior for their survival. It did not matter if it was the 30th patient of the day, Roger treated that patient as if it was his first...like he or she was his own Mother or Father. When he retired, I remember thinking "there goes one of the good ones!*
I worked with the author to 18 of his 26 years. I remember many of the stories. I can tell you what he did not....he was not only qualifies to fight death, he treated each patient he encountered with compassion and as a warrior for their survival. It did not matter if it was the 30th patient of the day, Roger treated that patient as if it was his first...like he or she was his own Mother or Father. When he retired, I remember thinking "there goes one of the good ones!*
November 16, 2018
This review can also be found at Carole's Random Life in Books.
I enjoyed this memoir. I sometimes wish that I would have gone into the medical field but I was still queasy about blood and other bodily fluids as a young adult. Let's just say that I got over that queasiness and enjoy learning about medicine in all of its bloody glory. I found this to be a well done look at being a paramedic that I found entertaining and informative.
Paramedics have been around for as long I can remember. I remember watching Emergency! on TV as a child in the 1970's. We actually caught a few episodes of the show on television not that long ago and I was somewhat surprised by how different things worked for the first responders. For an outsider, gradual changes in a profession aren't really noticed but when you look back it is obvious how far you have come. When Roger Huder started his career as a paramedic, the profession was just beginning and the textbooks had yet to be written.
I found this to be a very thoughtful look at the years that Mr. Huder spent doing this vital job. I did enjoy some of the cases that he talked about that has stuck with him over the years even though many of them are heartbreaking. I felt his frustration in getting the cooperation that he needed from hospital staff and his supervisors during the early years. I was also amazed by some of the dangerous situations that he was put in without a lot of backup. I found the portions of the book where he talked about how his job impacted his home life to also be quite powerful.
This was the first time that I have had the chance to listen to Tom Jordan's narration. I think that he did a fantastic job with this book. He has a very pleasant speaking voice that was easy to listen to for hours at a time. I thought that he was able to bring a lot of emotion into the book and his delivery made the story entertaining. I wouldn't hesitate to listen to his work again in the future.
I would recommend this book to others. I found this to be a book that really stuck with me and made me appreciate all of the first responders that risk so much to help others. I am very glad that I made the decision to give this book a try.
I received a review copy of this audiobook from the author via Audiobook Boom.
Initial Thoughts
I enjoyed this memoir. This is actually the second time I have read this kind of book this year. The first book was more on the gory side where this one was more thoughtful. I liked hearing his thoughts on being a part of a new profession as it was forming but my favorite parts of the book were some of the calls that he remembered from his years of service. Tom Jordan did a great job with the narration.
I enjoyed this memoir. I sometimes wish that I would have gone into the medical field but I was still queasy about blood and other bodily fluids as a young adult. Let's just say that I got over that queasiness and enjoy learning about medicine in all of its bloody glory. I found this to be a well done look at being a paramedic that I found entertaining and informative.
Paramedics have been around for as long I can remember. I remember watching Emergency! on TV as a child in the 1970's. We actually caught a few episodes of the show on television not that long ago and I was somewhat surprised by how different things worked for the first responders. For an outsider, gradual changes in a profession aren't really noticed but when you look back it is obvious how far you have come. When Roger Huder started his career as a paramedic, the profession was just beginning and the textbooks had yet to be written.
I found this to be a very thoughtful look at the years that Mr. Huder spent doing this vital job. I did enjoy some of the cases that he talked about that has stuck with him over the years even though many of them are heartbreaking. I felt his frustration in getting the cooperation that he needed from hospital staff and his supervisors during the early years. I was also amazed by some of the dangerous situations that he was put in without a lot of backup. I found the portions of the book where he talked about how his job impacted his home life to also be quite powerful.
This was the first time that I have had the chance to listen to Tom Jordan's narration. I think that he did a fantastic job with this book. He has a very pleasant speaking voice that was easy to listen to for hours at a time. I thought that he was able to bring a lot of emotion into the book and his delivery made the story entertaining. I wouldn't hesitate to listen to his work again in the future.
I would recommend this book to others. I found this to be a book that really stuck with me and made me appreciate all of the first responders that risk so much to help others. I am very glad that I made the decision to give this book a try.
I received a review copy of this audiobook from the author via Audiobook Boom.
Initial Thoughts
I enjoyed this memoir. This is actually the second time I have read this kind of book this year. The first book was more on the gory side where this one was more thoughtful. I liked hearing his thoughts on being a part of a new profession as it was forming but my favorite parts of the book were some of the calls that he remembered from his years of service. Tom Jordan did a great job with the narration.
November 21, 2022
Gutter Medicine is a memoir written by a paramedic. The author did a great job with this book. The writing style was engaging and easy to follow. Even the medical terminology was easy to understand and follow.
Some of his patient cases were really intriguing. I absolutely love reading medical professional's stories about their interesting patient cases.
the author did add in some personal information / stories, but a good portion of this shorter novel was based around his medical experience, which was great.
This is short in length so even easier to get through and enjoy!
Some of his patient cases were really intriguing. I absolutely love reading medical professional's stories about their interesting patient cases.
the author did add in some personal information / stories, but a good portion of this shorter novel was based around his medical experience, which was great.
This is short in length so even easier to get through and enjoy!
January 31, 2020
Hard book to read, but it gave me a new understanding and appreciation for first responders. Well-written and honest memoir.
March 20, 2025
This was a really great read about the early days in EMS and how it shaped and impacted one provider as he helped create the profession.
October 2, 2025
I absolutely ate this up. This is the paramedic equivalent of Report From Engine Co 82-it’s at the forefront of the profession as it came into being.
It is a little sad. That’s okay.
The -1 star is because it could’ve really used an editor. The typos were glaring but not obtrusive and I was able to move on from it due to the writing style. If it had been fiction it would’ve been a different story.
Also I wish these memoirs had a culminating point or revelation. His does a lot better than Pulse. Maybe it is all about giving your best on the street and leaving the rest out there.
It is a little sad. That’s okay.
The -1 star is because it could’ve really used an editor. The typos were glaring but not obtrusive and I was able to move on from it due to the writing style. If it had been fiction it would’ve been a different story.
Also I wish these memoirs had a culminating point or revelation. His does a lot better than Pulse. Maybe it is all about giving your best on the street and leaving the rest out there.
March 20, 2021
I wasn't sure about this book at first but it progressively gets better and better. It gives great perspective that really helped me appreciate my new career. Will reread.
December 27, 2024
I hope writing this book was cathartic for the author.
For me, it was relatable. Different city. Different types. Yet also so much the same.
This book is pretty much an annotated journal entry of experiences. Collected over years of providing emergency medical and fire service to whomever calls for it… and probably a bunch that didn’t.
Anyway. People in the industry will be able to relate. People outside the industry will probably not understand, even after reading this… but will want to say thanks. And like the author says, it’s not about saying thanks. It’s about living life to the fullest. Especially if you’re one that benefitted from a similar life threatening event and were saved.
For me, it was relatable. Different city. Different types. Yet also so much the same.
This book is pretty much an annotated journal entry of experiences. Collected over years of providing emergency medical and fire service to whomever calls for it… and probably a bunch that didn’t.
Anyway. People in the industry will be able to relate. People outside the industry will probably not understand, even after reading this… but will want to say thanks. And like the author says, it’s not about saying thanks. It’s about living life to the fullest. Especially if you’re one that benefitted from a similar life threatening event and were saved.
February 20, 2019
I have read a number of Dr. books from ER, Surgery etc, some better than others. This is one of the best.. It's not just a recollection of funny or most interesting "runs" (calls), but often from a historical perspective of being one of the guys who became first paramedics in the "70s. At that time the job was in its infancy - making it up as they went along, no standard training, or certification, disliked by nurses who thought they were taking away their jobs. Distrust from Drs that they could perform on the field without them. Mr. Huber gradually brings us up to date to where the word "paramedic" is a household name and a real job.
He also spends a lot of time describing the mental and emotional toll the job takes on all of them, and the way that he coped.
Good read - hard to put down.
He also spends a lot of time describing the mental and emotional toll the job takes on all of them, and the way that he coped.
Good read - hard to put down.
February 8, 2020
As a retired RN who has worked acute care, rehab, long term care, and jails I highly recommend this wakeup call to anyone thinking to enter any intense field that depends on those who are called to it and not just whatever they view as financial gain. I can relate to his nightmares and sense of futility as well as the high from making a positive difference. Excellent book.
When I listened to the audiobook I would often forget that Tom Jordan was not also the author because his presentation is that of one who has been there, done that.
I won this audiobook in a giveaway! I really win!
When I listened to the audiobook I would often forget that Tom Jordan was not also the author because his presentation is that of one who has been there, done that.
I won this audiobook in a giveaway! I really win!
April 28, 2019
This will let you know if EMS or Fire are for you...
After over 15 years in EMS, this book affected me in so many ways...I got the why and I got the near burn out...the job changes you and this book reflects that. If you can read this and still see yourself in his shoes or in my shoes, please make the step. If not, appreciate those who can and do on both the fire and the ambulance sides.
After over 15 years in EMS, this book affected me in so many ways...I got the why and I got the near burn out...the job changes you and this book reflects that. If you can read this and still see yourself in his shoes or in my shoes, please make the step. If not, appreciate those who can and do on both the fire and the ambulance sides.
July 16, 2020
This was one of the best books in the field that I've read. The strength of Huder's writing and understanding comes in the duration of his career. Most EMS/Fire books are from a short-lived career: the arc of newbie to rash adrenaline-junkie to burned out vet, most of whom retire and go to Law or MFA programs. Huder's years in the field, as well as his participation in the earliest stages of paramedic work, make this an invaluable piece of reportage.
August 9, 2020
Interesting. I learned a lot about the fire service and paramedics. My son is a firefighter. This was very enlightening.
December 31, 2020
Gutter Medicine
Roger Huder
.
I was so excited to read this book! Being a paramedic myself, it would be interesting to read a book about how it all started. It seems like the big ego and military mindset and exclusiveness of paramedic already started back in the day. Luckily, mental health is sort of looked after these days, depending for which company you work for. This is not a job you do for money; you will get burned out very quickly. You must love the job, not saving people (it is a big bonus though). If you become a paramedic to save people, you will struggle. Your job is just to try keep people alive till they get proper/long term help in hospital.
.
This book, however, is the story of Roger, a paramedic that worked in the USA back in the day when EMS barely existed. It’s filled with exciting, horrifying, sad, interesting and fascinating stories of patients and the events surrounding the calls he did with limited resources and trust. It’s so easy to compare the book with how it is today (in other words, easy to criticize their methods and treatments and protocols), but you can’t. Roger is from a completely different generation of medics and had to go through a lot as well.
.
What does sit wrong with me is this: he asked a new paramedic to help with a project and the rookie replies: “I need to talk to my union rep first”. He states that my generation of medics are only after money (very stupid profession to go in for money) and only worried about what our contract says (well, these days people get sued for every second thing). Roger got the mindset of an old school medic and this book describes it perfectly. Tough on the outside and in groups of their peers, no one else allowed in, no one understand them. But as you continue to read, you’ll realize that they were also human. They also suffered a lot mentally and only a handful lasted till retirement.
.
A good book to read if you want a picture of EMS – most things still apply today. Paramedics still go to all these types of calls and dangerous situations, just with maybe a police escort or a camera attach to the vest. My generation got different horrors as well – COVID19. EMS workers are tired – physically and mentally. It’s bad out there. Wear a mask, support your health workers, so that more medics reach retirement and write wonderful books to read for the next generation of medics.
.
#bookreview #bookstagram #bookstagramsouthafrica #EMS #paramedic #paramedicbook #guttermedicine #rogerhuder #oldschoolems #bookrecommendation
Roger Huder
.
I was so excited to read this book! Being a paramedic myself, it would be interesting to read a book about how it all started. It seems like the big ego and military mindset and exclusiveness of paramedic already started back in the day. Luckily, mental health is sort of looked after these days, depending for which company you work for. This is not a job you do for money; you will get burned out very quickly. You must love the job, not saving people (it is a big bonus though). If you become a paramedic to save people, you will struggle. Your job is just to try keep people alive till they get proper/long term help in hospital.
.
This book, however, is the story of Roger, a paramedic that worked in the USA back in the day when EMS barely existed. It’s filled with exciting, horrifying, sad, interesting and fascinating stories of patients and the events surrounding the calls he did with limited resources and trust. It’s so easy to compare the book with how it is today (in other words, easy to criticize their methods and treatments and protocols), but you can’t. Roger is from a completely different generation of medics and had to go through a lot as well.
.
What does sit wrong with me is this: he asked a new paramedic to help with a project and the rookie replies: “I need to talk to my union rep first”. He states that my generation of medics are only after money (very stupid profession to go in for money) and only worried about what our contract says (well, these days people get sued for every second thing). Roger got the mindset of an old school medic and this book describes it perfectly. Tough on the outside and in groups of their peers, no one else allowed in, no one understand them. But as you continue to read, you’ll realize that they were also human. They also suffered a lot mentally and only a handful lasted till retirement.
.
A good book to read if you want a picture of EMS – most things still apply today. Paramedics still go to all these types of calls and dangerous situations, just with maybe a police escort or a camera attach to the vest. My generation got different horrors as well – COVID19. EMS workers are tired – physically and mentally. It’s bad out there. Wear a mask, support your health workers, so that more medics reach retirement and write wonderful books to read for the next generation of medics.
.
#bookreview #bookstagram #bookstagramsouthafrica #EMS #paramedic #paramedicbook #guttermedicine #rogerhuder #oldschoolems #bookrecommendation
January 23, 2023
i am the type of person that hates small talk.. don't ask me how i am, or how my day is.. ask me what kept me up last night or why i love the sound of trees breaking.. i will never ask you "what's happening?".. i don't want to here that you are good or fine.. tell me something that you say in your mirror.. i want to be the fly on the wall.. read me a page from your journal.. then - you will have my undivided attention..
that is what this book captured for me.. the stories, the emotions.. a peek inside a day in the life of a paramedic.. normally i am irritated by typos & lack of editing, but in this case, i didn't care.. it seemed to come off even more raw & real..
it seems to sound trivial to call them stories.. i will call them happenings.. they kept my interest.. and it's not just the most shocking or gory happenings.. i like hearing the surrounding details.. what the homes looked like, the smells & moods.. i sometimes take more in when looking at the background of things.. setting up the room for me.. tells me more about a suicide then what a body looked like..
give me the human element any time..
Roger Huder: Thank You!
that is what this book captured for me.. the stories, the emotions.. a peek inside a day in the life of a paramedic.. normally i am irritated by typos & lack of editing, but in this case, i didn't care.. it seemed to come off even more raw & real..
it seems to sound trivial to call them stories.. i will call them happenings.. they kept my interest.. and it's not just the most shocking or gory happenings.. i like hearing the surrounding details.. what the homes looked like, the smells & moods.. i sometimes take more in when looking at the background of things.. setting up the room for me.. tells me more about a suicide then what a body looked like..
give me the human element any time..
Roger Huder: Thank You!
December 13, 2022
This guy has Been There and Done That and got several different patches.
This book is a chronicle of the author's time riding in Orlando in the very begining of EMS. He got his paramedic licensure back in 1977 and got out just after 2000. He helped develop the EMS system into what it is.
Oddly enough, he doesn't write about the process of medicine as much as he explores the emotional side of things. He's gotten to the point that he speaks of " The Street" as a constant companion to the work and the violence, the misery and the horrors. " The Street" always has more to dish out and more to play with.
This book is the clearest case of processing PTSD I've yet seen. People who work with trauma and emergency first responders should read this.
Enough firefighting is sprinkled in there for us knuckle dragging hose eaters that it keeps it lively. I also understand now why some people I know are the way they are. Doesn't excuse it but it helps.
I am so glad we have infectious disease protocols now though.
This book is a chronicle of the author's time riding in Orlando in the very begining of EMS. He got his paramedic licensure back in 1977 and got out just after 2000. He helped develop the EMS system into what it is.
Oddly enough, he doesn't write about the process of medicine as much as he explores the emotional side of things. He's gotten to the point that he speaks of " The Street" as a constant companion to the work and the violence, the misery and the horrors. " The Street" always has more to dish out and more to play with.
This book is the clearest case of processing PTSD I've yet seen. People who work with trauma and emergency first responders should read this.
Enough firefighting is sprinkled in there for us knuckle dragging hose eaters that it keeps it lively. I also understand now why some people I know are the way they are. Doesn't excuse it but it helps.
I am so glad we have infectious disease protocols now though.
April 27, 2022
meh.
I wanted to like this book because it was obviously a very personal memoir, yet I found it to be somehow very impersonal. It was written as though the author was only skimming along the surface of his memories at the same time he tried (unsuccessfully) to provide deep insight into life lessons of “the street”. Secondly, repeatedly using the pronoun “she” to reference the capriciousness of “the street” was really obnoxious. Lastly, there were a number of bizarre editing or proofreading mistakes, which always detract from the quality of a book - a more and more common occurrence in recent times, unfortunately.
I wanted to like this book because it was obviously a very personal memoir, yet I found it to be somehow very impersonal. It was written as though the author was only skimming along the surface of his memories at the same time he tried (unsuccessfully) to provide deep insight into life lessons of “the street”. Secondly, repeatedly using the pronoun “she” to reference the capriciousness of “the street” was really obnoxious. Lastly, there were a number of bizarre editing or proofreading mistakes, which always detract from the quality of a book - a more and more common occurrence in recent times, unfortunately.
January 16, 2025
*Read as an Audiobook*
This was one of the best Fire/EMS books that I have ever read. I've read many books that detail the highs and lows of this field but this author writes in such a way that I found myself saying "he gets it" so many times. This is a sad book and the author doesn't sugar coat that in the slightest and you feel his grief right along with him. There are also a few light hearted moments although admittedly few and far between. It's obvious that this book was written as an outlet for the authors grief and anger. My only real complaint with this book is in the narration. I didn't care for his reading. That said the writing was good enough to overcome that.
This was one of the best Fire/EMS books that I have ever read. I've read many books that detail the highs and lows of this field but this author writes in such a way that I found myself saying "he gets it" so many times. This is a sad book and the author doesn't sugar coat that in the slightest and you feel his grief right along with him. There are also a few light hearted moments although admittedly few and far between. It's obvious that this book was written as an outlet for the authors grief and anger. My only real complaint with this book is in the narration. I didn't care for his reading. That said the writing was good enough to overcome that.
March 3, 2019
MASH Meets Hill Street
Those who follow my "Book Reports" are aware I read widely. This audiobook came highly recommended and I'm going to pass that recommendation on to you. Narrator Tom Jordan "becomes" author Roger Huder as he shares incidents from his life as a paramedic. We take them for granted these days but in the 1970s they were a brand new concept in our frontline of First Defenders. So sit down, crack a beer, and share anecdotes--some funny, many tragic, but mostly a commentary and an education.
Those who follow my "Book Reports" are aware I read widely. This audiobook came highly recommended and I'm going to pass that recommendation on to you. Narrator Tom Jordan "becomes" author Roger Huder as he shares incidents from his life as a paramedic. We take them for granted these days but in the 1970s they were a brand new concept in our frontline of First Defenders. So sit down, crack a beer, and share anecdotes--some funny, many tragic, but mostly a commentary and an education.
August 1, 2022
3.25 ⭐️ If I had finished this book before May 15th, it would have received more stars. This book gives an appreciation to the early days of EMS. Back to when it was a developing career. It tells stories of calls, the ones that live with an EMS personnel for their entire life. However, halfway through reading this book I began working on a street truck and I no longer wanted to read of the things I was experiencing as well. But the words of wisdom that came along with the stories are words that’ll be with me on every call.
March 15, 2023
Like the author, I spent 26 years as a firefighter and paramedic. I want to thank him for putting into words many of my thoughts and emotions (and morose sense of humor) during my career. I found myself smiling and nodding my head numerous times over stories and terms that paralleled my own. While I enjoyed the read, I think that a lot of the terminology may be lost on some readers who do no have a background in EMS or firefighting. But, overall, it was thoroughly enjoyable. Thank you brother. Write more!
December 29, 2019
Highly recommend
By far a eye opener, an brings you to an understand of what life is like on the streets in the emergency service! Being a firefighter I could relate an understand what he talked about with life an death. An he says it in the book, you fight death every day, that is the truth. You see how close everyone is to death in the blink of an eye.
Absolutely an amazing book!!
By far a eye opener, an brings you to an understand of what life is like on the streets in the emergency service! Being a firefighter I could relate an understand what he talked about with life an death. An he says it in the book, you fight death every day, that is the truth. You see how close everyone is to death in the blink of an eye.
Absolutely an amazing book!!
September 3, 2025
A well written non glorified account of what it’s like to be a FF/medic. I especially enjoyed that this book accounts for the early days of EMS and that I can see how far things have come. Did a lot of highlighting of relatable passages. There were definitely a few to strike a cord that had me nodding my head in appreciate for a feeling that anyone outside of the profession would have a hard time understanding
February 12, 2019
old times
im in what I would call the middle times of firefighting. I started my career with guys like Rodger, and I can see the direction it is going and the firefighter/paramedics that are joining our ranks! Roger speaks the truth and I can envision all these stories, most of us have the same feelings! well writen and quick read. thanks for your time Brother!
im in what I would call the middle times of firefighting. I started my career with guys like Rodger, and I can see the direction it is going and the firefighter/paramedics that are joining our ranks! Roger speaks the truth and I can envision all these stories, most of us have the same feelings! well writen and quick read. thanks for your time Brother!
March 18, 2019
Paramedic First
This was a true story about a paramedic before there was such a thing.
Upon joining the fire department he had volunteered to be a paramedic.
No training he's thrust into the real world with fellow firemen. Split second decisions are to be made while doing everything in your power to save a life.
This was a true story about a paramedic before there was such a thing.
Upon joining the fire department he had volunteered to be a paramedic.
No training he's thrust into the real world with fellow firemen. Split second decisions are to be made while doing everything in your power to save a life.
August 22, 2019
Real and raw
Relatively short and raw this book tells the story of a firefighter/ paramedics life first through the author's emotions and thoughts and secondarily through the events and stories of his life. It's an adventure story, an action packed biography, but what's different is that you can feel the sadness, pain, fatigue and emotions in every sentence.
Relatively short and raw this book tells the story of a firefighter/ paramedics life first through the author's emotions and thoughts and secondarily through the events and stories of his life. It's an adventure story, an action packed biography, but what's different is that you can feel the sadness, pain, fatigue and emotions in every sentence.
August 28, 2021
Insightful and Impactful
As an aspiring paramedic, I wanted to get an idea of the horrors and pain I would come to know. This author shared it in the best anyone ever could. I still don’t know what it is like to be in his shoes, watching a a smoking baby be thrust out a window, but I have a little slice of what to expect, not of the street but of my own reaction to its humor.
As an aspiring paramedic, I wanted to get an idea of the horrors and pain I would come to know. This author shared it in the best anyone ever could. I still don’t know what it is like to be in his shoes, watching a a smoking baby be thrust out a window, but I have a little slice of what to expect, not of the street but of my own reaction to its humor.
November 30, 2022
Enlightening
I enjoyed reading a real life account. I worked in the medical field and it is amazing that when the author started working, gloves weren't required. Some other things about protocols I found interesting also.
I enjoyed reading a real life account. I worked in the medical field and it is amazing that when the author started working, gloves weren't required. Some other things about protocols I found interesting also.
January 3, 2026
Fascinating memoir from the infant days of being a firefighter paramedic. It tackles the reality of seeing death and not succeeding on every call. The internal debate of whether it’s “worth it” and finding your why.
Displaying 1 - 30 of 54 reviews