For fifteen years, Joanna Sokol filled private notebooks with her confusion, humour, and anger about the strange world of American street medicine. As her career progressed, she found herself taking notes on scraps of paper, backs of gloves, and margins of EKG printouts. She read about the history that brought ambulances into their current role as the caretakers of society's forgotten, and spoke to her colleagues about their own experiences and perspectives. Those reflections are collected here, in a series of raw, powerful essays about the state of American medicine. Sokol's life as a paramedic took her to three different counties: the casinos and trailer parks of the Nevada desert, the cosy beach town of Santa Cruz, and eventually the crowded tenements of San Francisco's Tenderloin district. There are no clear villains or heroes in Sokol's world, only a group of patients and medics who are doing their best in a deeply broken system. Sokol combines impactful research and the strong voices of her fellow paramedics to take the reader deep into the crumbling reality of the modern American ambulance.