Did you know that funeral directors were in the ambulance business for around 50 years before handing it over to emergency services?
Before the Civil War, ambulances were basically unheard of. Up until the mid-1800’s, people who were ill or injured were treated by a doctor in their home, whose medical calibre extended to no more than what could fit in the typical Physician’s “little black bag.” On the battlefields, the equivalent of this would occur with the doctor meeting their patient by horseback. Treating the wounded during war required expensive resources that were seen as being better used on people who had a higher chance of recovery and so, the battlefield wounded could be left on the field for days before being transferred to a treatment area- soldiers ultimately either died on the field or left it unscathed.
It was not until the Civil War, that the demand for immediate treatment increased. With each war came the improvement of general medical knowledge, usually through the practise of trauma care, which would always find its way into the civilian world. Battlefield trauma care was important at this time for proving the value of surgical intervention, and since surgeons were not permitted to perform such procedures on bodies during peacetime for experimental purposes, the battlefield became an important place for surgeons to be able to perfect techniques in base operating rooms and prove that under certain conditions, these supposed ‘mutilative’ methods could cure people. Due to this, as surgeons became more skilled, the demand to bring patients to the hospital operating rooms increased and the need for someone who owned a vehicle that was able to transport these people supine arose. The most appropriate candidate? The local undertaker.
This arrangement continued well into the 1960’s, and the hearse serving as an ambulance even helped in desensitizing the morbid nature of the funeral business. As the years went on, however, technological advances of the time began to catch-up with the ambulance- resuscitators, supplemental oxygen and inhalators became the standard of care and additional training was necessary in order to operate such devices. All of this, along with basic CPR training, led to the establishment of the Emergency Medical Technician program (EMT) which we have today. In 1966, two major changes to the ambulance industry occurred- the Interstate Commerce Commission (ICC) created rules in the spirit of public safety which ambulances had to follow, the Highway Safety Act and the Department of Transportation (DOT) program for the EMT curriculum also came about, outlining how poor vehicle design and lack of adequate training of ambulance attendants caused increased illness and mortality rates.
The ambulance had become a mobile hospital, and the funeral home was not financially capable or qualified to continue to run it, nor was it possible for funeral workers to continue to work in their primary role as funeral director and embalmer, while simultaneously training and retraining as EMTs.
And so, like most things of our past, the tides of change swept the responsibility away from the funeral home and towards emergency services, and the undertaker’s ambulance service came to an end.