Overview

Presents a unique view of social problems and conflicts over urban space from the cab of an ambulance. While we imagine ambulances as a site for critical care, the reality is far more complicated. Social problems, like homelessness, substance abuse, and the health consequences of poverty, are encountered every day by Emergency Medical Services (EMS) workers. Written from the lens of a sociologist who speaks with the fluency of a former Emergency Medical Technician (EMT), Medicine at the Margins delves deeply into the world of EMTs and paramedics in American cities, an understudied element of our health care system. Like the public hospital, the EMS system is a key but misunderstood part of our system of last resort. Medicine at the Margins presents a unique prism through which urban social problems, the health care system, and the struggling social safety net refract and intersect in largely unseen ways. Author Christopher Prener examines the forms of marginality that capture the reality of urban EMS work and showcases the unique view EMS providers have of American urban life. The rise of neighborhood stigma and the consequences it holds for patients who are assumed by providers to be malingering is critical for understanding not just the phenomenon of non- or sub-acute patient calls but also why they matter for all patients. This sense of marginality is a defining feature of the experience of EMS work and is a statement about the patient population whom urban EMS providers care for daily. Prener argues that the pre-hospital health care system needs to embrace its role in the social safety net and how EMSs' future is in community practice of paramedicine, a port of a broader mandate of pre-hospital health care. By leaning into this work, EMS providers are uniquely positioned to deliver on the promise of community medicine. At a time when we are considering how to rely less on policing, the EMS system is already tasked with treating many of the social problems we think would benefit from less involvement with law involvement. Medicine at the Margins underscores why the EMS system is so necessary and the ways in which it can be expanded.

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9781531501075

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Reviews

Christopher Prener offers a razor-sharp analysis of social marginality through a case study of emergency medical services. Medicine at the Margins is an essential read not only for those interested in a growing sociology of the ambulance, but also those with broader interests in urban sociology, medical sociology, and the sociology of work.---Josh Seim, author of Bandage, Sort, and Hustle: Ambulance Crews on the Front Lines of Urban Suffering.,

Medicine at the Margins is a deep dive into the world of EMS work that not only makes sense of that work in the intersection between medicine and our social safety net gaps, but also as productive of the urban landscape. Christopher Prener shows that EMS work helps to recreate our mental maps of the city, the kinds of people that we think live in them, and the kinds of resources we think they deserve. An excellent contribution.---Armando Lara-Millan, assistant professor of sociology at UC Berkeley, and author of Redistributing the Poor: Jails, Hospitals, and the Crisis of Law and Fiscal Austerity Christopher Prener offers a razor-sharp analysis of social marginality through a case study of emergency medical services. Medicine at the Margins is an essential read not only for those interested in a growing sociology of the ambulance, but also those with broader interests in urban sociology, medical sociology, and the sociology of work.---Josh Seim, author of Bandage, Sort, and Hustle: Ambulance Crews on the Front Lines of Urban Suffering.

Medicine at the Margins is a deep dive into the world of EMS work that not only makes sense of that work in the intersection between medicine and our social safety net gaps, but also as productive of the urban landscape. Christopher Prener shows that EMS work helps to recreate our mental maps of the city, the kinds of people that we think live in them, and the kinds of resources we think they deserve. An excellent contribution.---Armando Lara-Millan, assistant professor of sociology at UC Berkeley, and author of Redistributing the Poor: Jails, Hospitals, and the Crisis of Law and Fiscal Austerity, Christopher Prener offers a razor-sharp analysis of social marginality through a case study of emergency medical services. Medicine at the Margins is an essential read not only for those interested in a growing sociology of the ambulance, but also those with broader interests in urban sociology, medical sociology, and the sociology of work.---Josh Seim, author of Bandage, Sort, and Hustle: Ambulance Crews on the Front Lines of Urban Suffering.,

Author Information

Christopher G. Prener was Assistant Professor in the Department of Sociology and Anthropology at Saint Louis University from 2015 until 2022. In addition to researching stigma, mental health, and neighborhood disorder in a variety of settings, his research explored the consequences of historical segregation for contemporary life in St. Louis, Missouri. He is also a former Emergency Medical Technician and EMS dispatcher. He is now working as a research scientist outside of academia.

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