There are, of course, more important things to worry about in life -— the war in Iraq, the national debt or whether Social Security will be there when I get old enough. These are some of the most important things on people's minds today. So as I sit in Washington, DC's Reagan Washington National Airport waiting for a delayed flight, I cannot help but wonder about one thing. Why is it that wherever I travel, the local firefighters and emergency medical crews have different names for their ambulances? Wasn't the purpose of the National Incident Management System (NIMS) to standardize terminology and avoid the confusion of using different terms for the same thing?
Here's a story from before the days of NIMS: A friend of mine who was a fire chief in the Midwest became a fire chief in a medium-sized Colorado fire department. Within his first week on the job, he found himself as one of the first on the scene of a Winnebago fire on a major interstate with a water supply problem. He immediately picked up his radio and asked the dispatcher to send him a "tanker." The trepidation in the dispatcher's voice said it all, even though there was a resounding, "Clear, a tanker will be dispatched." Shortly thereafter, a division chief who was also responding had the chief immediately and without delay switch to a different radio channel and quickly informed the chief that he had ordered an airplane water drop on the Winnebago. To this geographically and terminology challenged chief from the Midwest, a "tanker" meant a truck with four wheels and a large cylindrical tank on the back that carries lots of water from a water source to the scene of the fire and usually gets dumped into a portable tank for drafting purposes. Little did he realize that he was about to unleash a scene from the movie "Flashdance," except on steroids to everyone standing on the interstate.
This mix-up in terminology brings me back to my original point - what do you call an ambulance? Go to New York City and it may say ambulance on the side of the vehicle, but they call it a "bus." The first time I heard an ambulance called a "bus," I had this striking image of a long vehicle with lots of windows and seats, one driver in the front who opened the door and another door about halfway back. To get on the bus, you had to deposit money in a box next to the driver. That is what a bus is supposed to look like! Then, you have to wonder, how the professionals in New York City ever got from the word "ambulance" to the word "bus." Two widely popular stories include the time when multiple people were picked up on the same ambulance run or when the same company that built buses for the city also got the contract one year to build ambulances. At this point, it is a story of legend.
In St. Louis, it is not uncommon to call an ambulance a "wagon." Unlike New York and the origin of the word "bus," I do know where the word "wagon" came from. In the old days of St. Louis, before the "horseless carriage," ambulances were horse-pulled wagons. As tradition would have it, when motorized ambulances came about, those who were involved in the ambulance business continued to call them "wagons." Newer generations came in, but they picked up the vernacular from the old timers and the tradition continues today.
When I visited Florida one year, a colleague kept using the word "rescue." The image I had in my head as he spoke was of the "rescues" in St. Louis and New York that were as big as Wayne Newton's house and carried lots of "rescue" tools and manpower. But the more he talked of "rescues," I knew he was not talking about those immense pieces of apparatus, but of a simple ambulance. I said, "Wait a minute - those aren't rescues, they're ambulances." I was immediately educated that most ambulances in Florida are called "rescues." I then asked my friend, "Well, what would you call that big truck with all the "rescue" tools, saws, ropes, cribbing material, and so forth?" He politely replied that those are called "squads." Without delay, I also attempted to educate him that in a lot of communities on the East Coast, up north and in many rural areas, ambulances are called "squads," not "rescues." He was then quick to point out to me that in Los Angeles, ambulances are called "ambulance rescues."
My travels around the country have also continued to enlighten me that the word "ambulance" is many times rarely used to describe an ambulance. Another popular term is to call an ambulance a "truck." Now, this makes a little more sense to me, since all ambulances are basically built on some type of "truck" chassis. "Not so fast," came the pearls of wisdom from an associate who reminded me that some ambulances are built on "van" chassis. He then made reference to those funny-looking ambulances coming out of Europe and wanted to know if I would call those a "truck." "I guess I wouldn't," was my reply as I tried to avoid a point-counterpoint debate, since I always seem to lose.
In other parts of the country, like San Francisco, an ambulance is called a "box." This also makes sense, since an ambulance is a truck chassis with a box on the back - unless it happens to be a van chassis, in which case it is usually a van that has been converted into an ambulance. If you travel anywhere in the Midwest, expect to hear the term "LSV" when referring to an ambulance. "LSV" stands for life support vehicle. Elsewhere, the word "ambulance" is rarely heard and more common terms such as "medic," "unit" or "rig" are used. Our more rough-minded friends also like to use the terms "meat-wagon," "horizontal taxi" or "garage queen," which describes an ambulance that spends more time in the repair shop than on the street.
I have pondered all the possible names you can call an ambulance and I am even more confused than before. Just like they say that "all politics is local," I guess the same applies to what you call an ambulance. What you call an ambulance depends on where you are. Hopefully, one term I will never hear is "ecnalubma" (that is ambulance spelled backwards for those of you who get those annoying questions from the public on why that is spelled the way it is on the hood of your ambulance). In any case, what do you call an ambulance?
GARY LUDWIG, MS, EMT-P, a Firehouse contributing editor, is a deputy fire chief with the Memphis, TN, Fire Department. He has 28 years of fire-rescue service experience, and previously served 25 years with the City of St. Louis, retiring as the chief paramedic from the St. Louis Fire Department. Ludwig is vice chairman of the EMS Section of the International Association of Fire Chiefs (IAFC), has a master's degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally. He can be reached through his website at www.garyludwig.com.
