American Academy of Orthopaedic Surgeons (AAOS)

The American Academy of Orthopaedic Surgeons (AAOS) provides education and practice management services for orthopaedic surgeons and allied health professionals. The Academy also serves as an advocate for improved patient care and informs the public about the science of orthopaedics. Founded at Northwestern University as a not-for-profit organization in 1933, the Academy has grown from a small organization serving less than 500 members to the world's largest medical association of musculoskeletal specialists. The Academy now serves about 24,000 members internationally.

Nancy L. Caroline

Nancy L. Caroline, MD, was only 58 when she died of multiple myeloma in 2002, but her spirit will never leave Emergency Medical Services. She has often been rightly called the Mother of Paramedics because of her dedication to paramedic education.

No physician can be more revered, yet Nancy never used the academic titles to which she was most entitled—everyone from a first year EMT to a distinguished leader called Dr. Caroline, simply, “Nancy.”

Nancy Lee Caroline was born in a Boston suburb to Leo and Zelda Caroline in 1944. Nancy had a strong social conscience, and devoted her life to medicine, teaching, and her patients.

Nancy’s medical career began at the ripe age of 15 in the pathology laboratory of the famous Benjamin Castleman, MD, at Massachusetts General Hospital. However, Castleman was unable to pay her for her services, because she was not of legal age to be working for money. Nancy went on to do actual medical research in Dr. Castleman’s laboratory, long before she entered college.

Nancy chose to major in linguistics at Radcliffe College. Not surprising, it continued to be a point of pride for her to develop a knowledge of the languages in whatever country she was working. She went on to receiver her MD from Case Western Reserve University in 1977.

After finishing her residency in Cleveland, Nancy took a fellowship in Critical Care Medicine at the University of Pittsburgh. Beginning in 1974, the late Peter Safar, MD, was overseeing a US Department of Transportation grant to create a curriculum for paramedics. Much of Safar’s work began to be delegated to (or, perhaps, seized upon by) young Dr. Caroline. Because of this work, Nancy served as an advisor to President Gerald Ford on EMS.

Dr. Safar offered Caroline an opportunity, as medical director of Freedom House Enterprises Ambulance Service, to train paramedics chosen from a group of African-American men who did not have a chance to complete their high school educations. Caroline was extremely successful—so successful that she was asked to write a curriculum for paramedic training, a curriculum that was published as Emergency Care in the Streets.

Nancy, proud of her Jewish heritage, took an opportunity to immigrate to Israel as the first medical director of Magen David Adom, Israel's Red Cross Society. During her first months in the country, Nancy rose early to attend the extensive Hebrew lessons required of new immigrants, then, spent her late afternoons and evenings training the first Israeli paramedics. She would then take a bus home, where she would spend a few precious hours working on the first edition of Emergency Care in the Streets.

After her tenure at Magen David Adom came to an end in 1981, Nancy relocated to Nairobi, Kenya, to become Senior Medical Officer of the African Medical and Research Foundation (AMREF), the foundation that oversees the famous Flying Doctor Service.

One of Nancy’s many duties at AMREF was writing a health advice column for the local newspaper, called "Ask Dr. AMREF." Nancy’s famous sense of humor made the column “must” reading in Nairobi. Nancy reported that one questioner had all the males on the AMREF staff quite concerned when he began: “Everyone knows that a normal male can go six times in an evening.”

No one who ever met her will ever forget her sense of humor, nowhere more evident than in her publications:

• Nancy made the editors of a proper Bostonian publishing firm gasp when she wore a hardhat with a revolving red light when she came to call.
• Nancy won permission to publish the first cartoon on the cover of the Journal of the American Medical Association for her article on the curative power of chicken soup. The cartoonist, her brother Peter, said he was sure it would be the last.
• Nancy lost an argument with her editors on her wish to have a series of case studies for paramedics called The Pulseless Man in the Topless Bar. The case book became Ambulance Calls instead—to her undisguised loathing.

During much of her life, Nancy would return to the United States to visit her mother Zelda, and her brother Peter. But, on her trips home, Nancy always found time to ride with working paramedics in several cities, to listen to their ups and downs, and to determine what real paramedics needed in any update of Emergency Care in the Streets.

When she discovered the awful famine that overtook Ethiopia in the early 1980s, Nancy became a consultant for the League of Red Cross Societies, writing a handbook on basic life support and running classes on first aid for African nations.

Nancy worked with the Ethiopian Orthodox Church to provide better nourishment and health care to children in over 600 orphanages, setting up small scale agricultural projects to feed Africans. In addition, Nancy served as director of medical programs for the American Joint Distribution Committee in Addis Ababa.

During Nancy’s time in Ethiopia, she had to return to the United States on a family emergency, Nancy discovered the only way she could get a plane to the United States was with a substantial cash ticket payment. The Christian Bishop of the Ethiopian Orthodox Church, to whom Nancy reported on the orphanages, personally got Nancy on a plane to Boston in short order.

Returning to Israel in 1987, she served as medical consultant for the Center for Educational Technology and for AMREF, developing training materials in emergency medicine and writing correspondence courses for rural health workers in Africa. She also served as an adjunct professor at the University of Pittsburgh's medical school, and, while volunteering in the Department of Oncology in Tel Hashomer, Nancy collaborated with Alexander Waller, MD, on a Handbook of Palliative Care in Cancer.

Nancy settled in Metulla, Israel. She realized there was a need for special care in north Israel for people with advanced cancer. In 1995, she founded the Hospice of the Upper Galilee (HUG). In 2002, she married geneticist and molecular biologist Lazarus Astrachan.

Nancy left the world too soon, but few people have done more to leave the world a better place. After all her accomplishments, however, the compliment that meant the most to her was Mother of Paramedics.