This week's Top Gear, which had a bit on homemade ambulances, made a bold claim. Host Jeremy Clarkson, known as the "Giant Ape" to his colleagues, actually said that New York City volunteer ambulance service Hatzolah has a response time of only four minutes. But he's wrong. It's faster.
Because Hatzolah's response time is actually only two and a half minutes.
Well, technically, that's only the Flatbush, Brooklyn division of the larger Hatzolah organization. And while it proffers an official response time of two and a half minutes, it says that the actual average response time is "less than two minutes." And as the Flatbush one is the biggest of all the independently-operating Hatzolah organizations, according to Leah, the helpful person on the other end of the line when I called, it should serve as a nice proxy for the rest.
Hatzolah (alternatively spelled Hatzalah) organizations are primarily centered around Jewish communities around the world, but serve all patients in their local neighborhoods. The organization's official name, Chevra Hatzolah, means "company of rescuers" in Hebrew, and since its founding in 1960 it has become the largest all-volunteer ambulance corps in the United States.
Unfortunately, the story of Hatzolah isn't all sunshine and roses. It began as a product of an extremely religious community in response to perceived delays for help from official sources, but as a result it feels the need to meet that community's needs and desires. To this day, it doesn't allow women to serve among its medical staff.
The reasoning behind that decision was complicated by both religious matters (including the intricate laws of Yichud) and the practical implications of those religious matters. Men and women working together might lead to improper relationships, so the thinking goes, and giving patients the option of choosing a crew comprised of men or women would actually cause them to take the time to consider a decision on the topic, potentially endangering their own lives.
And all of that has caused no shortage of controversy, even within Hatzolah's core of Orthodox Jews, especially as many Orthodox women feel uncomfortable calling for an all-male ambulance crew in the event of something like childbirth. Which has led to a female-only version of Hatzolah, Ezras Nashim.
But while anything involving the Orthodox Jewish community can be fraught with religious issues and arguments of modesty, it's hard to argue with Hatzolah's blistering speed.
How it manages such an insanely fast response time is actually fairly simple. Hatzolah volunteers, of which there are 202 Emergency Medical Technicians and 29 Paramedics (in addition to volunteers for other roles, such as interpreters), are virtually entirely decentralized. When a call comes in, a dispatcher puts it out over the radio to every volunteer, who is on call 24 hours a day, seven days a week. Whoever is closest responds, with generally two responders going to help the person in trouble, and a third going to get the ambulance from a garage or parking space.
The responders don't just show up empty-handed, either, as they carry a lot of life-saving equipment in their own cars. EMTs get oxygen tanks, semi-automatic defibrillators, and trauma kits. Paramedics carry even more in the trunk of their cars, with each one carrying $35,000 worth of cardiac equipment, intubation kits, and medical drugs boxes.
But is Hatzolah the fastest in the world?
It's hard to tell. There's no international database that ranks response time, and Dr. N. Clay Mann with the University of Utah and the National EMS Information System cautioned that urban EMS organizations have a geographical advantage in response time, and it's unknown whether they count response time as time from dispatch to response site or dispatch to the side of the patient, but Hatzolah's time "definitely sounds quick."
Especially considering that the 2011 National EMS Assessment gave an average American EMS response time of 9.4 minutes, and the FDNY's own EMS response time for life-threatening emergencies is almost seven minutes.
So, the honest answer is, a bit of "who knows?" But it's probably up there.
Photo credit: Danny Howard