A true account of going through UCLA’s famed Daniel Freeman Paramedic Program—and practicing emergency medicine on the streets of Los Angeles. Nine months of tying tourniquets and pushing new medications, of IVs, chest compressions, and defibrillator shocks—that was Kevin Grange’s initiation into emergency medicine when, at age thirty-six, he enrolled in the “Harvard of paramedic schools”: UCLA’s Daniel Freeman Paramedic Program, long considered one of the best and most intense paramedic training programs in the world. Few jobs can match the stress, trauma, and drama that a paramedic calls a typical day at the office, and few educational settings can match the pressure and competitiveness of paramedic school. Blending months of classroom instruction with ER rotations and a grueling field internship with the Los Angeles Fire Department, UCLA’s paramedic program is like a mix of boot camp and med school. It would turn out to be the hardest thing Grange had ever done—but also the most transformational and inspiring. An in-depth look at the trials and tragedies that paramedic students experience daily, Lights and Sirens is ultimately about the best part of humanity—people working together to help save a human life. “An insightful and tumultuous virtual journey that reveals the challenging rites of passage needed to become a paramedic…You will be inspired.”—Richard H. Carmona, M.D., M.P.H., FACS, 17th Surgeon General of the United States   “An authentic, compelling narrative…Grange is an excellent writer.”—Peter Canning, author of  Paramedic: On the Front Lines of Medicine “As fast-paced and thrilling as a ride along in a speeding ambulance.”—Judy Melinek, M.D., co-author of  Working Stiff: Two Years, 262 Bodies and the Making of a Medical Examiner   “Powerful…A raw, yet intimate view of the making of a paramedic.”— Paul A. Ruggieri, M.D., author of Confessions of a Surgeon and The Cost of Cutting Kevin Grange graduated from UCLA’s Paramedic Education Program in 2011 and is an award-winning writer with the Society of American Travel Writers. His first book, Beneath Blossom Rain , recounts a twenty-four-day trek in the Himalayas, and he currently works as a paramedic with the National Park Service. Introduction The fate of the wounded rests with the one who applies the first dressing. —Nicholas Senn, MD The 911 call came in on a Friday night in the summer of 2011 from a gritty part of Los Angeles known on the street as Ghost Town. As usual, it was a trauma. At the fire station on the corner of 124 East I Street and Avalon Boulevard, the lights flickered briefly, followed by the alarm tones, and then moments later, dispatch broadcast over the loudspeaker: “Engine and rescue. A stabbing.” In the upstairs bunkroom where he’d been resting, firefighter/paramedic Tim Hill leapt from his bed, sprinted to the fire pole, and began sliding down. The call also roused two other firefighters, who slid down immediately after Tim, and three more from the TV room downstairs, who hustled into the garage bay. And with that, Station 38 of the Los Angeles Fire Department woke to life: the lights on the apparatus floor blinked on, the station doors opened, and six firefighters could be seen stepping into rubber insulated boots, pulling up yellow turnout pants, and throwing on brush coats. The men moved with speed and precision, the result of years on the job. And then there was me—the paramedic intern. I’d just finished showering and was standing half-dressed in the upstairs locker room when the tones first went off. Before I even heard the nature of the call, I threw on a shirt, grabbed my watch, and tore down the hall. Forbidden to use the fire pole as an intern, I instead hurtled down the stairs toward the garage bay. A fall down those stairs would break my bones and knock me unconscious—but far worse would be watching the ambulance leave without me. Just the week before, a classmate of mine who’d been interning here on another shift had missed a call—a double shooting at a recreation center—and I hadn’t seen him since. No one had said anything but I didn’t need to ask. Miss a call during your field internship of paramedic school and you’re gone. In the garage bay, the fire engine pulled out and I picked up the pace, leaping down the last five steps and sprinting across the apparatus floor to the ambulance. Tim hopped into the driver’s seat of the ambulance and hit the ignition. Firefighter/paramedic Eddie Higgins slid into the passenger seat next to Tim, radioed to dispatch that we were en route, and grabbed the map book. Tim shifted into drive, easing his foot off the brake. I grabbed my gear, jumped into the back of the slow-rolling ambulance, and hollered, “I’m here!” Settling into the captain’s seat, I yanked my turnouts on over my shorts and buckled my seat belt. Tim pulled out onto the street and activated the emergency lights—red and white LEDs flashing in 360 degrees. Less than three minutes had elapsed