From hearses to ambulances: New book traces P.E.I.’s history of emergency care

Did you know ambulance services on Prince Edward Island were once largely provided by funeral homes?

For decades, if you needed urgent medical help, it was often someone from a funeral home who came to get you — in a hearse.

That little-known piece of Island history is explored in a new book, Answering the Call: The People and Stories of P.E.I. Ambulance Services, now available on Amazon.

It’s co-authored by former P.E.I. paramedic Sandy MacQuarrie and Islander Sylvia Poirier, who died in late November. Poirier was a former Holland College registrar and nurse educator.

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MacQuarrie, who now teaches paramedicine in Australia, said the book grew out of a simple idea: let the people who lived this history tell it themselves.

“We wanted the people to tell their stories. So Sylvia and I would arrange interviews with them and record them and transcribe them,” he told CBC’s Island Morning.

“We have very young people participating in ambulance calls as teenagers, sending the ambulance around to the high school to pick up someone so that they could assist in a calls, husbands and wives running ambulance calls together, every manner of conveyance from horse and wagon to hearse to station wagon to purpose-built vans by the 1970s.”

Early days

The book traces 100 years of change and at least 35 separate ambulance services starting around 1905 — when MacQuarrie believes the Island’s first ambulance operated in Charlottetown — through to 2005 when Island EMS took over as the province’s lone ambulance provider.

The authors interviewed a number of former ambulance staff and their families, combed through old reports and letters, scoured archives and even turned to Facebook to piece together the stories.

In the early days, said MacQuarrie, there was no organized emergency medical system.

“Funeral directors at that time were beginning to have hearses…. So they would come and get you,” he said.

“They did it because — I'm going to say quite honestly — no one else was going to, although there were others that took part.”

MacQuarrie noted that in 1915, Prince County Hospital had its own purpose-built, horse-drawn ambulance.

Over time, funeral homes turned ambulance work into a more formal service. By the 1930s, many were advertising ambulance offerings.

The care was basic, often just pickup and delivery, but “what came through in some of the stories was the compassion that they showed and the empathy,” MacQuarrie said.

‘The march towards professionalization’

By the 1950s and ‘60s, funeral homes were solidly in the ambulance business, sometimes competitively, MacQuarrie said.

Around Charlottetown, he said, four services competed directly with each other. Summerside had two competing providers for nearly half a century.

Yet they also worked together, and the push for professional standards partly came from within the industry.

“They evolved," MacQuarrie said. "They developed their own standards because there was not a lot of regulation.”

One section of the book, called The March Towards Paramedicine, was especially important to Poirier, who wanted that era of change documented.

Pressure for better training didn't only come from ambulance providers either. In 1955, the Women’s Institute passed a resolution calling for every ambulance attendant to have first-aid training — something that wasn’t yet the standard. Funeral directors also supported that.

A major government report in the 1970s pushed things further. It suggested first-aid training for all attendants and purpose-built ambulances — and the province pledged its support.

“That began what I call the march towards professionalization,” MacQuarrie said.

“Sylvia was so adamant that we needed to have that as a separate section in the book. The section… is Sylvia and everything that she lived through."

Ambulance-only services take over

By the 1970s, a new model was emerging: ambulance-only operations.

MacQuarrie noted that in Charlottetown, Neil and Gail MacDonald bought out the four ambulance licences held by local funeral homes and launched Neil’s Ambulance.

Other parts of the Island saw similar moves.

“That was a game-changer.”

By the 1980s, services had largely divested from funeral homes. By 1999, five ambulance operators remained: Kings County EMS (Montague and Souris), Neil’s Ambulance (Charlottetown), Royal Ambulance (Summerside), West Prince Ambulance (O’Leary) and Rooney’s Ambulance (Alberton).

“They were modern. The staff were well trained. They were starting to advance," MacQuarrie said. "They had medical direction, purpose-built ambulances.”

A long-awaited provincial study released in 1999 recommended moving to a single operator. P.E.I. issued a request for proposals in 2005, and Medavie EMS was awarded the contract. The company began operating on P.E.I. in April 2006 through its subsidiary, Island EMS.

‘She was a lighthouse’

MacQuarrie said the book, in many ways, is a tribute to Poirier, who was a driving force in paramedicine education on P.E.I. and helped launch the paramedicine program at Holland College.

"She was a lighthouse,” he said. “She was up above the horizon and could see around. And the time that I spent with her, I was so lucky. She was a storyteller.”

As Poirier’s health declined, finishing the book became a race against time.

“Most recently, the book was just about to go into production, and we worked very, very, very, very hard to get it done, to get it into her hands,” MacQuarrie said.

“And we did.”