{"id":2293,"date":"2020-04-02T10:00:36","date_gmt":"2020-04-02T09:00:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-humanities\/?p=2293"},"modified":"2020-08-11T02:51:56","modified_gmt":"2020-08-11T01:51:56","slug":"bandage-sort-and-hustle-ambulance-crews-on-the-front-lines-of-urban-suffering","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-humanities\/2020\/04\/02\/bandage-sort-and-hustle-ambulance-crews-on-the-front-lines-of-urban-suffering\/","title":{"rendered":"Bandage, Sort and Hustle: Ambulance Crews on the Front Lines of Urban Suffering"},"content":{"rendered":"<p><strong>Book Review by Christopher Bosley<\/strong><\/p>\n<p>Josh <span class=\"markfsyzc03k7\" data-markjs=\"true\" data-ogac=\"\" data-ogab=\"\" data-ogsc=\"\" data-ogsb=\"\">Seim<\/span>. <i>Bandage, Sort, and Hustle: Ambulance Crews on the Front Lines of Urban Suffering<\/i>. University of California Press, 2020. 272 pages. ISBN: 9780520300231<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-2294\" src=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/03\/Bosley-Christopher-Review-Josh-Seim-Bandage-Sort-and-Hustle-Ambulance-Crews-on-the-Front-Lines-of-Urban-Suffering.jpg\" alt=\"Josh Seim, Bandage, Sort and Hustle Ambulance Crews on the Front Lines of Urban Suffering\" width=\"300\" height=\"450\" srcset=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/03\/Bosley-Christopher-Review-Josh-Seim-Bandage-Sort-and-Hustle-Ambulance-Crews-on-the-Front-Lines-of-Urban-Suffering.jpg 300w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/03\/Bosley-Christopher-Review-Josh-Seim-Bandage-Sort-and-Hustle-Ambulance-Crews-on-the-Front-Lines-of-Urban-Suffering-200x300.jpg 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>This book offers a stunning analysis of the Emergency Medical System (EMS), its frontline workers, and its patients. Seim concentrates on the ambulance as an institution that, because of its mission to help the suffering, assists in governing the urban poor through labor processes. The labor processes identified are Seim\u2019s three central themes: \u201cbandaging,\u201d \u201csorting,\u201d and \u201chustling\u201d bodies. Seim\u2019s ethnographic deep-dive into the world of urban ambulance work as \u201cpeople work\u201d and the labor processes that define it attempts to make sense of how the poor, marginalized, disenfranchised, and otherwise \u201cothered\u201d people are bandaged, sorted, and hustled within the urban setting by those who serve and protect the community.<\/p>\n<p>The labor process of \u201cbandaging bodies,\u201d or the \u201cphysical regulation of \u2018spaces in bodies,\u2019\u201d is Seim\u2019s definition of clinical interventions into the body, to treat illness and injury. Seim states that crews bandage bodies on a complaint-based continuum, a scale that ambulance crews use to morally classify bodies. \u201cLegit\u201d patients are viewed favorably by crews because their complaints are deemed medically valid, require more clinical knowledge and interventions, and fulfill a sense of vocation within the crew\u2014the reason why they entered this type of people work. \u201cBullshit\u201d patients are the opposite of \u201cLegit\u201d patients, representing the bodies in spaces work that requires little more than a ride to the hospital for a minimal medical complaint. The regulation of \u201cbodies in spaces\u201d is evident when a crew is presented in the field with a \u201cbullshit\u201d patient that wishes to be transported to the hospital for a social problem. The crew must perform sorting labor to \u201cmedicalize the body,\u201d because crews are expected by emergency department (ED) staff to arrive with a \u201clegit\u201d patient.<\/p>\n<p>Seim seamlessly turns from the bandaging of bodies to the sorting of bodies. Sorting bodies is the part of the labor process that attempts to restore order to areas occupied by \u201cspatially mismatched\u201d persons. Essentially, bandaging and sorting are labor processes that govern the urban poor through a taxonomy of suffering. This is one of the most interesting and informative parts of Seim\u2019s analysis. Bandaging and sorting patients that are deemed \u201csocial burden\u201d cases by the public or the police are less about temporarily bandaging bodies via the legitimacy of a potential medical or psychiatric complaint, and more about temporarily bandaging the public areas from being \u201cinjured\u201d by the presence of poor, suffering, marginalized, and vulnerable populations. This \u201cburden shuffling\u201d does not end with <a href=\"https:\/\/metroaviation.com\/\">air ambulance company<\/a> transport, but rather is a process reset by ED staff. Staff discharges the \u201cbullshit\u201d or \u201cburden\u201d patients back onto the streets, 9-1-1 is called again, and the labor process is repeated.<\/p>\n<p>Bandaging and sorting are regulated by speed and efficiency, reflecting the third central theme of the book, \u201chustling bodies.\u201d While hustling bodies sounds like a process that may intensify bandaging and sorting, there is an external influence involved in hustling\u2014capitalistic bureaucracy. Seim\u2019s research took place at a private ambulance company. These companies are for-profit and are guided by what Seim calls \u201cvertical capitalistic forces\u201d that exist \u201cabove the ambulance,\u201d or rather stem from the company\u2019s office. Horizontal, street-level bureaucracies govern the field work of bandaging and sorting. Capitalistically allegiant bosses hustle crews into bandaging and sorting as many bodies with as few ambulance workers as possible because of responsibilities to the for-profit system in which these companies exist. The rate of hustling bodies is high in the fee-for-service model found in private EMS companies because bandaging and sorting poor, underinsured, and otherwise marginalized people negatively affects profit margins.<\/p>\n<p>Increased rates of hustling bodies can lead to crew exhaustion, and practices of labor self-regulation that is misidentified as laziness by supervisors. Without help in hustling, crews become emotionally jaded, supervisors become despondent to crew needs, and the capitalistic wheel keeps spinning because emergencies, the company\u2019s need for financial capital, and \u201cburden shuffling\u201d are not stopping. Seim states that hustling bodies to the point of exhaustion and coping with such exhaustion by crews self-regulating labor puts the community at risk, a risk shared by both the company and the workers. This \u201clean fleet\u201d system is not habitable to a healthy workforce, or a responsible delivery of emergency services to the community.<\/p>\n<p>The framework that Seim uses of a labor process governing the suffering of the urban poor and marginalized is a concept that is certainly salient in an American healthcare system that relies so much on the profitability of medical treatment rather than the Hippocratic tenets upon which medicine was built. <em>Bandage, Sort, and Hustle<\/em> could easily be included on medical sociology, occupational sociology, and\/or medical humanities syllabi. It is a great source for highlighting how well-intentioned labor processes within seemingly benevolent occupations can further marginalize people and reproduce social inequalities.<\/p>\n<p>&nbsp;<\/p>\n<p>Christopher Bosley is a PhD student in Sociology at the University at Buffalo. My research is primarily in medical sociology, concentrating on medical occupations and the emergency services.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Book Review by Christopher Bosley Josh Seim. Bandage, Sort, and Hustle: Ambulance Crews on the Front Lines of Urban Suffering. University of California Press, 2020. 272 pages. ISBN: 9780520300231 &nbsp; This book offers a stunning analysis of the Emergency Medical System (EMS), its frontline workers, and its patients. Seim concentrates on the ambulance as an [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2020\/04\/02\/bandage-sort-and-hustle-ambulance-crews-on-the-front-lines-of-urban-suffering\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":345,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2965],"tags":[15063],"class_list":["post-2293","post","type-post","status-publish","format-standard","hentry","category-book-reviews","tag-review"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Bandage, Sort and Hustle: Ambulance Crews on the Front Lines of Urban Suffering - Medical Humanities<\/title>\n<meta name=\"description\" content=\"Christopher Bosley&#039;s review of Josh Seim&#039;s &quot;Bandage, Sort and Hustle 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