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COLLECTION Identifier: MC 531: Vt-139: DVD-2

Papers of Nancy L. Caroline, 1905-2007


Papers of Dr. Nancy Caroline, pioneer in the training of paramedics and emergency medical technicians. Caroline worked in Pittsburgh, Pennsylvania, and in Israel and Africa.


  • Creation: 1905-2007


Language of Materials

Materials in English, German, Hebrew, and Yiddish.


Access. Collection is open for research. An appointment is necessary to use any audiovisual material.

Conditions Governing Use

Copyright in the papers of Nancy L. Caroline is held by the President and Fellows of Harvard College for the Schlesinger Library. Copyright in other papers in the collection may be held by their authors, or the authors' heirs or assigns.

Copying. For reproduction of all or some of the papers for dissemination via the internet the permission of the donor's literary executor is required.


23.27 linear feet ((52+1/2 file boxes, 1 folio+ box) plus 2 folio folders, 1 folio+ folder, 2 oversize folders, 1 supersize folder, 5 objects, 1 videotape, 1 DVD, 67 photograph folders, 2 folio photograph folders, 1 folio+ photograph folder)

This collection documents Caroline's private and professional life, and provides information on the Freedom House Ambulance Service and on the development of emergency medical care in Israel and Africa. The collection consists of correspondence, diaries, school notes, essays, newspaper columns, articles, and other writings, photographs, school yearbooks, and memorabilia, including wooden objects and sixteen buttons and a ribbon originally attached to a 3.5"x28" strip of fabric. There is material in German, Hebrew, and Yiddish. The bulk of the folder headings were created by Caroline; those folder headings created by the processor appear in square brackets.

Additional material received in 2006 and 2007 (accession numbers 2006-M157 and 2007-M163) was added to the collection in May 2017. These materials are housed in Series VII. Addenda (#49.1-54.11, F+D.1), PD.65-PD.70, and PD.1f+; single items were added to #14.15, 15.1, 15.2, 40.7, and 45.13.

Series I, Family papers (#1.1-1.11, OD.1), consists of family trees, and correspondence, essays, poems, and clippings related to members of Caroline's extended family, including her parents, brother Peter, sister-in-law Sally, and nieces Rebecca and Melinda. The series is arranged chronologically.

Series II, Biographical and personal (#1.12-14.10, 48.1m-48.2m, FD.1-FD.2, OD.1, 47F+B.1v), consists of four subseries, arranged chronologically, except where noted.

Subseries A, Biographical (#1.12-1.17), consists of Caroline's curricula vitae and other items providing information about her life.

Subseries B, Personal (#1.18-3.6, 48.1m-48.2m, FD.1-FD.2, OD.1, 47F+B.1v), consists of personal items kept by Caroline, such as a coloring book she designed with her brother, visas, passports, and political buttons. Also included are two scrapbooks covering Caroline's life until approximately 1971. These include childhood Valentines, report cards, letters of sympathy on the death of Leo Caroline, and photographs of friends and of neighborhoods in Boston and Cleveland. (Several photographs of Boston's West End are included, as well as Caroline's essays on the demise of that neighborhood.) The scrapbooks also include clippings on local and national events, and items related to Caroline's involvement in the civil rights movement, such as her ticket to the 15th anniversary convention of the Americans for Democratic Action in 1962.

Subseries C, Diaries ( #3.7-9.9), offers a detailed look at Caroline's life from the age of 10 to 52. Entries provide information on her schooling; her thoughts about family and religion, particularly her identity as a Jew; her feelings for Israel; work; and romantic relationships. Included is a moving description of her trip to Atlanta in April 1968, to attend Martin Luther King Jr.'s funeral. Pages and entries in several volumes have been torn out, presumably by Caroline. Several folders include clippings in Hebrew or Yiddish.

Subseries D, Schoolwork and research (#9.10-14.11, OD.1), consists primarily of notes for courses taken at Radcliffe. Also included are school yearbooks, elementary and high school report cards, Caroline's own childhood assessments of her elementary school accomplishments, her undergraduate thesis and correspondence regarding the possibility of its publication, notes on experiments undertaken in medical school, and records dealing with medical boards and licensing. The subseries is arranged in the following groupings: elementary and high school, college, leukemia research (including an unpublished novel), and medical school and licensing.

Series III, Writings (#14.12-16.15), consists of two subseries.

Subseries A, Articles (#14.12-15.9), contains published articles with supporting correspondence. Topics range from the curative powers of chicken soup to death with dignity, to emergency medical response to a terrorist attack. Some rejection slips are also included here.

Subseries B, Other writings (#15.10-16.15), consists of poetry and prose by Caroline, including an unpublished novel, essays on the professors and doctors who played key roles in her life and on experiences in hospital work, memories of her childhood home, other autobiographical writings, some rejected articles, and publicity material for her books. This subseries is arranged chronologically.

Series IV, Correspondence (#16.16-40.5, 48.3m, OD.1), consists of three subseries.

Subseries A, By correspondent (#16.16-31.3, 48.3m, OD.1), includes correspondence with Caroline's mother, brother, and eventual husband, as well as with friends and former teachers. (Correspondence with some of these individuals also appears in Subseries C.) The subseries provides detailed information about Caroline's work, difficulties she encountered, and her feelings about Israel. Some letters sent to Zelda Caroline by other individuals are also included here. The subseries is arranged alphabetically.

Subseries B, Correspondence with publishers (#31.4-35.8, OD.1), is arranged chronologically and consists of correspondence with Little, Brown and Company and other publishers of Caroline's books. Correspondence with co-writers and editors is also included. Caroline's brother Peter provided cartoon illustrations for Ambulance Calls: Review Problems in Emergency Care, and some correspondence focuses on that.

Subseries C, General correspondence (#35.9-40.5), consists of correspondence with a variety of individuals, some of whom are also represented in Subseries A. Some overlap with Subseries B also exists. Correspondence with cousins and other relatives is included here. The subseries is arranged chronologically.

Series V, Professional (#40.6-46.25, FD.1, OD.1-OD.2, Vt-139, DVD-2, Mem.1-Mem.5), consists of six subseries, arranged chronologically, except where noted.

Subseries A, Freedom House Ambulance Service (#40.6-41.7, Mem.22), describes the development, activities, and eventual demise of the ambulance service. Detailed descriptions of daily ambulance runs and types of patients encountered are also included.

Subseries B, Israel (#41.8-42.7, OD.1, SD.1, Mem.1-Mem.2), is arranged first with correspondence and other documents related to Caroline's decision to immigrate to Israel, and her work for, and frustrations with, Magen David Adom, followed by material documenting other aspects of her work in Israel. Included are fragments from a katyusha rocket which almost hit her in 1981. Some material in this subseries is in Hebrew and Yiddish.

Subseries C, Africa (#42.8-45.10, OD.1-OD.2, Mem.3-Mem.5), documents Caroline's work in various regions of Africa. Included are her health column, "Ask Dr. AMREF," correspondence with the African Medical and Research Foundation and other agencies, surveys and health care materials drawn up for Ethiopian orphanages, and materials related to a massacre in Kenya's Northeast Province. These include a detailed account of the massacre and Caroline's efforts to provide aid. The series is arranged with folders related to specific organizations and locales appearing first, followed by more general material.

Subseries D, Conferences and speeches (#45.11-46.1), consists of presentations given by Caroline, and conference programs and announcements.

Subseries E, Awards, honors, and memorials (#46.2-46.10, FD.1, Vt-139, DVD-2), includes honors and awards Caroline received during her lifetime, as well as tributes accorded her after her death.

Subseries F, General (#46.11-46.25, OD.1), includes material related to Caroline's work at Shadyside Hospital as well as letters of recommendation.

Series VI, Photographs (#PD.1-PD.70, PD.1f+), includes numerous images of Caroline and family, friends, and colleagues. Photographs of Caroline and emergency workers in Pittsburgh and in Israel and Africa are included, as well as disturbing images of victims of a massacre in Kenya. A number of photograph albums focus on Caroline's farming initiatives in Africa.

Series VII, Addenda (#49.1-54.11, F+D.1), consists of material sent to the library in 2006-2007, much of which was retained after Caroline's death by her mother and Eugene Nagel. The bulk of it consists of letters from Caroline to her mother and Eugene L. Nagel, as well as articles by and about Caroline, eulogies and obituaries.


Nancy Lee Caroline, daughter of Leo and Zelda Caroline, was born on June 27, 1944, in Newton, Massachusetts. From a young age, Caroline had a strong social conscience and a strong sense of her identity as a Jew; these two qualitites informed many of the professional and personal choices she made throughout her life. She began her medical career while still a teenager, as a photographer and lab worker at Massachusetts General Hospital, and received her B.A. in linguistics from Radcliffe College and her MD from Case Western Reserve University in 1966 and 1971, respectively. After carrying out residencies at University Hospitals and the Veterans' Administration Hospital in Cleveland, Ohio, Caroline began a fellowship in critical care medicine at the University of Pittsburgh. In 1974, the university received a grant from the United States Department of Transportation to create a curriculum for nation-wide emergency medical services; this project was overseen by Dr. Peter Safar, but much of the work was delegated to Caroline, who also served as advisor to President Gerald Ford on emergency medical services.

Safar also recruited Caroline as medical director of the Freedom House Enterprises Ambulance Service, which provided emergency medical care to the city of Pittsburgh. The ambulance service had been established in 1967, to provide an opportunity for underprivileged African Americans to train as paramedics; the organization had encountered police opposition and financial and administrative difficulties and was on the brink of collapse when Caroline became involved. Despite Caroline's successful rehabilitation of the service, funding was cut in 1975, when the city of Pittsburgh decided to launch its own ambulance service. In 1976, Caroline became deputy director of the emergency department of Shadyside Hospital in Pittsburgh. During the 1970s Caroline met Dr. Eugene L. Nagel, who was head of the City of Miami (Florida) Fire Rescue and Paramedic Vision and who was one of the developers of the Biocom modulator, a device that transmitted EKG readings from an ambulance to a hospital. He arranged for her to visit Magen David Adom, the Israeli counterpart of the Red Cross, in the late 1970s.

In 1977, Caroline immigrated to Israel, where she began work as the first medical director of Magen David Adom. Caroline developed a training program which enabled emergency workers to respond to terrorist attacks within minutes, but she experienced some frustrations with Magen David Adom and left in 1981. She served as medical consultant to several hospitals before relocating, in 1982, to Nairobi, Kenya, to become Senior Medical Officer of the African Medical and Research Foundation (AMREF). At AMREF, she managed the Flying Doctors emergency service, conducted classes for health workers throughout Kenya, Tanzania, Uganda, and southern Sudan, and wrote a weekly health advice column, "Ask Dr. AMREF," for the The Standard, Kenya's main daily newspaper. During this time she also served as a medical consultant for the League of Red Cross Societies, writing a handbook on basic life support and running a Red Cross seminar on first aid for African nations. She also worked with the Ethiopian Orthodox Church to provide better nourishment and health care to children in over 600 orphanages, and developed a non-profit organization, Agro-Africa Limited, which set up small-scale agricultural projects to provide assistance to victims of Kenya's massive droughts. In addition, Caroline served as director of medical programs for the American Joint Distribution Committee in Addis Ababa, overseeing medical projects in the Gondar Province.

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, on a volunteer basis, as a doctor and medical advisor for Magen David Adom, the Department of Oncology at Chiam Sheba Medical Center, and Tel Hashomer Hospice. In 1995, concerned about the limited care provided patients with advanced cancer, she founded the Hospice of the Upper Galilee; this hospice cared for her when she herself became ill with cancer. In 2002, she married geneticist and molecular biologist Lazarus Astrachan, whom she had first met while in medical school. She died at home in Metulla, Israel, of multiple myeloma on December 12, 2002.

Caroline wrote numerous books and articles, primarily in the field of emergency medical services. In 1979, her book, Emergency Care in the Streets, became the first, and, for a decade, the only, resource for paramedic care; several editions of this book have been published. The following is a list of additional books written by Caroline: National Training Course, Emergency Medical Technician, Paramedic: Course Guide (1977), Workbook for Emergency Care in the Streets (with James C. McClintock, 3rd edition, 1987), Ambulance Calls: Review Problems for the Paramedic (3rd edition, 1991), CPR for All: An Illustrated Manual of Basic Cardiopulmonary Resuscitation (CPR) in Adults, Children, and Infants (with Ilan Yeshua, 1991), Emergency Medical Treatment: A Textbook for EMT-As and EMT-Intermediates (1991), A Manual for Instructors Adapted to Emergency Medical Treatment (3rd edition, 1991), Workbook for Emergency Medical Treatment: Review Problems for EMTs: With Answers (1991), Handbook of Prehospital Medications (1995), Study Guide for Emergency Care in the Streets (5th Edition, 1995), Handbook of Palliative Care (with Alexander Waller, 2nd edition, 2000), Nancy Caroline's Emergency Care in the Streets (6th edition, 2008).


The collection is arranged in seven series:

  1. Series I. Family papers
  2. Series II. Biographical and personal
  3. Series III. Writings
  4. Series IV. Correspondence
  5. Series V. Professional
  6. Series VI. Photographs
  7. Series VII. Addenda

Immediate Source of Acquisition

Accession numbers: 2003-M88, 2004-M46, 2005-M30, 2006-M64, 2006-M157, 2007-M163. Accession numbers 2006-M157 and 2007-M163 were added in May 2017.

These papers were given to the Schlesinger Library by the estate of Nancy Caroline in July 2003, with additional donations from her mother, Zelda Caroline, and her brother, Peter Caroline, between April 2004 and August 2007.

Processing Information

Processed: January 2006

By: Susan Earle



Caroline, Nancy L. Papers of Nancy L. Caroline, 1905-2007: A Finding Aid
Arthur and Elizabeth Schlesinger Library on the History of Women in America
Language of description
Processing of this collection was made possible by a gift from the Edward, Frances and Shirley B. Daniels Fund, and from the estate of Nancy L. Caroline.

Repository Details

Part of the Schlesinger Library, Radcliffe Institute Repository

The preeminent research library on the history of women in the United States, the Schlesinger Library documents women's lives from the past and present for the future. In addition to its traditional strengths in the history of feminisms, women’s health, and women’s activism, the Schlesinger collections document the intersectional workings of race and ethnicity, gender, sexuality, and class in American history.

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