On a sunlit highway in Israel in 1978, an ambulance races toward a burning bus under live gunfire. Inside is a young physician who helped write the rules that will decide who lives and who dies in the next few minutes. Her name is Nancy Caroline, and this moment captures the idea that would define her life’s work: survival is decided long before the hospital doors ever open.

In this episode, PMHX traces the extraordinary story of the woman who helped invent modern paramedicine. Nancy Caroline helped prove that advanced medical care belongs wherever people collapse, bleed, and stop breathing... not just inside hospitals. You’ll follow her as she transforms struggling street crews into true clinicians, writing the protocols, building the training, and standing beside her medics under real danger. You’ll see how that vision spread beyond the U.S. to Israel’s national EMS system, where her training was tested during mass-casualty attacks and later to remote regions of Africa, where she carried emergency medicine to places that had never known it.

This is a story about beating the clock, about collapsing the deadly gap between injury and care, and about a physician who believed that if you know how to help, you have a responsibility to step forward. Because sometimes the difference between death and survival is nothing more than what happens in the next few minutes and who is willing to stand there and act.