Night shift #1. No runs for me -- a dry night. It poured rain; it flashed and vented the atmosphere's rage just beyond the open ambulance bay doors. Every other unit at the squad seemed to be out running car accidents and other mayhem whilst I vacuumed the training room and stayed quasi-useful.

Things got grim when the ambulance that was dispatched to pick up our dinner got a call mid-trip, and didn't return with the food until 10:30. We distracted ourselves with training videos about pediatric emergencies and gang violence. The "gang expert" interviewed on the videos looked like Art Garfunkle -- he's probably out putting a flower in the barrel of some young punk's Glock right now.

We learned this: Don't cut colors. Art Garfunkle says it's a sign of disrespect and you shouldn't do it in front of other gang members. If you have to expose the patient, do it inside the unit. Also, "don't assume that you can read gang graffiti after only one lesson." I guess you need to go through a full Gang Graffiti Literacy Program first.

At midnight we watched "Emergency!" -- the show that launched a thousand EMS careers. Score another save for Johnny and Roy. Because of their quick thinking and medical skills, a rock climber with internal bleeding but no speaking part survived to go on to other bit roles in 70's TV dramas.

Night shift #2. The next day I returned to pull a shift for fellow probie Steve. It was not such a quiet night. Boom boom boom. Try this, really: breathe in. Breathe all the way out. Just enjoy doing that for a little while. Not everyone gets to live.

I continue to be fascinated with the leadership structure at the squad. With its paramilitary system of rank, this squad is most more regimented than the one where I worked seven years ago. Back then, I worked day shift with the same group of people day after day, and we developed an informal system in which each individual performed a role in patient care under the loose coordination of the senior member. After a while, we hardly had to talk during a call -- we easily and fluidly worked as a team, anticipating each other's needs and actions. I sometimes wonder if this experience didn't forever ruin my ability to work in office America, with its bitter interpersonal intrigues over meager, less-than-life-and-death stakes.

This squad tends to concentrate authority and control in the "aidman," the head of the unit. S/he calls the shots, and all other members follow that person's instructions. This is partially made necessary by the fact that the crews for each unit change constantly, crewmembers may not know each other well, and there are multiple levels of experience on any crew.

At the moment, though, I'm less interested in leadership systems than in leadership itself. Last night I worked under a paramedic who displayed total calm and deliberate focus during a code (full arrest), and the other crew members and I molded to his example. The whole scene was amazingly organized. I have worked with other people whose adrenaline understandably got going in tough situation , and their excitement was immediately transmitted to the rest of the crew. Things got rushed, crazy, out of control.

This is why I love working with people who've been doing emergency medicine for many years. Their experience gives them strength, presence. When I worked in an office, I often resented people who were more experienced in my field. I was too smart and too allthat to waste my time in the trenches for the time necessary to earn their level of respect and recognition. At the ambulance, that all gets turned on its head. It is virtually the only place in which I'm not inherently resistant and resentful toward authority figures. The only reason I can find is that this, unlike so much else, matters.