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The Shift is a new column by Michael Morse, author of Rescuing Providence and Responding. Over 2014, it will take readers through a typical 24-hour shift in a busy urban fire-EMS department. For more Morse, see installments of his previous column, Stories from the Streets, on www.emsworld.com.

It’s 2015 hours.

“Yours is the one without cheese,” says Okie as we join the crew. The firefighters have made plates for us, covering them with tinfoil and placing them on top of the oven.

“Thanks, Okie.”

We have no problem making fun of each other. We relish the opportunity to expose chinks in the armor of our workmates. Bad haircuts, bad dates, blown streets, white socks—you name it, we’ll have something to say. But underneath the incessant banter lies a kinship like no other. Okie is a member of Special Hazards and one of the best and fittest firefighters in the entire department. EMS is not his forte, and his outward demeanor toward those in the department who choose the path of EMS borders on scorn. But he left the cheese off my chicken parmigianino, remembering I’ve been dairy free for a while, and that small gesture says more than a thousand good-natured insults.

There is no mention of the body on the highway during dinner, which is uninterrupted by the tones. We finish eating, cleanse our plates and help with the overall cleanup. Many hands make light work, and the place is back to pre-dinner condition in no time.

“Rescue 4 in service, clear of decon,” I say into the mic, and the division chief raises an eyebrow but remains quiet. He knows that if a call had come over the airwaves, we probably would have taken it.

Jared goes his way, and I go mine. I have two reports to do and like to stay up on them before they get out of hand. There’s nothing worse than a stack of paperwork waiting at the end of a long shift. Before I dig in, I call home.

“Hello.”

“Hi, it’s me.”

“Oh, I was hoping it was my boyfriend.”

“Is he still calling? I thought you wore him out.”

“Not yet. How are you?”

“Dead guy on the highway.”

“You OK?”

“I’ll survive. I have to.”

We talk for a few minutes, a comfortable give and take, the cadence of our conversation flowing naturally, nothing deep, just two people staying connected while they are physically apart. Some people use my frequent calls to and from home as a subject to ridicule, but I honestly believe their criticism is born from jealousy rather than scorn.

The conversation ends, and the paperwork begins. Almost.

“Rescue 4, respond to 168 Broad Street for an intoxicated female.”

“Rescue 4, responding.”

“At 2032 hours.”

The paperwork will be there when we return. Back down the stairs and into the truck, where Jared waits. It’s Donna, and she’s sloppy. The shelter is packed, perhaps a hundred people clamoring for position, setting up their possessions on the floor in what they call the common room. The smell of unwashed humanity assaults my senses, clings to my skin and permeates my uniform.

“I’m not going,” says our patient, and “the chorus” chimes in.

“You gotta go, girl, you had a seizure,” says one.

“You fell and hit your head,” emphatically states another.

“You drunk on your ass,” comes the truth from Winston, who lies nearby in his sleeping bag, keeping one eye on the festivities and the other on his things. I see the usual familiar faces joined by the constant barrage of new ones as the train of homelessness brings people in and out of this place. Some of the regulars try to help, others just stare, most make no eye contact at all and stay to themselves, their eyes downcast, trying to disappear into the asbestos tile floor. The newcomers shuffle along, uncomfortable in their surroundings, lost in repose, wondering how on earth they ended up here.

Jared is a fast learner and leans close to Donna and lends a hand, which she takes, and we help her to her feet and assist her as she walks out of the shelter and into Rescue 4. Without asking, my partner helps her onto the stretcher, straps her in, obtains the necessary vital signs and goes to the front to drive. We arrive at the hospital in a few minutes, wheel our patient close and wait in line. The triage area is packed, ambulances from all over fill the bay, the crews assigned crowding the cramped doorway and corridor with their cargo lying on their beds, watching, sleeping, trying to escape or barely breathing. The worst go first, the rest wait. A drunken man pisses on the floor, a college kid vomits in his stretcher, a trauma victim is rushed past, accompanied by a crew from Massachusetts, one of whom bags the victim while another stands on the stretcher rail doing compressions.

More units arrive, and Jared, Donna and I wait our turn.

I feel at home here in the ER and watch the familiar faces do their things, the ambulance crews dressed in blue, the hospital staff in their colorful scrubs, security in black and patients wrapped in white sheets or blankets. All of us have a place. I look at Donna, drooling on my stretcher, lost and alone. Life is funny. A wrong turn here, a missed opportunity there or a tragic accident like the one that happened to Donna decades ago can change everything. The car she was driving while intoxicated crashed, and her daughter was killed, and she lost her home, her hope and her dignity as a result.

It occurs to me that it could be me, or any one of us, on the stretcher and not standing next to it, and instead of having three places where I feel at home, I very easily could have none.

“But for the grace of God, there go I.”

Michael Morse, EMT-C, is a rescue captain with the Providence (RI) Fire Department.