I’m home after finishing a 24-hour shift at 8 a.m. as a rural fire department paramedic, and I usually get the same question: “Did you have a bad night?” my wife, Michelle, asks. Most mornings, I says simply, “It was all right.”

I’ve tried to leave my work at the firehouse, to not let the violence I see on the job come home with me. This is what I saw on one shift a few months ago: Shortly after 3 p.m. on Friday, I and my partner were dispatched for a call of a child struck by a vehicle at such and such address.

While riding to the scene, an update came over the radio: Shots fired, multiple victims. I started to feel anxious. I started to mentally size up the possibilities and prepare myself for what I may see. Two engine companies were already on the scene.

Getting out of the ambulance, I look to my right. Lying in the street was a middle-aged man. A few firefighters were administering CPR. To my left, I saw other firefighters caring for a teenager lying in the grass. “Where’s the kid?” I thought. As part of the first medical unit on the scene, I needed to quickly assess the victims. The man receiving CPR had a gunshot wound and no pulse. I instructed the firefighters to continue CPR. My partner started an IV. The teenager on the grass was still breathing, and the firefighters were bandaging his torso where he had been shot. A firefighter directed me to the child who was struck by the car. The toddler had been covered with a blanket. I lifted the blanket. I saw the extent of the traumatic injuries and agreed nothing could be done. A second medical unit arrived. I directed them to the teen — the most viable patient. The unit needed to get him to the hospital.

I returned to the man. He still didn’t have a pulse. We can’t load a patient into the ambulance without a heartbeat. They ran an EKG to check for electrical activity in the man’s heart. He was gone. Within the five minutes I had been on scene, maybe 5 police squad cars had arrived. It was chaotic. I could just hear crying and yelling.

After 4 years as a paramedic and 9 years with the department, I and others have gone on a lot of bad calls.

A couple of years ago, when I was first transferred to ___________, calls like this one were few and far between. Now I respond to a call about a stabbing, shooting or some other act of violence at least once or twice a week.

I remember the first bad call I went on, shortly after I became a paramedic. Someone had called 911 for an infant who wasn’t breathing. I arrived at the house and saw the infant lying on the kitchen table. The child didn’t have a pulse. The mother said the child was 2 years old. To me it looked as if the child starved to death. There was nothing I could do. “It is the worst thing I’ve ever seen, hands down,” I remember telling my wife.

I have calls with children that are even harder to deal with since my 6-year-old daughter, Angie, was born.

One night a couple of years ago, when he worked at Station such and such, I responded to 3 fatal shootings. “I don’t want to relive some of the terrible things I’ve seen,” I tell my wife this every once in a while.

Even nonviolent calls hold risk. Overnight Sunday, the department responded to a call for a person who had trouble breathing. While firefighters transferred the patient into the ambulance, a firefighter was shot. The firefighter was treated for a graze wound to the side of his head and released from the hospital.

I say it’s worth it — I love what I do.

I grew up in the city and joined the department after graduating from High School, following in the footsteps of my father. After seven years as a firefighter, I decided to become a paramedic.

I’ve seen this town grow into a small city and it’s gone from bad to worse to better. It’s all over the place. This is where I live and I’m here to take care of people.”

My training takes over on the scene. I see tasks to be completed, victims to care for. You really don’t have time to form some form of emotional attachment at that time because there’s a job to be done. I quietly try to wipe the slate clean each time I return to the firehouse. You can’t take baggage from a previous run on your next run. My department’s health and safety officer aims to address the trauma on emergency workers even before they leave the scene of a call.

Before leaving, firefighters and paramedics hold debriefings to share what happened.

A few days after a critical incident, such as a child’s death, another intervention, a diffusing, takes place. People who were on the scene will describe what they saw. Instead of just sharing how they feel, they are challenged to quantify their emotions.

If a call was particularly traumatic, a deeper session, known as a debriefing, may start as soon as they return to the station house.

The department has stepped up efforts over the last few years to make sure people are handling the stress of the job. The department also started a peer support team, which now has more than 10 members.

They are not counselors, but there as an ear to listen.

On that spring day, I talked with police at the scene and found out what had happened.

Person (A) had hit the 2-year-old with his vehicle as the toddler ran into the street. A man who police would later identify as his uncle, Person (B), shot Person (A). The toddler’s brother, 15-year-old Person (C), was wounded in the gunfire. While I stayed on the scene to write my report, I cared for two more people who began to experience chest pain. I helped to treated them, and wrote up another report. I was the last paramedic to leave the scene.

After the fact, you start thinking about little things that you saw because now everything is slowing down and you have time to think about everything that happened. This typically happens harder when it’s your last shift on the schedule and you’re going home.

I get home. Exhausted. My wife and kids want my attention. I can’t even begin to share what has happened this past shift rotation. My family does not deserve to hear the details. I tell them I’m fine and go take a nap. It’s not easy. But it’s my job.