FORTUNE -- Joshua Sparks and Ed Shoemaker postponed their first interview with Fortune because they had to get in a helicopter and save someone's life. It was, perhaps, the most valid reason for rescheduling I've heard.
Sparks, 37, and Shoemaker, 42, are, respectively, a critical care paramedic and pilot on the University of Massachusetts Memorial's Life Flight team. Life Flight responds by helicopter to emergency medical situations all over Connecticut, New Hampshire, Massachusetts, and New York.
Shoemaker actually works for a company called Air Methods, which partners with UMass for its Life Flight program. On every flight, there's a pilot employed by Air Methods and a nurse and EMT from UMass. The three work together -- mid-air -- to care for patients with urgent medical conditions. It's trauma-treatment teamwork in the sky.
Sparks and Shoemaker took a brief break to talk about providing critical care in a chopper.
Fortune: This work is so intense. Did you guys always know you would end up doing something like this?
Joshua Sparks: I've worked as a street paramedic in urban settings for the last dozen years. I think for anybody who's going to stay in this field, it's a fairly natural progression.
Ed Shoemaker: I got into EMS [emergency medical services] right out of high school. Shortly after that, I decided to become a paramedic and worked as a paramedic for about 10 years. In my quest for the latest and greatest new challenge, I decided I want to be a flight medic, which, after the first ride in a helicopter, turned into, "I want to be a pilot."
So a month later, I packed up the truck and sold everything I had and went to flight school. After flight school, I bounded around the country, earning time flying helicopters as a tour pilot, and I hooked up with Air Methods. Just by sheer dumb luck, I came back home and have been flying here for about seven years now.
What is it like to treat patients in flight versus on the ground?
JS: It's just a completely different world, to put it mildly. The street environment can be somewhat chaotic -- there's moving vehicles and angry family and pedestrians and any type of variable that you could possibly imagine, but you always tend to have some sense of control over your situation, because, at least, you're on your own two feet and you can walk, run, or drive away. The aviation component changes your entire mindset. All of a sudden, you've got these other concerns about other traffic in the air, about how you're functioning as a team. On top of that, the patients we tend to see are some of the most critical patients out there.
What about your job, Ed?
ES: The mindset I have when I'm at the controls is that I'm just flying a helicopter. I can't allow myself to get concerned about what's going on in the back. In fact, the pilot's never given a nature of the call, just the location. And that's specifically so that we're not pushed to make a decision based on whether the patient is a child or a cop that was hit on the street, or something like that. That allows us to solely concentrate on flying the aircraft from point A to point B.
Yeah, that's a good point. Helicopter trips can be dangerous. How do you make sure you don't take on a mission that's too risky?
ES: Being in the air is one of the more difficult places to start making multiple decisions. That's why only the pilot can accept a flight, but anybody can turn it down for any reason with no questions asked, no repercussions.
Wow. Full veto power for the whole team. Is that typical in medicine?
JS: No, not even remotely. On a ground ambulance, we tend to have really equitable partner relationships. But it doesn't have the same strength as some of the decision-making that we're talking about here
What have you learned about yourselves from working in this kind of environment?
JS: I think it pays to constantly be introspective of the decisions that we make. One of the toughest things people can do is be critical of their own actions and try not to make risky choices in spite of their instincts. It really pays to slow down and try and take it all in, to have good situational awareness, and follow a procedure as much as possible.
ES: As corny as it sounds, if I've learned anything from this job, it's to enjoy every day because bad things happen, and you know, just enjoy it while you got it.
Do you ever think, "This is too hard, I'm going to do something less demanding?"
ES: I've often thought of joining my pilot brothers in a pressurized metal tube at 30,000 feet, doubling my salary, and how neat that would be. But I'm still an EMS junky at heart.
JS: There are so many different careers in health care that would easily triple my salary and give me a much more comfortable lifestyle at home, but the fact is, I do fine, and I'm doing something I enjoy. I really like trying to organize the chaos. I think that's the mindset you tend to find in this field.
ES: I think it's telling that I have to wake up at 4:00 in the morning for my day shift, and I absolutely love coming to work. I have no problem going out in the darkness when it's cold in the middle of January because I get paid to fly a helicopter.
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