Hoffman says Steadman's central location and its variety of specialties contribute to the frenetic pace.

"It's a house that does a lot of different things," he says. "They got their hands in a lot more of a mix than most firehouses in the country."

But there's another reason for Steadman's high rate of emergency calls, firefighters say. In a city where one in four residents lives below the poverty line, problems are bound to occur in high numbers. Fires, they say, are a byproduct of societal decay.

"Fires are a barometer of a society's health," says Battalion Chief Frank Hazzard, who works at Steadman. "If you see a neighborhood with a lot of fires, I'll show you a neighborhood with a lot of problems with poverty and crime. …

"We get calls for asthma attacks because roach eggs cause asthma. We get calls for fires because people use candles because they can't afford heat. We get a lot of calls because of heroin. Baltimore is the heroin city. There's no way to explain our per capita heroin use."

Indeed, poverty and dilapidated housing often contribute to fire rates, fire officials and studies say.

"Virtually every study of socioeconomic characteristics has shown that lower levels of income are either directly or indirectly tied to an increased risk of fire," the Federal Emergency Management Agency wrote in a report linking poverty levels to fire rates.

Hook says he's frequently responding to houses most would deem unlivable.

"Some houses don't have lights," he says. "It's not uncommon to see bugs crawling all over the place."

Minutes after leaving the scene of the stroke victim, Hook responds to a call for an assault. The perpetrator is a young man being held at the Western District Police Station. An officer struck him in the shoulder with a Taser after he threatened her, police tell Hook upon arrival.

Officers bring the young man out of his jail cell. He looks at Hook with disdain. "No I don't want to go to no hospital," he says.

This confrontational attitude is yet another problem Hook says he encounters around Baltimore. He says it's not uncommon for paramedics to be harassed as they try to help a victim in the street.

While riding on some calls, "you're not supposed to wear your badge," Hook says. "You don't want to be confused for police."

Once the man at the police station refuses treatment, the paramedics leave, and within a few minutes another call comes across the radio — this one for a car accident. Hook and a team from Steadman arrive at the scene and carry two women away in stretchers.

Throughout the day, Hook sees a heart attack victim and a woman who needs to be transported between hospitals, and answers several false alarms.

It's not even lunch time.

There's an excitement to the job, but there's also a sense of duty, of helping some of the most troubled people in a troubled city.

"They just roll and roll and roll," Hazzard says of the medics. "There are only a few other cities that get our kind of volume. There aren't a lot of cities around the U.S. that have our kind of vulnerable population."

Hoffman says the volume at Steadman on this day is no different than years ago. They just have fewer firefighters to help out, as the department has shrunk and stations have been closed.

Steadman employees, he says, are no different from their colleagues at other stations, but it takes a special breed to work at the nation's busiest fire station.