HUDSON, Ohio An alarm shrills, like a buzzer ending a basketball game.
Tina Maier dumps her hefty paramedic textbook. Bob Carleton climbs into the driver's seat of an ambulance. Bo Marshall and John Montgomery scurry into the back.
"Guys ready?" calls Carleton, blaring the siren and switching on the lights.
This is why they volunteer.
Like 83 percent of the 69-member Hudson Emergency Medical Services squad, Maier, a student; Carleton, an advertising recruiter; Marshall, a Children's Hospital trauma tech; and Montgomery, a retired executive, are unpaid.
Nationally, the majority of emergency medical technicians - many of whom are also firefighters - are volunteers, according to the National Association of Emergency Medical Technicians. And 73 percent of firefighters, too, are volunteers, according to the National Volunteer Fire Council.
But in Northeast Ohio, EMS Director Bruce Graham cannot name another EMS department set up like Hudson's, which marks its 30th anniversary this year.
The department pays him and an operations manager, as well as an administrative assistant, five shift officers and four paramedics. The rest of the department's workers commit to shifts in their spare time.
"It's unique for a community that size to do that because of the increased runs," said Howland Fire Chief George Brown, president of the Ohio Volunteer Fire Chiefs Association. "It's very admirable."
Each state-certified Hudson EMS member staffs the station and serves as back-up about 12 hours a week. Some work from 1 to 7 p.m. Others squeeze in a 7 p.m.-7 a.m. shift between their day jobs and pray they get to sleep.
Together, they responded to 1,464 calls last year.
"We man the station, always have, since the day we started, April 2, 1977," said Graham, 49, who joined in 1995. He calls his unit - a distinct entity from the Fire Department with which it shares a building - "an island in a sea of paid departments."
Hudson's 32 noncareer firefighters, paid a modest $10 an hour for calls and training, are also considered volunteers. Rather than manning the firehouse, the chiropractor, ministers, pilots and executives respond from home or work to about 800 calls a year. About 600 are handled by a single officer.
That's a more traditional volunteer model expected in rural, blue-collar communities throughout the Midwest.
Hudson, of course, is not rural. Nor blue-collar. Nor small.
A city of 23,000 people and 25 square miles, Hudson has a median household income of $99,150, according to the 2000 census. The median house costs $236,700. About two-thirds of residents hold at least a bachelor's degree.
"We've got some BMWs in the parking lot that aren't being paid for by taxpayers," said Fire Chief Bob Carter.
Montgomery, 69, is a retired electrical company vice president from Dallas who moved to Hudson to be near his wife's hometown, Ravenna. An EMT-Basic with hundreds of hours of training, he's been a volunteer for the last five years.
Carleton, of Hudson, has worked the same Friday afternoon shift for a decade.
"It's a lot different than my regular job" in advertising, Carleton said. "It's exciting. It's very rewarding."
The rest of Friday's crew - a half-dozen members wearing identical Hudson EMS T-shirts, navy pants and serviceable black shoes - perch around a picnic table, teasing each other.
EMS members seem to genuinely like the work, and they enjoy hanging out with others who like the work.
The crews drive ambulances to Donatos for lunch, quiz each other on EKG rhythms, sprawl on overstuffed couches and watch movies. And when the call for an accident with injuries crackles over the radio, they transform.
No longer a group of friends jawing about gas prices and the Cavs, the EMTs are serious and efficient, assessing and backboarding an accident victim in 10 minutes.
Inside the ambulance, as Carleton drives Code White (no lights or siren) to Cuyahoga Falls General Hospital, the rest of the crew buzzes about, giving the 37-year-old man oxygen, sticking in an IV and monitoring his heart rate.
"Are you remarkably attached to this shirt?" asks Marshall, 24, of Copley Township.
"Mind if we cut it off?"
As with volunteer departments across the country, it's getting tougher for Hudson EMS to recruit members.
People are busier, with two-income couples and kids' sports teams, longer commutes and more commitments. Providing emergency medicine is tougher as calls increase and citizens raised on "Rescue 911" expect more services and fancy machines.
A number of traditional volunteer fire departments have switched to paid on-call or part-time firefighters, said Shane Cartmill, a spokesman for the Ohio fire marshal. "There is a struggle always to get volunteers."
Four years ago, Hudson EMS had 95 members. Graham needs at least 65 to keep three people at the station at all times.
For the foreseeable future, he said, the volunteer model can work - if the organization gets creative about recruiting.
Volunteers save the city about $1.2 million a year, allowing it to host training sessions and buy high-tech equipment, said city spokeswoman Jody Roberts. The city provides training for EMT-Basics and foots the $3,900 bill for a paramedic course for members who stay at least two years.
"It has been since Day 1 a training center," Graham said. "We're going to take people who are local, get them to stay here."