When it comes to illness, mayhem, death and destruction, there is little that Gwen Wickline hasn't seen.

Wickline is a D.C. Fire Department paramedic, a job that demands skilled hands, a cool head and more than a little guts.

And though some people would find dealing with blood, broken bodies and broken spirits intolerable work, Wickline said she likes the excitment. Her reward is the ability to make a difference in people's lives.

Wickline's job also has its drawbacks.

"At first, you're overwhelmed with the verbal abuse," she said. Some citizens complain that the ambulance didn't come quickly enough; others challenge the capability of the medical technicians because they aren't doctors.

Often the city's medical technicians and paramedics serve as peacemakers, calming angry adversaries who are still arguing as the wounded are loaded into the van, and soothing the rattled nerves of worried relatives.

Learning to deal with stress, said Wickline, "is on-the-job training."

Wickline is one of the fire department's 137 emergency medical technicians (EMTs), about 20 of whom are women. They work for the ambulance service that responds to 911 emergency calls. She is one of 36 paramedics, which means she has received additional training and can give certain types of drugs to patients.

While EMTs staff the regular ambulances and can give basic first aid, paramedics ride the city's three mobile intensive care units. They usually are called to back up the basic units for accidents, drug overdoses, shootings and heart attacks.

The ambulance service makes 90,000 calls a year. Some of the calls are for life-threatening situations. Others involve lesser injuries. Still others are what the paramedics term "junk calls" -- nonemergencies. "We call it ghetto cab company," a paramedic quipped, recalling the cases in which they did little more than provide people with a free ride to the hospital.

The aggressive, 29-year-old Wickline is from Takoma, Washington. She joined the Navy when she was 17 and was trained as a medic. She enjoyed medicine, so when she came to the District in search of a government job four years ago, the fire department's ambulance service was enticing. The money looked good, she said, and, better yet, it was "a job that won't be replaced by machines." Her size -- 5 feet 2 inches, 110 pounds -- posed no problems.

"I lift weights," she said, displaying a well-developed bicep.

An average day for Gwen Wickline could include anything from a person suffering the effects of too much alcohol to a serious car accident.

Last Friday, Wickline worked the 4 p.m. to midnight shift. She arrived at the fire station at 1533 C St. SE early enough to watch the end of "General Hospital," a daytime soap opera. By 3:45 p.m. Wickline was chatting with Larry Porter and Henry Lyles, who had just ended their shift on Medic 9. She climbed into the boxy ambulance to check over her supplies.

The first call of the evening came over the radio at 5 p.m. Wickline and her partner, Joe Rainwater, slid into their seats, Wickline behind the wheel. She hit the flashing lights and nosed the ambulance out into the street.

The call was for a fender-bender. A 21-year-old man had slammed his car into the back of another automobile and struck his jaw on the steering wheel. Wickline guided the tall man to a bench inside the ambulance and gave him a tray for spitting blood. She surveyed the damage. At least one tooth was missing and two teeth were shove into the gums.

"Look in the car for teeth," she shouted to an observer. While Rainwater collected details on the accident, Wickline called area hospitals on the radio trying to locate an oral surgeon. She got her answer and off they went to D.C. General Hospital.

The accident victim had just been wheeled into the hospital when the next call came in: a drug overdose in Northwest. An ambulance was responding but the other two advanced life support vehicles were tied up. It took 10 minutes for Wickline to drive across town to Rhode Island Avenue and Second Street.

When Medic 9 arrived, EMTs already had put a tube down the unconscious man's throat to help him breathe. His friends, also high, were shouting into his ear. "Wake up baby, come on, man."

Wickline injected two vials of Narcan into the patient. The drug counteracts narcotics. It's a "junkie's nightmare," according to Wickline. A few moments later his eyes opened and he struggled to his feet. His buddies thanked the street doctors. Ambulance Supervisor Paul Harvey shook his head. "He's on his way, off to look for money to get another one (fix)."

The ambulance crews packed up and headed home. Before they got there, another call came in. Time: 5:55 p.m. Ambulance 5 got to 34th and Clay streets NE first and Medic 9 was waved on. A woman, drunk, sat on the curb holding her head. No injury.

The radio squawked again. It was 6:10 p.m. Back to Northwest via Benning Road and Florida Avenue. Medic 9 pulled upon a back street and an entourage of medics and police officers followed a wandering alley toward Rhode Island Avenue. Creaking metal stairs took the group into an abandoned boarding house -- a shooting gallery in the language of the drug world. The litter on the floor was two inches deep.

Curled up on the floor in the fifth room down the hall was a young black man. The police waved everyone away. "He's dead. Call the coroner," an officer said.

Wickline pushed her toe through the debris, her sharp eyes finding the needle. She leaned over the city's newest overdose statistic, felt his skin, and eased his eyelids shut. She estimated that he has been dead for about five hours.

At 6:45 p.m. Medic 9 was home, in time for dinner: baked zitti and salad. Every firehouse has at least one good chef.

The break gave Wickline a chance to talk about her work. Despite its high emotional impact, she likes the challenge.

"I love trauma -- blood and gore," she said. "There's so much to learn from it. It's about the only time you can see what the inside of the body looks like. Your adrenaline starts pumping (when you're) thinking about what you should do."

While blood doesn't bother her, Wickline said frankly, "The only thing I can't handle is someone throwing upon on me."

Like a soldier on a battlefield, Wickline has learned that a strong sense of humor, albeit a morbid one, is a saving grace.Her favorite story is about the "great big guy who was standing up in the street waving his arms yelling, 'I've been shot!" Indeed, the man had a bullet hole clear through his head. But just moments before, she'd seen an almost identical scene in a Clint Eastwood movie.

Wickline's toughest case occurred just a few weeks ago. It was early evening when she was called to Moore Street in Northeast. When she turned the ambulance onto the street, Wickline saw a child's tennis shoe in the middle of the intersection. It belonged to a 6-year-old boy who had been dragged 50 feet down the street by a car.

The child had a deep cut on the left side of his chest. Wickline said she thought the license plate on the car had cut through the boy's chest and into the major artery that leads to the heart. The boy seemed to have lost half of his blood while lying in the street.

"I just picked him up in my arms and held him against my chest for pressure. The first thing he said to me was, 'I'm going to die.'" He said that three times before they reached Children's Hospital, Wickline recalled.

Wickline was blood-soaked and shaken. "It was the first time as a paramedic that I felt incompetent," she said.

Paramedics are required to follow a different set of rules with children. They are trained primarily to treat adults, and because children's bodies respond so differently to mdeication, the medics are limited to providing basic first aid before rushing a child to the hospital. Medics call the procedure "drape and boogie."

Wickline, a usually energetic woman, spent much of the rest of that evening shaken and quiet. A doctor later told her that the boy had survived; he termed it a miracle beyond his explanation.

The next call came in at 7:10 p.m., before Wickline finished eating. A man in his 50s had chest pains. Indigestion was ruled out and when Wicline and Rainwater ran an EKG, they found nothing unusual. However, they coaxed the man into letting his children take him to the hospital to see a doctor.

At 8:30 p.m. Medic 9 answered a call at 15th and Gayle streets NE. The paramedics were greeted by a woman's hysterical wails. "Please somebody take me to the hospital," she screamed while jumping up and down. "I feel sick, my heart is beating hard," she said repeatedly. A neighbor suggested that the woman had been given some type of drug at a friend's home.

She was guided into the ambulance while crying tearlessly and repeating her mother's address. Wickline looked into the woman's eyes, which she later described as being "as big as space potatoes."

"Stop it right now," Wickline said sternly. "Stop screaming at me, I'm not 10 feet away . . . you're okay."

The woman's eyes and hyperactivity convinced Wickline she'd taken some type of speed. During the ride to D.C. General Hospital, the patient confessed she had taken a drug. Wickline shook her head. "Next time, don't take so much," she admonished.

At 8:50 p.m. a call came in for an unconscious person at the Safeway at the new Hechinger Mall. Medic 9 was greeted by a fire engine and another ambulance. A young Hispanic woman lay on the floor by the diary counter, shivering under a blanket. She said she slipped on a puddle of blood, perhaps from the meat counter, though Rainwater said the floor was dry. b

When the medics attached electrodes to take a cardiogram and put a blood pressure cuff on the woman's arm, her uneasy husband began questioning them.

Wickline waved the man away.

"We're paramedics, it's okay," she said with obvious annoyance. The woman's blood pressure was low. To boost the pressure and stave off possible shock, Wickline inserted a small needle into the woman's arm. The needle and the attached tube allowed a blood supplement to drip into the patient's vein.

The husband was furious when he saw the needle and a trickle of blood on his wife's arm.

"Oh, my God, what are you doing to her? You're going to kill her. . . . Take that thing out of her right now," he shouted.

Wickline pursed her lips and helped the other medics lift the woman onto a stretcher and wheel her toward the ambulance headed for Capital Hill Hospital. Much to Wickline's relief, the husband gathered up his small daughter and drove to the hospital in his own car.

The two paramedics finished their paperwork on the case and went back to the station. It was 10:30 p.m. and Medic 9 had made its last call of the evening. The ambulance didn't roll again until about 1 a.m.

Wickline pulled her hair out of its tidy bun, shook her head, gathered her needlepoint materials and headed for the door. It had been a relatively easy Friday night. Shootings, stabbings, overdoses and car accidents are standard fare on weekend nights.

She knew the midnight and Saturday shifts would have their hands full. On Monday morning, the log book showed she was right.