They rappel down buildings, dangling upside down when mangled scaffoldings mangle limbs.
"Here they are, in a situation where they think it's the last moment on earth. And here we are, trying to convince them that's not gonna be the last moment they have on this earth," Juan Henriquez said.
They could be the most elite city paramedics in the world. Henriquez and Don Feith are among the 104 rescue medics of the FDNY.
They train for the most rescues and before firefighters can shore up a scene to make it safe, these are the guys who go right in to treat the patient at nearly any cost.
"The first thing they tell us in class is if you're not willing to go into a situation that's not stable, that's still dangerous, you need to get up and walk out," Feith said.
About twice a year the rescue medics come to the FDNY's training facility on Randall's Island to go through simulations and hone their skills. But almost every day, they see people in need of rescue in real life.
Like in March, when rescue medics braved chest deep mud to treat a worker trapped while building the 2nd Avenue subway.
Or in 2008, when a massive crane crushed a walkup building in Midtown. It was Juan Henriquez who administered aid to a resident whose legs had been crushed.
"They will always put themselves out right to the edge, for anybody," Captain Louis Cook said.
Cook runs the rescue medic program, which exists in part because of something they call the smiling death. When muscles are crushed, they release lethal toxins into the blood, which can kill the victim once he's free.
"Somebody's extricated, they're happy to be out, and will die a day, two, three days later," Cook explained.
"It's kind of sad, they have hope and it gets taken away," Feith said.
The fire department used federal grants to kick off the program in 2006. Since then, it's more than doubled to eleven specially equipped ambulances.
In 2012 alone, rescue medics responded to more than two dozen confined space rescues. They're constantly training for more, getting ready to pull someone to safety from the next disaster.