Like another poster in this thread, I work in the fire/EMS service. Been at it 25 years; 12 of it was on an ambulance rotation on a busy rig wherein sleep within a 24 hour shift was almost non existent. Also worked a side job doing carpentry for most of it.
I've always loved the job (both jobs, I should say), but as I get older and look back, there's just no denying the toll lack of sleep takes on one's overall fitness, wellness, relationships, etc. Most fire departments work a 56 hour week, which was likely a better fit in the 60's when the FLSA language allowing it was passed. At that time, most departments did fire suppression only and there was more down time and regular sleep in the 56 hour work week. Now EMS and ambulance work is pretty standard, yet the 24 hour shift remains. On the department I work for, our slowest engine is now 2X busier than our busiest engine was in the mid 90's.
As much as its an interesting and challenging job that I still get a kick out of, I don't think I'd do it again, or at least not on the 56 hour schedule. I'm still at it, so I'm conflicted on what the best answer is, but I've come to the realization that a person has to take care of themselves in order to enjoy an engaged and fulfilling life, and it's just a reality that there's certain job circumstances that make doing so difficult. We still live in a free-ish country where one can make choices about work and location, and I dont think it's wrong to prioritize wellbeing over monetary bottom line, so long as one can still meet obligations.