Hey Fatigue...I think you would find that most of us who are US EMS pilots relish the 7&7 12 hour schedule. As for going over the twelve hours that does happen, not regularly but it does happen, and only if it is deemed a medical necessity. As for your opinion of night VFR being "unsafe" and landing at unknown landing sites, I'm sure that once again you would find the majority of us who do it on a regular basis are well trained as well as professional enough to know when an lz is unsafe or when we shouldn't be out flying VFR, SPVFR, or for that matter SPIFR. Until you do the job you know not of what you speak.