Mr Coyle,
I have an 1200' tower just right of the approach course and 8.11 nm from the the nearest airport with scheduled service that's been NOTAMed as intermittently illuminated for 6 years. That's right, SIX years.
Sometimes it has 1 light (the top), sometimes more, and lately new lights, generally working. But 6 years. Yes, I reported it to the FCC after talking to the FAA. I even talked to the company contracted to monitor it. Still, 6 years is a long time. You can tell how urgent the situation is for the tower's owners.
At my program, no pressure to accept dispatch, and no medical information shared prior to dispatch. I'm paid to say no, it's the hardest part of my job. The medics I fly with share the same attitude, in that saying no is tough. They'd rather not go than abort a run, with or without a patient. The time wasted in that process is completely NOT what we're about. When in doubt, chicken out- and go back to bed.