Russ Reina experienced the early days--and it toughened him. His EMS life began as an ambulance attendant in the Big Apple borough of Queens in the early 1970s. He later grew to EMT and, through an early pilot program, MICU paramedic in Daytona Beach, FL. In 1978 he rode west to Santa Barbara, there cofounding the California Paramedics Association. He burned out on the politics, if not the work, and left the field in the mid 1980s. Subsequently he explored areas including alternative medicine, counseling and personal growth programs, ultimately becoming a minister in the Universal Life Church and developing a workshop, "The HeART of the Healer," that uses acting and improvisation exercises to strengthen healers' "ability to use heart-consciousness, complete presence in the moment, and connection" as tools of their craft.
Against that medical/spiritual backdrop comes his self-published book, Moments in the Death of a Flesh Mechanic...a healer's rebirth. Completed after Reina moved to Hawaii in 2003, the work chronicles defining instances in his progression from detached streetwise technician ("flesh mechanic") to the fully spiritually, emotionally integrated and involved "healer" he finally became. "The truths I learned," Reina relates, "had more to do with relationship than technique. My lessons were not about medicine, but about myself." For purchasing information, visit VirtualBookworm.com.
I'm sure lots of EMS providers struggle against just being "flesh mechanics." What does your book have to tell them?
My overall goal is to expand the conversation within emergency medical services. In my experience as a medic, we very much relied on the TV show Emergency! as our touchstone. And Johnny and Roy were quite competent flesh mechanics, but they didn't have an ounce of wonder in their bones. My experience was that I was being barraged by very human experiences while being asked to perform as a competent mechanic on human beings. That rocked every aspect of my world. I wanted to convey that because back in the station, back in the hospital, such things are not spoken about. Such things may be joked about, may be laughed about, may be mocked. But when people's worlds got rocked in areas beyond the technical part, they didn't have much of a venue to talk about it. I was one of the maybe 20%, 25% of medics out there curious about exploring some of the more esoteric aspects of what it means to be a healer in the back of an ambulance. Part of the motivation for writing the book is to help give some permission to people in EMS to be able to expand the conversation and talk about the very human experiences they have in the backs of ambulances.
How did that sort of awakening and rebirth happen for you?
It was kind of forced upon me. I'd gone into emergency medical services as a green first aider in the 1970s. Without any tools to work with, I found emotions were a very important part of the work I did--my connections with patients were very important. But then, after paramedic training, all my focus went up to my head, and I built a hard shell. Gradually that got chipped away, and part of the challenge of the book was to show that happening in moments that were very challenging, and through experiences that called upon me to go into deep reserves.
I'm trying to show you can maintain your sensitivity as a human being and still do the work. This is one example of one guy who managed to do the work and have an emotional life in the process. But that can't happen in a vacuum. The book is not enough to do it. The book needs to be a springboard for medics to take responsibility for themselves and, at the very least, listen to each other and respond honestly when one of their partners or peers talks about stuff that shakes up their world. Give them an audience, and people can work through this stuff--that's my point.
Do you get a sense that medics today are more connected to their emotional sides than they were back in the 1970s and '80s? Has the macho culture diminished at all?
What I'm finding is that online, medics are able to talk about this stuff. Participating in online forums, they're a lot more proportional. And when people new to the field talk about things they don't know how to deal with, I've seen a lot of hardened, seasoned guys stepping right up and giving them that emotional support. But I suspect it's not as prevalent in the workplace. I don't think it's a hell of a lot different there than it was 25 years ago, as far as the outward culture. But I see medics are talking about it and looking for support online, where it's a safe environment.
I realize this whole idea is bucking the dominant culture. The dominant culture of EMS is much like the fire, police or military--it's a warrior class, and I think that's a really good thing. It's important for many people, to be able to do the work, to see themselves as warriors. I approve of that--and I want to make room for the 20%, 25% who are able to enhance their experience by more fully experiencing themselves as human beings doing the work and saving lives.
How did filtering your journey onto paper change you? Did you gain any insights from the writing process?
To adequately and accurately describe my experience as a human being in the back of an ambulance has been a 25-year quest. This started in 1985 or before. While I was still in the field, I was taking notes and starting to write short stories. I always wanted to convey the kind of world a paramedic lives in emotionally, as well as physically. As the years went by, I saw most every book done on this was from the point of view of a flesh mechanic, or someone on the road to becoming a flesh mechanic, and burned out. I knew there was so much more to it. I always wanted to help paramedics expand their understandings of themselves as healers.
So this has been a lifelong explanation. My Firetender website talks about what I did with my experience as a paramedic, and how it was the foundation for the next 25 years of exploration of the healing arts. It has permeated every aspect of my life. And it's based on my finding all this out in the very nitty-gritty world of the back of an ambulance.
Was it always your intention to self-publish, or did you try traditional publishers first?
I finished the first version of the book probably around 1996, and I tried the standard publishing route for about 10 years. That meant sending the book in completed form out to publisher after publisher, agent after agent. Everybody passed on it. Many near hits. A version got picked up by an agent, but he got ill and dropped all his projects, including mine.
By 2005 I got involved in some online forums and realized the voice of the book more fully, and I did some rewrites. By the time I got through with those, the industry had changed completely. It had moved away from the traditional brick-and-mortar bookstore sales of books into an online enterprise. Now all of a sudden you had the opportunity to publish a book on your own and maintain complete control over the final work.
When the technology was able to support that, I realized I didn't have to convince anybody to love my book--I could publish it on my own and reach my own audience. It gave me complete and utter control. I ended up formatting and designing the cover and doing everything on my own, which was a great learning experience.
The technology lets you get something out there relatively cheaply, and have it well represented and find an audience for it. I heartily encourage EMTs of all stripes to take the time to sort through their experiences and work them out on paper, put them in words, see what it looks like--see what kind of worlds they can discover inside themselves.
Russ, anything else folks should know about your experiences or perspective as they read this?
It says it all on the cover: You have the Star of Life up there, and being a medic is all about life and death and judgment and action taking place in that. But there are areas we don't deal with, and that is the flesh and the spirit, and the head and the heart. These are things that have to get mobilized in the process in order to become a good paramedic. That's pretty much the hub of my wheel: I'm saying to medics that the world they live in is going to consist of conflicts between their head and their heart, and having to deal with the differences between flesh and spirit. These are things that do not get spoken about, and these are things I want to be spoken about, so that every medic, when they think in terms of their relationship to the Star of Life, will also consider those other elements of flesh, spirit, head and heart in all the work they do.
Excerpt from Moments in the Death of a Flesh Mechanic...a healer's rebirth
This wasn't the first time I had told an attempted suicide I'd prefer to be helping someone live who wanted to. It didn't happen often, and only with repeats, but still, it was inevitable given the number of such calls I had to run. Too many ambulance calls are about providing a chance to live to people intent on seeking death!
It used to be I wanted to pass on some sense of responsibility to them, to inject them with the idea they actually do affect people. What I said never really had an effect; they were wrapped up in themselves, I decided, so I stopped trying to be the one to re-instill their will to live.
Teresa didn't feel wrapped up in herself today. Not like in the past. Today, there was a quality of resignation in her I hadn't noticed before; and something else, a sort of strength.
Something was brewing in me, as well. It dawned on me, loath as I was to admit it; I had a relationship with this woman. My life had intersected with hers at very crucial junctures. I knew this woman at her most human points, and something had changed in her. I was a little chilled by it. But I couldn't help myself; I wanted to know more.
I stopped my busywork and just looked at her. Her eyes were staring at a space just above her feet. It wasn't a vacant stare; it was more a look of solid determination.
"What are you doing?" I asked, "Where are you at?"
Whenever she ended up in my ambulance, whether I liked it or not, I got another glimpse into her life. Her distaste for life hadn't seemed honest to me. There had always been an edge of her playing, toying with the idea of ending it. It felt more like she wanted to run from her life, which is different from wanting to end it.
I'd do my job; get her to the hospital alive. I'd even lecture or question her. The last time, I yelled at her. She, like so many others, was a drain; on everyone in her life, the system, me, and your pocketbook. I couldn't respect her because she really wasn't serious. That makes it feel like we're all being jerked around for fun. But today, I sensed something was a bit different.
"Let's face it, kiddo," I said, maybe wanting to test her, "you must not have been completely ready to check out today. Neither were you ready the last two times before that. How many other times did you try when it wasn't me that picked you up this year?"
"Five times this year!" I exclaimed. "What's that tell you?"
"I'm incompetent?" she asked seriously.
Most people I pick up screw up the attempt once. The second time they figure it out and do it right, if they're serious. Either that or they quit and just get on with living as best they can. I wasn't trying to shame her. My point was valid. People who are really intent on suicide commit suicide. Quietly. Irrevocably. If ever there's a bit of wavering, a doubt, often it won't be successful.
True, there are accidents, where in a "call for help" they just happen to get the technique right and do themselves in. To decide what is a call for help gone awry and what was the genuine article is a crapshoot when it comes to drug overdoses and flesh wounds. The ones who are intent, however, leave little doubt, for their choice of vehicle is irreversible. Most often, if not dramatically throwing themselves in front of trains or well-planned hangings, it involves guns. It's the ones who are serious that I was comparing her to this day.
One day in Florida my partner and I arrived on a scene just prior to the Sheriff. We had both been dispatched to check out the concerns of a panicky family member who had received a "disturbing" phone call from her nephew, across town.
The relatively small house, on a corner of a typical residential neighborhood, had a thick wall of tall bamboo encircling it. Me and my partner cautiously knocked on the locked door, and getting no answer, walked around the side of the house to the back yard. We passed through a corridor of bamboo and both stopped in our tracks, awestruck at the sight of the garden.
Apparently, it was an Oriental garden of such design that it radiated "peace" as soon as we entered it. Not knowing anything of Feng-Shui at the time, I was bowled over by the precise, evocative beauty of its design. My partner was no less stunned. I literally felt a wave of peace, contentment and serenity wash over me. It was an incredibly long moment, but only a moment because it was part of our steady approach to the back of the house.
There was a walkway that went between the rear door of the house and a freestanding garage beside it. When we looked into the open garage we saw a body hanging from a rafter, a thick rope tied into a perfect Hangman's Noose around his neck. His face was bulging blue--clearly dead. Closer examination showed the man had stepped up on a rickety step stool, slung the rope around his neck and then shot himself in the heart with a small caliber pistol. This dude was serious!
"I've tried pills...twice," Teresa said. "I even tried gassing myself. What more can I do?" She wasn't pleading. She was asking a direct question.
"The phone keeps getting in your way for one," I replied. "It did this time for sure. You left it off the hook, and your brother got alarmed. You knew damn well that he doesn't stay away for very long at a stretch. He leaves the house and you think about it and you think about it until maybe just an hour before he comes home, you decide to do something. But by then, he's home and we get called. To be honest, Teresa, your tactics and timing suck."