The world stopped. They didn’t

Giovanni Cappa

Emergency room physician
Rotaract Club of Pavia, Italy

I am a medical resident in one of northern Italy’s university hospitals. We’re a big emergency room, one of the biggest in Italy. We’re at the epicenter of this huge storm.

When the coronavirus hit Italy, the first cases in China had been recorded just two months before. A lot of research came out day by day, so we had briefings every morning. Guidelines about drugs and ventilation parameters would change daily. We would discover new things about the disease’s pathology and have to adapt.

In the first days, we had waves of patients. Many emergency rooms in the region collapsed — hospital personnel got infected, or the hospital didn’t have the ability to accept coronavirus patients. So we received patients from other parts of the region too. We didn’t have space. We had patients everywhere. We set up a new emergency room in a day, but we were lacking things we were used to having, like computers for administering the logistics. That was just a little thing. There were many times we didn’t have enough oxygen supply for everybody.

We had to make many difficult choices. Many coronavirus patients cannot breathe when they come in. They’re in respiratory distress and they need ventilation. We had patients walk into our emergency room and collapse. People were so scared. The small number of beds in intensive care were filled instantly. Coronavirus patients don’t spend one or two nights there; they spend weeks.

We were used to giving all the best medical care to anybody who needed it. That wasn’t the case anymore. We needed to use our resources with common sense. We needed to prioritize care to the people who would survive. It was catastrophic medicine. Shortly after, the Italian society for anesthesiologists published guidelines to help make those decisions.

We would tell families that their loved ones didn’t make it, and we couldn’t let them see the body. They would implore us for a farewell, but we couldn’t let them. Those were some of the hardest moments.

We are used to working in cotton scrubs. They’re really comfortable. The emergency room is quite hot, and we need to move a lot. At the end of February, we got the orders that we had to wear full gear every day, for 13 or 14 hours in a row. It’s like full body armor, and it makes you sweat. It’s challenging because in an emergency room you have to move fast and make precise maneuvers, and now you have to do those things in bulky gear. And you can’t even make your patients feel better with a smile. You lose the human connection.

The silver lining is that we’re learning a lot. We keep facing really strange and difficult situations. We are working together, young residents and more experienced physicians. There is real teamwork; the whole hospital is collaborating because we have a common enemy.

It’s not easy. It’s something none of us were prepared for. The huge amount of work distracts you from the emotional aspect. There is so much to do. Even though we see a lot of death, we are saving a lot of lives. You try to be strong for your patients and for the families you are trying to help.

Many doctors and nurses are burned out. Many got sick. Many of my colleagues have not seen their families since the beginning of the outbreak. Many moved to another flat, away from their loved ones. They’re scared they might infect family members.

We’ve had huge support from the community. We’ve had help from Rotary clubs and Rotaract clubs. Every day we receive donations from restaurants, or people buy pizzas and have them sent to the emergency room. These are simple acts, but it makes us really happy to know that outside these walls, the community is thanking us for the work everyone is doing. We feel the gratitude.

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• This story originally appeared in the August 2020 issue of The Rotarian magazine.