Emergency Observations -Inside Italian First Aid

I would never have expected to end up in a First Aid waiting room on my last Italian “holiday”. Then again, I bet nobody in the said emergency room ever expected ending up there. Positively speaking, it was the perfect chance to do some emergency observations: to look at Italians in a very different environment, in a big hospital in Bologna.

Italy dealt with a massive Corona outbreak, pushing it over the limits of its hospital capacity. To remind us of how things were for four months ago, here is a little article containing Olmo Parenti’s short documentary from a Milan hospital, “Coronavirus From One Meter Away“.

Triage

Being a Finn (that is, hysterical with organization and hygiene), I did some shocking emergency observations at the corner of the triage nurses. This is where they assess the severity of the patients’ situation and allocate them to four different waiting lines according to how fast they must be treated. In other words, this is the place where you first go to share your worries, and then the tired and rude nurse either sends you back home or pays to you the minimum attention needed. I was allowed in the space even if it wasn’t me who needed medical assistance and had a chance to look around.

I had free access to see two computer screens at the same time and hence, I could easily have gotten glimpses of private patient information. Many nurses didn’t wear medical masks nor gloves. Most of the female nurses wore their hair open and had rings and other jewelry in their hands, something even a non-nurse working at a hospital would be wary of doing in Finland. There were a lot of stuff lying around the tables and under them. The patient information system looked like an ancient one, probably dating back to the 90’s.

In this triage corner, several patients were consulted simultaneously. Hence, no-one’s faces and problems remained a secret. None of the complaints included Covid-19, however, as a special route and area inside the hospital was reserved for cases with the nasty virus. I think this triage setting was something temporary and improvised to deal with the Corona outbreak, but the lack of attention on some basic details made me a little worried.

The Waiting Room

We were further invited to sit in the actual waiting room. I spent five hours pretty much observing the surroundings, because a certain level of tiredness makes even browsing the mobile not an option. Plastic chairs went around the quite dirty yellow walls of the waiting area. In the middle of the floor there were spaces marked with colorful tape for hospital beds. More and more people were pushed in on wheeled beds or in a wheelchair and placed inside the taped spaces to ensure the 1.5 meters distance.

In a corner, a skinny girl with a black mask was studying what looked like geometry and mathematical equations. Her mother arrived after a while, a calm blond trying to keep her daughter distracted until she was taken to operation around 3 AM. In the center of the floor a gazelle-eyed very young Muslim girl was lying quietly. Her husband sat further away, looking at his mobile with headphones on. He did not look at her much and when he did, the eyes were a mixture of fear and unreadable coldness. A pissed-off nurse came to ask whether the girl had a headache, and as she and the translating husband confused the Italian words for headache and dizziness, the nurse seemed to draw the conclusion that there was no problem at all.

The elderly seemed to have the hardest time as they one after the other discovered that the First Aid waiting room was not a five-start hotel. One was complaining about too bright lights. Another one first complained for a while of not getting any attention. When the nurse then came calling her name, she didn’t say anything. The nurse walked up to her and asked whether she was Signora Rossi (name invented). The patient admitted this was the case. “Why didn’t you tell it right away then?” asked the nurse. “Because I had to wait for so many hours and nobody came.”

I’m sure my reader understands why that kind of a martyr behavior is wrong in so many ways when we are in an emergency room at a hospital in any time, especially in Covid time. Then again, when you are old, you are more tired and perhaps more scared. None of the old people in the waiting room had someone to accompany them. When people don’t have much sense of control over their situation, complaining is a tempting option. Also, when nobody seems to tend to your needs, it’s easy to start whining about things to get attention. In many settings, especially in a hospital, this ends up being counterproductive. The nurses don’t care if you’re cold -they are trying to save lives while all you need to do is to wait patiently.

Another elderly, a man in his old man’s pajamas, complained first of not being able to go to the toilet (even if he did get to the toilet), and then about everything. First, he tried to make the nurses and doctors passing by to stop by raising his finger as if asking for a bill at a restaurant. As this did not bring results, he started waving a bit more aggressively. When the staff still continued to ignore him- probably after labeling him as a complainer who didn’t really need anything- he moved into a hand gesture that is approximately the equivalent of “What the fuck?!”. The gesture appears on this video at 0.13:

The end point for this one man’s parade was an Italian style flow of verbal rudeness, of which we could only tell apart “god” and “pig”.

A young man had drank too much vodka and vomited spectacularly on the floor. There was also another one who had had a little too much to drink. He wobbled along the corridor with his head covered in blood and babbled in a mixture of Italian and something else, probably a fantasy language. What was completely loud and clear though was that he wanted a female doctor -DOTTORESSA! DOTTORESSA! In his mind, he had scripted the First Aid as a fantasy scene where he can have a sexual encounter with a female doctor, in the style of many adult movies, and was not aware that it would never happen anywhere else than in this imagination.

A very skinny young man sat with an expensive-looking feminine handbag in his lap and watched football on his phone. His aura told clearly that he couldn’t care less of the drama around, nor of the fact that he was himself in need of emergency care. He would do here exactly the same thing as he would at home -watch football. He also got a female friend bring him a water bottle and her company, something only the luckiest ones in the room had.

The nurses were Italian Italian: loud, verbal, and on top of the situation. When one of the drunks had yelled for DOTTORESSA for long enough, a male nurse came to him and said in a clear but calm voice: “We all have a job in this world. My job is to be a nurse and yours to be a patient IN SILENCE.” Another patient, a woman in her thirties, had been waiting for many hours and was asking the nurse if she could just leave. The nurse said what is actually a good piece of advice for anyone facing a challenge to their patience: “You have already climbed 99 steps, don’t give up now that you are so close to the 100th”.

Time Is Relative, and So Is Suffering

The nurses did not generally put much effort into trying to be nice, and I don’t really blame them. If you are an Italian nurse in 2020, you have probably been dealing with the worst Corona outbreak in Europe. You have dealt with a lot of pressure and uncertainty in impossible circumstances. At that point, people complaining that they have to wait a couple of hours with a stomach ache before seeing a doctor is not what triggers your empathy.

I admit that I also was guilty of complaining, albeit silently and only to the person with whom I was sitting in the waiting room (as a true Finn). I complained because the triage nurse with whom we first spoke had said that we needed to wait for two hours for the doctor’s appointment. It soon became clear that this was an underestimation, and I swore that we would sit in the first aid for a few days. It ended up being five hours. I’m still not over the annoyance. If the waiting time is five hours, a Finn says that the waiting time is at least five hours. For an Italian, time is a relative concept. Also and especially in the emergency waiting hall.

Just a few months ago global cries for solidarity in the pandemic were spreading in the social media, as many of us sat at home in social isolation. First the call was to wash your hands, then everybody was encouraging each other to stay at home, then started the enticing to wear a mask. “We will make it through this together” was the motto. Now that Covid-19 is not fresh news anymore, it’s easy to forget what was likely going on for example in this very hospital just earlier this spring. Now things have normalized and people have assumed their regular level of selfishness -asking for lights to be dimmed in the hospital just so that one can take a nap.

Or maybe it’s not selfishness, just human. When you or your friend or family member is ill and in pain, the frame of mind just changes. In that case, the fact that one is at least not suffering from Covid is not helping to put things into perspective.

Andrà tutto bene

I was impressed by some of the nonchalant, silent patients: the ones not making a fuss, not panicking, not asking for anything. The ones looking at each other and smiling encouragingly. The opposite of emergency observations -observations of “everything is going to be okay”- included seeing the friends and relatives bringing a water bottle to their loved one or helping a stranger to the toilet. It’s almost like there is a lot of hope left in this world. Also (or especially) in a First Aid waiting room.

For something else than emergency observations from this trip to Bologna, you can read this.