Pray, sit and read a small illuminating example of why.
Last Monday was a very full day for me, with trips to the embassy to conduct a variety of errands, a studio work visit, making dinner, Skyping with my Dad, and somehow finding time to also work on my online classes. The humid heat is rough here, for me. Add to it a mask in public transit spaces or other indoor locations, poorly cooled (if at all) mass transit, a lot of stuff to haul around on foot, and a studio space that is actually not air conditioned at all but IS partly subterranean (thereby offsetting the full heat, but making it just more humid, really), and I can't keep up with staying properly hydrated. So I'm not only hot, sweaty and tired, I'm also aggravated at the world. But I have Things To Do. Gotta Keep Moving.
Bedtime. I don't feel well. My lower abdomen hurts. And honestly, I feel a little bit nauseous.
I'm not allowed to get nauseous. The reason for this is that I had surgery for a herniated esophagus years ago, and throwing up, I was warned, would potentially undo the repair work.
So, I take some anti-nausea medication. I take a few other OTC medications to hopefully help with the discomfort. I need to sleep.
And I can't. I still feel nauseous and I still feel general pain in my abdomen.
ALL night. I even tried to throw up. No joy.
I found that I could only comfortably lie on my back. I'm a side sleeper, but any pressure on my abdomen yielded only pain.
The following day, I stayed in bed, frankly. I was exhausted. I was still uncomfortable. I could doze off for a few minutes here and there, but only on my back.
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By late afternoon, I have a fever. It's not really high, but it's noticeable for me. Head is hot. Extremities are cold.
And of course, all I can think is: CRAP, I have that damned virus. Fever and GI issues are on the symptom list. While the PHS teleworks, I lie on my back and wait to see if the fever might subside. Or if it's a glitch.
An hour into it, it's a few tenths of a degree higher.
By the evening, my PHS phones the embassy physician, shares with her the situation, and she tells us what we already knew: you show up at a hospital ER with a fever and they're going to COVID test you first. Once results are in hand, they will proceed with what to do. Here is the name of COVID hospital closest to your address. You can't just go to any hospital right now with an undefined fever and expect treatment.
PHS hails a taxi. The hospital in question is no longer a COVID hospital, they say. And besides, we're full. Sorry.
I've forgotten my all-important Italian ID (I would love to choke the person who told me eons ago to only ever carry a photocopy of that ID in my wallet...) anyway. Ride back to apartment. Get ID. Find the next closest COVID hospital. Except that this one is really not close to us AT ALL.
Have I mentioned that Roman roads are full of flaws and Roman cars and buses have zero shock absorption? That pain, with every bump and turn and brake stop. Mmm.
A special entrance for COVID testing. A guy all done up in TYVAC with triple masks on takes a few stats, some blood, scrapes my brain with the long swab for COVID, says nothing about how long anything will take, puts an admission bracelet on my wrist and waves at my husband. "Byeee-byeee." He cannot, of course, come in with me.
I am placed on a gurney. Wheeled into a space where all staff are dressed as if prepared to handle toxic waste, and I am left in a dark corner of what appears to be an examining room that looks out to a hallway with pedestrian barriers that declare lanes in the hallway, and identifies the bathroom as being for COVID patients only.
So I'm on the edge of the COVID ward of the 2nd largest hospital in Italy. It is midnight, and I have with me my phone, a portable charger that is already half-dead thanks to my PHS's need to use it during all of this nightmare, and my purse. We were told by the embassy physician- who behaves as our advocate through much of this - that once the test results were in, I would surely be placed in a room. She is, at the very least, confident that my fever is not COVID-related.
Hours go by. I can hear an elderly man who probably has dementia, crying out, repeatedly. I can hear coughing. Staff are pretty regularly walking in and out of a larger room that I presume has more than a few patients in it. I see other people wheeled in and parked in the hallway or nearby dark rooms. When I get up to find a bathroom I'm allowed to use, I see them, curled up with their phones, a jacket placed over their eyes to block the fluorescent lighting. They look miserable.
I can walk, slowly. Getting in and out of the gurney is torture. Pain is still just as fierce as ever and the fever is still on board. I find a stack of small plastic cups sitting on a desk. I get water from a tap.
At 4am, I am retrieved....for a CT scan of my abdomen. 1 out of 3 people working here speaks a shred of English. The doctors, on the other hand, are quite fine. One says that they had to learn English in order to become physicians. I'm placed in the room with the noisy machine, struggle mightily to move myself, lie somehow even flatter on my sore back and listen to a man bark through an intercom: BREATHE. DO NOT BREATHE. Over and over.
When it is over, I'm wheeled right back to my dark corner. The gurney is left rails up. I am hemmed in. I think that this must mean that I will be taken somewhere else soon.
But I am not. Some of the people who were brought here to wait - like me - disappear, and others appear. I manage to squeeze myself out and off the gurney, at the open corner between two rails. More cups of water. A bathroom visit. I figure out how to disable a long gurney rail, lower it, and wince my way once again into it.
All this time, I receive no updates on anything. I am given no information. No one talks to me.
By noon the next day, someone appears. They hook me up to two small IVs. Antibiotics and paracetamol (like Tylenol), I'm told.
They leave. I still have zero information about my COVID test or anything else I have had done here.
I get into trouble with one of the COVID nurses because she gives terrible directions to the bathroom I'm supposed to use, and I wind up using a COVID bathroom...or at least I think I do, given her ire. That bathroom, with a lidless toilet and a paper towel dispenser that has been improperly stocked (what IS IT with people not learning how to properly stock paper towel dispensers? I cannot enumerate how many I have taken apart and fixed in public bathrooms in various places....but not this one) adjoins a large room populated by a ring of sick people of all ages. These are not ICU-level COVID people. But if the hospital has taken them on, then you know that there is a decided probability.
The IVs run out pretty early. They are not replaced. Nor are the empties taken away. The paracetamol did absolutely nothing for my pain, strangely.
By 3:30 in the afternoon, I am brought a wheelchair and wheeled to a room. They are still assembling it when I arrive. I am alone in the room, on a floor with other GI patients. The staff is dressed like regular medical staff, but masked perpetually.
A little information starts to flow, but it's confused. Did you get a COVID test? What were the results? Have you had any contact with anyone who has COVID? Where have you been? You're....American? What are you doing in this country?
Where is this pain? What happens when I press here? What happens when I let go? Do you have a fever?
We will bring you more paracetamol and start up more antibiotics. You have an infection.
At 6:30pm, I ask for a better painkiller. I ask about when I might actually get it. I have lost two full nights of sleep. I will lose my mind too if I don't find a way to rebound.
Adesso, they say. Now.
At 9:30, toradol is fed into my line. Adesso? But I still cannot sleep very well on my side. The gravity feed of the line doesn't work well if I turn over.
But I sleep. A little. Between night sweats.
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Thursday, Friday, Saturday and now Sunday. Lather, rinse, repeat. Still here.
In addition to the CT scan on day one, I have had two ultrasounds. Blood tests almost every day. One round of blood cultures. I have been administered at least 4 or 5 rounds of one kind of antibiotic plus 2 to 3 rounds of another kind of antibiotic EACH DAY. And by round, I mean something ranging between the size of a mustard bottle and a medium size bag of chips (yes, I know that the suspension in NaCL is part of the volume, but...) The last two days have involved a slow drip of potassium because my blood pressure became low. I am given a daily bag of the usual IV glucose cocktail to keep me from eating the sheets. I did not break that fever for good until yesterday, Saturday, which is not incidentally the first day I've not had a vicious headache. On my arms, I have ugly contusions where someone attempted and failed to hit a vein after another one blew. They've tried all the tricks: back of the hand, under the upper arm. They have dug and dug and dug. I'm far happier when the nurse who comes to do anything like this is a middle-aged woman or man. The young folks - they need more experience before coming at me with sharp things.
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| If I could have, I would have leapt around the room for joy. It was the first non-fever reading. |
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| This nice lady has the demeanor of a drill sargent. She found me a better IV caddy today, so I'm no longer fighting with the one that behaved like the trashy shopping cart that has three wheels resolutely pointed at the store and one at the parking lot. |
The staff have been generally great, the facility is nice and modern enough, and I have seen actual physicians on their rounds at least once a day, if not more often than that. This is a teaching hospital, so they come with a team of young white coats, all crammed into the room, to watch the master (or mistress) speak English with me. We all smile while they deny me any food (broth with child-sized pasta came for the first time today, and I was beside myself...but it was a short-lived win because it was brought to me again this evening and then abruptly taken away) whatsoever, insist that I can only have sips of tea (hot tea with sugar and lemon came in the morning for two days in a row, but that has stopped, and I cannot quite describe the depth of my desolation), speculate about my malady, 'visit my belly' (some of the English speaking has indeed been charming), and string me along without actually telling me the super-factual results of my myriad tests. Now that I have been wheeled down the hall a couple of times, I realize: I am the youngest person on this hallway. Easily.
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| My tea came the first day in a cup. Then it came the second day in this bowl. I thought: where do they think I'm from? But then thought: wait, that's more tea for me. YAY. |
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| Vegetable broth with pasta 00 ('doppio'). Tinier grain size than the tiniest couscous. |
I didn't write all of this to portray the Italian healthcare system as somehow less than good. It IS good, clearly, or how else would the country have the second oldest population of people on the planet (behind Japan)? It also bears mentioning that Italy's COVID numbers are excellent, overall. The care with which i have been submitted to a variety of evaluative measures - plus the gift of protracted time to observe, to measure, to treat...ironically, in this context, I realize - tells me that i wound up in good hands.
I didn't write all of this to induce your sympathy either.
I wrote all of this as a lesson. It is one that your friendly neighborhood healthcare providers can teach you too. It's about how a pandemic changes the way you can get care and how long you have to wait for care.
Believe me, I had some time to think about this as I lay in feverish pain on a gurney in a dark corner, considering how I needed to be thankful that I was by an open window and that the night air was cool enough to warrant bringing that hospital sheet over my shoulders. I was starving, but thankful that I had found a water source.
I am not and was not infected with COVID. Thankful for that, too.
But I think it came close to killing me anyway.
COVID changed how quickly I could be seen by a physician. It literally and figuratively kept me in the dark. It made a very large hospital even more capable of confusion and crossed signals. Even if it is not on the rise here right now, it still takes up its own resources and space and staff, therefore making a huge facility perpetually full. I waited at least some of that long, long time because there was literally no room in the non-COVID part of the hospital for me.
COVID make me SICKER. 15 hours on that gurney. One dose of paracetamol. One dose of antibiotics. Definite and prolonged dehydration. What if my appendix had burst while I was there alone? What if the peritonitis had become more and more acute?
By virtue of its consumption of time and materials and person power, COVID made me so sick that I (an otherwise healthy person, it turns out, given the battery of tests that I've been given here), the middle aged chick whose hospital stays prior to this amounted to one, and that was a planned, overnight post-surgery, have been in the Pope's hospital for almost a full week...and I don't have a definite discharge date yet.
I seriously doubt that any readers of this fall into the bizarre group of mask-regulation-buckers out there - and trust me, I wouldn't touch them with a 10-mile pole - but obviously, you all know what to do.
And besides that, don't get sick. Don't hurt yourselves. Don't have accidents. Stick close to home, wash your damned hands and understand this: even if you do all those things, that virus can still make you sick - or dead - without ever having infected you.
