The virus has broken too many lives, the lane hasn’t killed his dreams by a whisker. For the first time since he has a lab coat on, medicine has betrayed him. “Stop! I can not do this anymore. I stop, I’m done with resuscitation. Actually no, I quit. I’m not going back to the hospital. ” Marco, the anesthetist, entered the clinic exhausted, tired of everything, the pain, the doubts, the tiredness, tired of having to adapt to something that no man is really suitable for: the idea that the pandemic has abolished the concept end. Like Francesca, physiotherapist, respiratory rehabilitation expert. She too came to this room besieged by shadows. Every night a sleepless night. And who knows for how long. «I am not sleeping, doctor, when I switch off and go home my head fills with images and memories, I see patients with air hunger dying. I have to go back to work tomorrow. Give me something or I can’t. ‘
And the trouble is that more and more often, many do not really succeed. Doctors, but above all nurses and health workers enter this protected area to get out of the orbit of Covid. Psico-Careggi is the name of the psychological support clinic for the staff of the Florentine polyclinic. Rolando Paterniti, psychiatrist and director of forensic psychiatry and criminology, opened it 5 years ago on the proposal of the general management. “But I’ve never seen so many people every day as in the last few months.” At Psico-Careggi, explains the head physician, at least 5 or 6 people have been turning to since mid-October. “And most of them are asking to be exempted from Covid lanes.”
This room is one of the most important for the maintenance of the Tuscan health system, the key element of a program on the psychic well-being of employees developed with the Regional Center on relational criticalities led by Laura Belloni. A plan to study and heal the cracks that the pandemic is opening in the minds of those who work on the front line, to mend the tears in relationships in the teams. “Unfortunately, most of the people I see ask me to be exonerated from the Covid departments if not from work – says Paterniti – Almost all of them accuse psychological disorders of adaptation. They have fears, phobias, are anxious, depressed, crushed by stress and a sense of inadequacy. They can no longer bear what they used to overcome thanks to enthusiasm ».
So now the stories of those who pass by Psico-Careggi are also a response to the lack of staff in hospitals, they even illuminate the dramatic side of the protests of those who, like the Order of Nurses, ask hospitals to revoke the stop on holidays decreed to face the emergency.
Many nurses sit down grieving, and tell them they feel overwhelmed with guilt. “When a patient dies, the wives, husbands or children call the ward, cry, despair and ask the staff what the last words of their loved one were, if those who died first left a message of love, to whom thought about death. Nurses are haunted by remorse, because maybe they weren’t by the side of the patients when they left, they regret not having asked the sick if they wanted something to say at home. They are asked for a relational and psychological effort for which they are not prepared ”.
Under stress, every certainty collapses, even the experience gained in an entire career. “A nurse came to me terrified. She said she could no longer bear the diving suit, the double gloves, that under her visor her eyeglasses fogged up and she had to take them off, but at that point her hand trembled every time she inserted a needle into a vein or intubated a patient. She was blocked by the idea of making mistakes ». The group of Paterniti and Belloni is also trying to understand what repercussions on mental health the lawsuits filed by the relatives of the victims will have. “Because this has also begun: while previously flowers were brought to the Covid departments, now the deniers who offend them on Facebook go crazy. And many suffer the anguish of the denunciations of those who accuse them of being responsible for the death of relatives ”.
The phenomenon, however, began a few weeks ago. Not since last spring. “Some psychiatrists have ventured diagnoses of post traumatic stress syndrome for doctors and nurses who experienced the first wave in the Covid wards – explains Belloni – Well, I like to talk on the basis of numbers. And this summer we conducted a survey on the well-being of the staff of Careggi and Tuscany with 2 thousand online questionnaires. No one has experienced post-traumatic stress disorder ». In short, the first wave was not a Vietnam. Not an engine for the pathology described for the first time in American veterans, who returned from the jungle depressed, tormented by recurring nightmares, annihilated by a war of nerves as well as by a bloody conflict.
“While the first wave for doctors, nurses and Oss was also an emotional wave, now we are witnessing a phase of tiredness and great fatigue, almost of rejection – explains Paterniti – the epic phase of the pandemic is over”. In spring the country sang on the balconies, praised the heroes, who was on the front line was driven by a strong motivational charge. “So much so that in the summer those who came to psychological consultations above all wanted to tell their own experience, it was a sort of catharsis. And if there was anyone plagued by the pandemic it was because they had remained in the second line. He felt missing, guilty for not being at the side of those who sacrificed themselves. The most dramatic cases concerned those who feared, returning home, of infecting family members, and chose to isolate themselves », says Belloni.
A Vietnam in lane is being fought now. “PTSD may find fertile ground in this second wave, but we’ll diagnose it in six months or a year. Now anxiety, stress, lack of appetite and insomnia dominate, and above all the agonizing feeling of not knowing when it will end ». Now, psychiatrists say, even the media seem to be going through a depressive phase. «No more faces, no more epic – says Paterniti – The narrative has been stripped down, dehumanized, reduced to the data of the infections. Even if they continue to spend exhausting shifts of 10-12-14 hours inside a diving suit, and to save and see lives die, doctors and nurses live a sort of existential lockdown, they feel isolated, rejected by society, locked up in those suits that have hitherto been the symbol of their heroism. Let’s not forget: they are really the first line against the virus ».
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