Interview with Galileo Vergari, a young medical graduate from the University of Bologna in 2019; operator in the USCA , Unità Speciali di Continuità Assistenziali, from May 2020 to February 2021 during COVID; now specialising in Anaesthesia at the University of Bologna, with shifts in Cesena.
What has been your experience during this year of Covid-19?
I spent the first two months of lockdown (March and April) in Bologna and then decided to move to start working in the USCA [Unità Speciali di Continuità Assistenziale, Ed.] in Puglia. It was my first real job, which lasted until February 2021, when I returned to Emilia-Romagna to start my specialisation in anaesthesia, which is still ongoing. During the lockdown I was preparing the exam for the specialisation and I was also attending some lessons to know and understand what the Covid was: I was more interested in these rather than in studying subjects related to the test. In the USCA it was a question of dealing with Covid patients at home. In the first period, from May to August, the numbers were very low; then from the end of August, beginning of September, we began to work more intensely; in November we were so busy that we had to overran the shifts; at about the end of December, beginning of January, the amount of work was reduced, remaining stable until February, when I left to begin my work as an anaesthesist in Cesena, where I was sent on rotation by the University of Bologna, where I had won the grant. Initially, I was mainly in the operating theatre, where the activities of the first year would be centred, because in February-March the third wave had not yet arrived. When it came, some operating theatres were closed and we started helping in Covid internal medicine ward, both day and night – and those were the first nights I was in hospital. That’s what I’m still doing: operating theatre work, Covid internal medicine, and since a couple of weeks, I’ve also started doing Covid vaccines.
What were the emotions and responses of the mind and body to this abnormal situation?
Well, certainly, the first lockdown period was the heaviest because we were closed for so long, although the conditions were not too bad for me because I was at home with some friends. But it was alienating: moments of depression and euphoria alternated. In the summer period, June-July, of normalisation and relaxation of restrictions, I was in Puglia, and it seemed as if the Covid had vanished. Then it got worse again, with the second wave and the resumption of work. In any case, I preferred to work, to have an active life, despite the risks associated with Covid (contracting it and passing it on to friends and parents), rather than stay at home and do nothing. It was very satisfying to give ‘my contribution to the cause’, but also simply to bring a little comfort to people not doing well, both because of the disease and because of the stigma attached to it, I mean, because of the way it is seen in a small town like the one I was in [Nardò, in the province of Lecce, Ed.]: when it is known that a family is positive to the virus and the whole neighbourhood hears about it, the sick are often marginalised and looked down upon. When I moved to specialise, the pace of work increased, the tasks were different and it was quite a depressing time, especially at the beginning: I missed my family and close friends and had to build new bonds. It was also difficult when they put us on the Covid ward: I would come home after twelve hours of tiring work and it was hard to find a moment to switch off and relax with only the company of my flatmates whom I didn’t know well yet.
What was the role of the group, the community of colleagues, in dealing with the situation?
I can answer mainly in relation to the USCA experience. The service was activated in May and we were all new recruits, we all had to face this new experience and we remained those six-seven people until January, so a nice bond was created: it was something new that we all faced together, a work never done by anyone before. Also, if Covid came in March and we started working in May, inevitably it was a new job in whatever way you look at it. So we pushed each other. In fact, I think it was very important that the shifts were always organised in two people, that you were never alone, because we were very strong: wearing the suit [the sterile garment worn by health workers to avoid infection, Ed.] for six to seven hours going around visiting people is very demanding. We often found ourselves in unpleasant situations with families who did not want to hospitalize their sick loved ones because they were afraid of hospitals, afraid of never seeing them again. With colleagues on duty, we were able to pull it off, and this really brought us together.
How do you stand and act in the face of something as unknown as Covid? Were the skills that you had and that you now have adequate for the challenge offered by the virus? What has had to be adapted?
Again about the USCA, at the beginning we were very keen to start, to see, we planned everything in detail, we did a lot of brain work, but there were few cases. And you can plan as much as you want, but it’s not until you put things into practice that you can identify the critical points… Gradually, as we started to do the examinations, to wear and remove the gear, the fear of infection diminished and we learned to manage the examination and the patients better, we realised that you are really protected by the safety devices. As for the tools, they were few, but the ones we had were enough. Speaking of skills, I would say yes, they were adequate: the assessment was quite simple, in the sense that the things that matter most are the objective cardio-pulmonary examination and saturation. The cases that needed to be hospitalised, that could not be managed at home, were easy to identify. Then there are always the ‘grey’ situations that generate problems… More than anything else, there were few therapeutic tools: there were no drugs that could actually change the prognosis, one could only work on prevention, for bacterial infections or thrombosis, and start oxygen therapy. Obviously, the obstacles were mainly at the beginning: for example, in organising an adequate nursing service because the patients to manage at home are several and, among other things, it is important to carry out blood tests (but this was absolutely impossible at the beginning), to do wound dressings or to teach how to do injections. These were the critical points.
How did it feel to be part of the category of newly qualified young doctors?
In the first period of my first work experience, I felt deeply insecure and unprepared to handle a work assignment: you feel a bit thrown into the void. You do the internships, but you don’t come out of them able to do: it’s one thing to see things, it’s another to be on your own, to be able to manage them and be responsible for them. So, at the beginning, there is certainly a lot of fear, especially of making mistakes, of doing harm; but it gradually fades away and a bit of security takes over once you start doing a job and gain confidence. It’s slowly improving, but there’s always a lot to learn, a lot of experience to gain. The important thing is to be able to spot from the beginning the cases at risk, so that you can take the right precautions and adjust accordingly.
How does it feel to embark on a career as an anaesthetist in the time of Covid?
It feels like a big responsibility since, as we know, the most critical Covid patients end up in intensive care, so it is mainly anaesthetists who are in charge of them, obviously with the support of all the other medical professionals. You are one of the main figures in contact with the most serious patients, those who are at mortal risk. I think that even if there had been no Covid, I would have considered anaesthesia as a carrier, but at the same time the pandemic has led me to consider it with a different eye.
What have you given and what have you lost in this year?
What have I given and what have I lost in this year? I think I have helped as much as I am able, I have given my contribution, however small, in helping people in this pandemic, whether it was to see if a patient needed hospitalisation, to prescribe a drug or simply to give a word of comfort to a covid positive patient who has been shut in for a month. I have made an active contribution, albeit maybe a small one. I have lost many opportunities to live my age (my 27 years of age!): I have lost the chance to travel, to go to concerts, but also to meet up with friends from whom I have inevitably distanced myself a little because I have not seen them for a long time. I mean, I’ve lost a bit of life opportunities, I’ve lost a bit of my experience. But I also gained a lot of work experience and even working, even with Covid, I met people, whom I wouldn’t have met otherwise.