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A doctor in the heart of Italy's outbreak shares what life is like in the hospital now

Photo by JC Gellidon on Unsplash

Those of us living in countries like the U.S., where coronavirus has arrived but not quite exploded exponentially, seem a bit conflicted about what our individual responses should be.

Ideally, we'd simply heed the advice of medical experts at the CDC and WHO instead of politicians who have a vested interest in over-or under-hyping a potential pandemic. But in a heated election season, that appears to be a tall order.

Everyone agrees that we shouldn't panic (no one responsible would ever tell people to panic), but what does that mean exactly? Is stocking up on food and toilet paper a sign of panic, or a smart precaution? What's the sweet spot between alarmism and aloofness?

When numbers are still low where you live, it's easy to say, "Eh, this isn't that big of a deal." But the reality is even if you yourself are not at high risk of dying from the virus, millions of people are. And unlike the flu, there's no vaccine for this. Measures that might seem "extreme" or "panic-driven" are designed to keep spread of the virus to a minimum.

And an ICU physician working in the heart of the outbreak in Italy, Dr. Daniele Macchini, has eloquently explained why limiting the spread is vital.

On February 27, Italy had 650 confirmed cases of COVID-19. Less than two weeks later, they have more than 10,000. The entire country is on lockdown and hospitals are over capacity—a massive contrast to the calm that preceded the storm in the Bergamo hospital where Dr. Macchini works.

Dr. Macchini posted a description on Facebook of what the hospital was like on March 6 vs. what it was like a week before. Below is a condensed translation of his post (which is written in Italian and can be read in its entirety here).

"After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.

I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people, I shudder.

I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly "emptied", elective activities were interrupted, intensive care were freed up to create as many beds as possible.

All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.

I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.

The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace. The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.

Now, explain to me which flu virus causes such a rapid drama. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is"temporarily" put in crisis, the epidemiological disaster is taking place.

And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us. Cases are multiplying, they arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.

Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.

The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask "what can I do for you now?"

Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.

There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.

Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.

We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy."

Macchini was speaking to his countrymen, but those of us who live in nations with numbers like Italy had two weeks ago should take note. It's not just a matter of our own personal risk of critical illness; it's also about the capacities of our hospitals and the availability of medical personnel. (I live five hours from Seattle, and a nurse friend here told me yesterday that facilities are offering up to $5000 a week for nurses to go work in Seattle right now to help manage the outbreak there. Things are getting real, real quick.)

Italy had 650 cases less than two weeks ago. As of the writing of this article, the U.S. has 755. If we don't take extreme measures—which many will call mistakenly call "panic"—to keep spread to a minimum, we may soon be facing the same dire straits Dr. Macchini describes in Italy.

Let's all agree to hunker down at home as much as possible, wash our hands religiously, avoid crowded spaces, stop hoarding medical equipment, and ask that our government be proactive with testing and truthful and transparent about the numbers. And let's do all of the above without calling any of it "panic." At this point, it's not panic, but practicality.



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Kids can drive mini cars into surgery at this hospital, leaving their anxiety in the dust.

All good parents want their children to live happy and healthy lives. But for parents of sick kids, particularly those with chronic and congenital health conditions, that's a much more difficult goal to achieve.

Unsurprisingly, anxiety is ever-present in both these parents and kids' lives.

As a mother of two children with congenital health conditions, I know first-hand how scary it can be when you’re worried and trying to process the “what if” or expected eventuality of surgery.    

We also often worry about what it will mean when our children are old enough to process the risks of surgery. It’s difficult for any parent to see their child fearful or in a state of discomfort.

And surgery is much harder to explain to a child than small medical procedures like shots — the stakes are higher and the unknowns can make the process even more terrifying, especially for young kids.

In California, one hospital is doing what they can to make the idea of surgery less daunting by allowing kids to drive mini cars into the operating room.

At Doctors Medical Center in Modesto, California, they know that fun can be a great distraction from anxiety.

The innovative solution to reducing kids' discomfort came from pre-op nurse Kimberly Martinez after she read about the long-term impact cars have on young kids. To put her plan into action, they let kids choose between a mini pink Volkswagen Beetle and a Black Mercedes.

So far, the results have been awesome (and adorable).  

“When the children find out they can go into the operating room riding in a cool little car, they light up, and in most cases, their fears melt away,” the hospital wrote in a statement to PEOPLE. “In addition, when parents see their children put at ease, it puts them at ease as well.”

Once the video started to go viral, folks in the social media world expressed their gratefulness for the opportunity to see something so positive vrooming down their timelines.

Doctors Medical Center is far from the only medical facility taking steps to reduce children's anxiety. A number of resources are dedicated to helping children headed to surgery, as well as their parents, however, sometimes adding a reading list to an already addled family isn't a practical solution.

Many of these parents are so busy and stressed they simply can't make the time to do socio-emotional research on reducing anxiety on top of learning about their children's health conditions.

Innovative programs like that at Doctors Medical Center take one more thing off parent's plates and make what can be a tense experience go more smoothly for everyone.

Other hospitals are catching on, too. It's why Sheffield Children’s Hospital offers it's kid patients their own sweet ride into surgery.

The more medical facilities that utilize creative solutions like this to easy young patients and their families' anxieties the better. Here's hoping we see many more fun, innovative ideas sprouting up in hospitals all over the country.

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These postpartum rules for moms in the 1960s are going viral because they're ridiculous.

If you don’t believe the hospital experience for new mothers has changed that much in the last few decades, read through the mind-blowing instructions one institution issued every one of their postpartum patients.

“My mom was going through her things and we saw this, it's rules in regards to just having a baby,” Micala Gabrielle Henson wrote alongside the document which she posted on Facebook. The letter had been issued to her grandmother the day her mother was born.

“INSTRUCTION FOR MOTHERS,” the slightly yellowed document issued by Cabarrus Memorial Hospital in Concord, North Carolina reads.

Henson, who welcomed her first child, a little boy, just five months ago, says she was “so surprised and kind of in disbelief” when she read through some of the issued “routines” and instructions ordered by nursing service department, which claimed to be devised in order to “safeguard you and your baby.”

First off, forget about spending your hospital stay bonding with your new baby.

Instead, you can spend less than two hours a day viewing them from behind glass. “Babies are on display at Nursery window from 2:30 to 3:30 P.M. and 7:00 to 7:45 P.M. Please do not ask to see baby at any other time,” reads one of the rules.

And when it comes to actually nursing your baby, they get even stricter/more absurd. Another rule lists the hour increments (three hours apart) when “baby will come to mother for feeding.”

During the first 24 hours after the birth, a mother is only allowed to nurse her baby for five minutes, followed by “approximately 7 minutes” on the second and third days and 10 to 15 minutes the fourth and fifth. “If Baby Nurses Longer It May Cause The Nipple To Become Sore.” Because, um, a sore nipple is much worse than a hungry, screaming newborn.

Note that “No visitor is allowed on floor or in room during nursing periods, including father,” because god forbid someone else — especially the baby’s father — get a glimpse of that breastfeeding action. I mean, they might even see a (gasp!) boob.

Oh yeah,  and while smoking in general isn’t discouraged, nurses lay down the law when it comes to lighting up. “Do not smoke while baby is in the room,” they instruct. Because back in the 1960s, smoking in the hospital was totally a thing.

The nurses also had some pretty strong orders about what foods new moms should absolutely not to eat.

They issued the list of forbidden foods in all caps, just to make sure everyone knew how seriously to take the restrictions. “DO NOT EAT CHOCOLATE CANDY, RAW APPLE, CABBAGE, NUTS, STRAWBERRIES, CHERRIES, ONIONS, OR GREEN COCOANUT [sic] CAKE,” they warn. But, perhaps brown coconut cake is okay? We may never know.

Commenters were as shocked as could be expected. Some wanted to know what green coconut cake is and why exactly it was blacklisted? Others couldn’t believe new mothers weren’t discouraged from smoking in general (“Ladies put your cigarettes down when you feed the baby,” joked Sydney Miller). However, a slew of mothers pointed out that they experienced similar restrictions — just twenty years ago!

“I would be barred from the hospital!” wrote Lisa O’Neil. “21 years ago I had my first baby and the rules were pretty ridiculous then also, my urge to mummy my daughter won me the right to be ignored by the midwives.”

While we’re all pretty blown away by the antiquated practices of 1968, as a new mom, Henson found the nursing rules to be particularly shocking — especially the suggested breastfeeding time increments.

“I absolutely could not believe that,” she says. “I guess I had never thought about how breastfeeding wasn’t always such a big thing. But wow, only breastfeeding my baby for five minutes?! Especially when he was a newborn?! My baby would be so upset!”

The letter has been shared thousands of times, and rightfully so. Every single person on the planet needs to read it, take a moment to absorb its ridiculousness and be reminded of how things have seriously changed for the better in the last 50 years — at least in regards to birthing a baby!

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