37 – getting to know the hospital well

A month or so later, Mamma, was admitted to hospital, suffering from heart problems.  We visited her twice daily, while “Ugo” insisted on keeping her company, by diligently staying by her bedside each day. This hospital was in fact a private clinic, set in attractive grounds with a stylish marble reception area.  There were rooms for “paying guests”, however it seemed that there was an agreement with the regional health authority, to provide some additional beds for national health patients.  These public wards were pretty spartan consisting of small rooms, each containing three uncomfortable beds.

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The toilets and showers were at the end of a long drab corridor which had a holy shrine with a statue of the Madonnina”.  She had been repainted in rather garish colours and her broken hand had been crudely stuck on with cellotape.  “Surely they could have made a better patch up job” we thought, “especially with it being a hospital !”   

The nurses generally seemed to be under-staffed, overstretched and somewhat brusque, and spent the absolute minimum of time with each patient. Theirs was purely a medical role, thus they did involve themselves in assisting patients with washing, dressing or feeding. This was generally the family’s responsibility.  If a patient had to ring the bell for assistance there would always be a long wait before a nurse responded.   Mamma, who spoke Italian, gradually succeeded in pulling down a few of the invisible barriers, and little by little began to befriend some of the staff by making friendly conversation and getting them to laugh.  Slowly but surely they became more relaxed and helpful.

It seemed, however, that hospital food was just as inedible in Italy as it is renowned to be in most UK hospitals.  The meals were most peculiar and generally unappetising,  An example: a tasteless watery soup or “brodo” with a few small pasta shapes drifting about in it, followed by a large piece of cold ham and a huge helping of cold soggy carrots or a large slab of cheese with plateful of green lettuce.

Italian womenfolk often brought in food parcels or flasks of nourishing hot food to help sustain their ailing relatives, laying out cutlery and a wholesome meal on pretty crocheted cloths.  Visiting hours were unbelievably chaotic, often patients would have 6 or more animated visitors at one time, who sat vociferously chit-chatting, whilst small, lively children bounced around and ran amok in the corridor unattended.  Each patient was allowed to bring in a small TV set from home, each would inevitably tuned into a different channel, all blaring loudly, adding to the general cacophony.  All in all this was very disturbing, especially for the more poorly patients.

Each morning before visiting hours,  the doctors would carry out their rounds, a very formal, farcical affair lead by the Head Cardiologist.  He strutted about, with his chest puffed out like a prize cockerel, his white coat casually draped over his shoulders, bristling with his own self-importance. The nursing staff and junior doctors scuttled around after him and seemed to be totally in awe of his persona.  His bedside manner left much to be desired, as he hardly took time to acknowledge the poor patients, generally talking about, instead of to them.  He seemed to delight in prolonging his rounds, and keeping patients and their families as much uninformed as possible. 

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The system appeared to be somewhat haphazard, yet somehow it actually seemed to work and things did eventually get done.  We could not find fault in the actual medical care my mother received.  The hospital was very well equipped, the medical staff were quick to administer the necessary medication and treatments and x-rays and other investigations were carried out swiftly and efficiently.  We also noted from my mother’s 12 day hospital stay, that there seemed to be no particular rush to discharge patients.

A few days after Mamma was allowed to come home, my father was admitted to the same hospital, once again suffering from heart and blood pressure problems.  During his stay it was found that he needed to have a pacemaker fitted, and the procedure was carried out within the week.  However, while incapacitated in bed he began to develop acute gout in his feet, which resulted in excruciating pain whenever the affected area was touched or moved.  Once back home this condition slowly but surely improved. 

During the next two weeks my father had a couple of peculiar fainting turns, which our GP put down to sudden alterations in blood pressure.  Then in the early hours of one morning, “Ugo”  began to experience pain in his chest and left arm, and felt very breathless, yes – the classic symptoms of a heart attack.    Yet instead of alerting us immediately, he chose to suffer this for about five hours alone, as he said he hoped that the pain would go away.  As soon as we realised what was happening we rushed him to the main hospital, where blood tests confirmed that he had indeed experienced a heart attack.  He was kept in a Special Care Unit in the Cardiology department, and was monitored day and night for 5 days in order to stabilise his condition.  One doctor in particular took a great interest in my father’s case. And generally we found the staff in this ward to be far more relaxed, friendly and helpful than those at the private clinic.  Here there seemed to be a totally different atmosphere and the visiting hours were very flexible.    At the end of the corridor was a shrine with a statue of the Christ with the shining Sacred Heart which seemed somewhat fitting for a Cardiology ward.  

Meanwhile, back at home, Mamma once again had been feeling very breathless and ever more poorly.  Over the past few months she seemed to have lost a lot of weight and had become very frail.  Our GP, Dottore Rossi measured her blood pressure and found it to be dangerously low, and her pulse extremely weak, in fact almost non-existent.  Despite her protests the doctor immediately sent for an ambulance.  Despite “Tre Cancelle” being slightly off the well beaten track the ambulance only took 10 or so minutes to arrive.  Paul drove down the tortuous potholed road to meet them at the turning by the cemetery and escorted them up to our farmhouse. 

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The ambulance crew, a doctor and two paramedics were wonderful, so kind, reassuring and efficient.  Mamma was rushed to the Emergency Department, Pronto Soccorso”, and tests revealed that she was extremely anaemic so she was admitted and immediately given a blood and iron transfusion.  So for a day or two we had both of my parents as patients in the same hospital. 

Then suddenly, out of the blue, we received a phone call from the hospital to alert us that “Ugo” was about to be discharged, however once again suffering from severe gout.  He seemed to be far more fragile than he had been before the heart attack. One of the Cardiologists had also picked up from the tests, that he seemed to have a problem with his kidney function.  We were swiftly referred to theNefrologia” Outpatients Clinic where more tests were carried out.  Then we received another phone call from the hospital to say that Tina was being sent home, so we suddenly found ourselves looking after two very poorly patients.  Mamma’s condition gradually seemed to improve, however my father’s seemed to be worsening steadily. 

That weekend we decided that we needed hospital intervention so once again we called for an ambulance.  The ambulance arrived swiftly and transported him back to the same hospital.  This time “Ugo”  was admitted to the Nephrology department where the ward looks out over the sea with beautiful views of the long sweeping bay, stretching one side to Gaeta and the other southwards towards Naples.  We could watch the ferries and hydrofoil coming in from the islands of Ponza and Ventotene.  A battery of tests and scans revealed that my father had abnormally small kidneys, that had probably been damaged some years back by an infection of some sort, and that he only had a kidney function of 35%.  Once again he developed severe gout, however after an 11 day stay he eventually was allowed home thankfully feeling significantly better. 

Unfortunately over the next few days his condition began to deteriorate progressively.  One evening, having felt out of sorts during the day, he once again began to suffer from chest pain and breathlessness.  This triggered yet another ambulance call out, and thus he was whisked back to hospital where blood tests confirmed that he had experienced another heart attack, so before long he was back in the Special Care Unit in Cardiology to be  monitored.  The staff remembered him from his previous visit and was henceforth nicknamed “The English Patient” and were by and large very kind and attentive.  The hospital padre also recognised him and offered blessings and kind gentle words.  This time my father’s stay was prolonged as he was suffering from severe peaks in his blood pressure levels.  The doctors were concerned that the heart by-pass, which had been carried out 12 years previously, seemed to be failing.  An appointment was arranged for him to undergo an Angiogram, to determine the severity of the problem, with the possibility of him undergoing Angioplasty. This was to be carried out at another hospital with the suitable facilities near Naples.   Despite “Ugo” not being able to speak much Italian, he managed pretty well, and some staff tried to speak a few words of English to him here and there.  Indeed we learned a lot of “useful” Italian medical terms such as:  “flebo finito” – the drip’s finished, papagallo” pee pot; padella” – bedpan !!!

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37  –  bedfellows in medicina generale

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