Emergency ambulance crews in Madrid, Spain, recount how ‘We have to watch people die'
At 8h00 on a normal weekday, the streets of the Spanish capital, Madrid, would be choked with traffic. But there’s been no such thing as a normal day in the capital for well over a month. Normality has long since disappeared in the fight against COVID-19 and the city’s main arteries are unclogged by cars. This makes life easier for the 29 specialised ambulances of the regional medical emergency service (Summa), which have traversed in and around the capital since mid-March, responding to a seemingly endless series of calls. On-board one of the ambulances, callsign UV16, is Dr Alonso Mateo, the assistant head of Madrid’s regional transplant coordination service. After setting up a makeshift hospital in a hotel and doing shifts at the huge field hospital at Madrid’s main convention centre, Mateo now forms part of a mobile crew. Alongside him are Marta Vivas, a nurse and two technicians, Daniel Martínez and Miguel Collado, the latter of whom has recently returned to work after being off for 20 days with COVID-19.
“I’m not scared of it at all but I’ve got a healthy respect for it and I want to do my bit when it comes to putting an end to this nightmare,” says Collado. After coffee and a careful revision of their kit, the first call of the day comes in and they set off at full speed from their base in the working-class neighbourhood of Vallecas. On arrival, they suit up in their personal protective equipment. All cases must be treated as potential COVID-19, so overalls go on, along with gloves and masks. They dress with practised speed and efficiency. Inside, one of the technicians remains at the door as the designated ‘clean man’. It is his job to help his colleagues out of their gear when they emerge and disinfect their outfits
Mateo has been an intensive care unit doctor for 15 years, “But it was only during the time of Ebola that we learned to put on isolation suits, even though we always carried them in the ambulances”. Things are different now, he added, “For any kind of urgent job we use total isolation measures and hard-core suits for the patient’s protection and for our own. A very high proportion of people who have caught the disease are health workers and we just can’t do what we’re called on to do if those numbers stay as they are.”
“Getting to someone’s house and being able to help them when they’re hanging between life and death is something money just can’t buy,” says Vivas. But sadly and as Martínez points out, that’s not always the case. “Sometimes we have to watch as people die and there’s nothing we can do about it,” he says. “That’s really tough and something you just have to try to learn to live with. You just have to keep it together because there’s always someone who needs your help and you need to fight to save their lives.”
Mónica Coll, the doctor on ambulance UV15 gets one such call mid-afternoon. She and the nurse, Guillermo Lago, arrive to find an elderly woman with breathing problems and a fever. Everything points to COVID-19 and there’s nothing that can be done. The pair treat the woman’s sister with enormous care and kindness and, thanks to them, she watches her sister die with an uncommon serenity. They tell her that she died without any pain or suffering and that that is the most important thing in the circumstances.
On the other side of the door, UV15’s technician, Roberto Gonzalez and Javier García, are waiting. The report needs to be filled out before their colleagues can be disinfected.
Even in times such as these, older people are scared of going to hospital because it means they will be on their own. They tend to leave it to the last minute, by which time it’s often too late. They fear the loneliness and the idea of being left to face their final moments alone. They also know that most of their relatives will not be able to come to their funerals either because coronavirus has done away with the familiar norms, like going to hospital when you feel ill; like knowing someone will be beside you when you die.
And that is where the ambulance crews that tear across Madrid come in: it’s not just physical help they bring, it’s psychological support, too.
Although the pace of the day is relentless things calm briefly when the team stops for dinner. They have 15 minutes for a salad and coffee before work resumes. It’s not that they are immune to fatigue, says Collado, who can remember the tiredness he felt when he had the virus, “It’s the love and the vocation you have for this that gets the adrenaline flowing. You have to give it 100 percent because there are lives at stake.”
Source: The Guardian