In the summer and fall, Dr. Laura Franceschetto can often be found at goth and punk festivals and squat shows across Europe, enjoying their favorite music. But they are also a doctor based in Italy, and have been working long hospital hours on the frontlines of Italy’s COVID-19 epidemic for months. Here is one of two articles featuring Your Goth Doctor, who describes their current conditions in Italy, and what keeps them going.
What are your working conditions right now?
Finally, lately I have an ffp2 mask. Its filtering effectiveness is about 85%. I’ve had it for three days. It’s effective for 8 hours, so I disinfect it with sterile gauze and 70% alcohol every 8 hours. I got the face shield from the pile of gardening tools that my grandmother left me. Jokingly, I tell my colleagues I no longer know who I am: a carpenter or a gardener? Above the lab coat, I have a fabric backing that looks like paper. It’s disposable, but I’ve been using it since I don’t remember when. But it’s always disinfected. Water repellent suits I dream of. At best, I use rubbish bags. But today, the civil protection agency says that materials will arrive from China and Brazil. THANK YOU! We have been fighting with spoons for a month.
Meanwhile, three of my colleagues are in intensive care (one together with his whole family), my head nurse and 4 nurses are positive …. I swab the first patient treated as a COVID patient …. they are negative. So officially there is nothing written on them. But a month has passed and I’m still here, among people who cough, have a very high fever and can’t breathe well except with support …
What are your patients’ demographics? Are they old, are they young? Outgoing or private lifestyles?
Ok. I’ll take you with me: we’re in the middle ground, in a Medicine, between First Aid and Intensive Care. From the emergency room there are also people who test negative at the first test, who then positivize or evolve, in a short time, within the framework of typical signs and symptoms of COVID. We’re ready for anything. We learned that three negative swabs do not ensure a diagnosis of the virus’s absence. We have learned to treat all patients as possibly infected: That a stable patient can suddenly go into cardio-respiratory arrest and be intubated and ventilated. We have adapted our structure to support intensive care. Like any other ward in this hospital, from neurology to cardiology, now supports intensive care.
What worries me are the devices for ventilation and cardiovascular monitoring. They are not enough and those we have are old: rightly, the priority is for intensive care. And it is also a question of organization that is being resolved with the help of a private hospital that has recently made itself available publicly. Because here we are close to Lombardy and what you hear from Bergamo or Milan also affects us. Our hospital serves a mostly elderly population. Rather, this is the area with the highest elderly rate in Italy. But COVID isn’t just about them. We are – and I am proud of it – a public hospital, so I have patients of all kinds, not just the elderly: young people, graduates, unemployed, immigrants, homeless. ALL. Because this virus does not pay attention to these distinctions.
The first patients were only elderly. So much so that when we had the first news from China we thought of a resurgence of the usual influenza that already forced us into exhausting work. Then the message from the Levant was very clear, and very close that we are no longer in the time of Marco Polo. It took a bit of politics …. and here are the first twenty, fifty, thirty year olds …. there they are. There is Francesco, a 24-year-old student. Allergic to pollen. He could not breathe. He believed it was an allergy attack. Instead he had bilateral pneumonia from COVID. There is also the husband of one of my former high school classmates. Gaetano, an unemployed surveyor, 50 years old, a heavy smoker and diabetic. These are things that mark you and chase you because in a small town, you know everyone personally. And you know that death from COVID is horrible: you die ALONE, without the comfort of someone who loves you. We, the medical professionals, are the only ones to accompany you. And even that may not happen, since death is fast and sudden.
Can you describe what is known about the basic science of the virus for people with no science background?
COVID is a sneaky BASTARD. Can’t wait to get into your mucous membranes to spread. And, if he likes you, to let loose in you. And, even if you are already healed: it is not at all certain that it will not stick to you again.*
[*Editor’s note: A detailed answer to this question is found in Ask Your Goth Doctor 1]
When did you begin to fear that this COVID-19 would become an overwhelming problem for humanity?
Immediately. From the first news from China. We are not in Marco Polo’s time. And there was already something wrong with the first cases of viral polomonites that weren’t responding to known treatments. I barricaded myself in the hospital. I lived in there for 15 days. The government said nothing, it minimized itself. And I felt, and I feel, like a Cassandra in alerting superiors, in alerting friends and family… with this stray plague of mine. And, along with others, I was right. Unfortunately.
What advice do you have for people who are in self-isolation right now?
First of all: my applause. WELL DONE! You got it right! It is the only effective weapon we have. The one to contain it. Because we can all be its carriers or, if we are lucky to get out, fall back. The pharmacological solutions you are hearing about are currently only antiviral or anti-inflammatory or for organ support. A drug banned both in Europe and in the USA will soon be tested in my hospital. It is young, and little is known about it. And we are also experimenting. Even on us. Today we transplanted a new heart (the original one had been demolished by the virus) to a young COVID patient: the first to do such a thing in the world. And I’m happy about it. Just as I’m happy that someone follows what we say. Those who isolate themselves are an example for others.
The recommendations are and must be simple: those of the WHO. Personal, home and frequently used items must be hygiene with chlorine or alcohol based products. Distance from the others by at least two meters (= 6 ft). When you are not alone that you are queuing for bread, remember to protect others from your sudden sneezing or spitting when you speak. Then something goes for the mouth and nose. The best is an ffp3 mask. But it’s like looking for a diamond in the desert. Then you just need to sneeze into the inner crease of your elbow or put on at least a bandana or scarf. But remember that you do not have to use it at home except to disinfect it; inadvertently you can give passage to bacteria and viruses entering your mucous membranes. No crowded places, not even outdoors. Don’t go to see your friends or family: too risky, you can lower your alert and fall into the bastard’s arms. Get organized for work and chores.
For the diet: I know there is news about the miraculous effects of vitamin C supplements or other things like that. Look that only their producers thank you. Just avoid junk food, drink water and take some time for exercise. It is also an opportunity to quit smoking: if you smoke, stop it. Immediately. And when you use the toilet bowl, lower the lid before flushing the toilet. Bastard Virus can also lurk in your stool or urine. If you don’t lower the lid, there is an aerosol effect that the virus has a party with. And read …. not social media but novels and listen to or make music. Isolationists: I envy you! They are not so difficult of rules, true? Because it is a lifestyle of love for oneself and others. They are rules of the civilized life that we had forgotten about. We just have to go back to making them ours.
In California and other parts of the U.S., our health and government officials gave very vague instructions that would change over time. Many people, understandably, do not trust the government or the media, so now there remain some that continue to visit friend’s houses or gather in parks. What advice do you have for them?
With the pandemic declaration, all governments are now forced to follow the directions given by the WHO. It was time! Because they are our belly expression. Be they democratic or totalitarian. Here instead you have to use your head or, at least, common sense — which says that prevention is the only weapon to contain this virus waiting for solutions capable of annihilating it. That says it affects us ALL. Even those who are not yet in an isolated area. We Chinese, Italians … we learned it with our skin while you were watching. Don’t make the same mistakes! Act now, immediately: stay safe! STAY AWAY! Love and salvation are now the physical distance. Respect for the other is respect for yourself. To protect yourself is to protect others. And viceversa. Is simple. And then we are lucky: we live in countries where we are not forced to stay on a boat surrounded by garbage, washing our hands with polluted water. This worries me: countries where people don’t have access to hygiene.
Don’t embark on a more elaborate lifestyle. Then, behaving selfishly and always partying despite everything, do you happen to become Italian? Here, now, if you are not informed, you are not fashionable (which we still care about): So we are changing. With the virus, we are hardly the ones you knew before.
Me too: I’m not the same. I now live in a one-room apartment. Near the hospital. Alone. Before, I was in a sort of social center (community housing; cooperative living) between friends with my own aptitudes. It was my parallel world of art and life. Now, always living against death without knowing if it is a holiday is not easy. I do not go out except to go to work (I shower before entering and going out, my clothes are immediately washed on return and my shoes are left on the door mat) or to the supermarket. I hardly ever meet neighbors. And if I meet them you are at a distance. They ask me for information and I answer with pleasure. And it’s easy: for them who saw me earlier as a hero, I soon became as familiar as a plumber.
I don’t leave the neighborhood except to do the shopping for my elderly parents. I don’t even let them open the door. I leave everything on the mat. And I caution them to take the bags with gloves, to be removed and disposed of immediately. And that they are careful not to rub their eyes after putting everything back in place. And that they wash their hands.
I haven’t seen my parents for over a month. I haven’t seen my friends for over a month. And for months now, for my job, I haven’t been to a gig (I love what you do in California so I say it with pride: the last band I saw are Esses). I miss traveling for gigs and festivals: it’s my self-care and my spiritual retreat.
Fortunately, to buy something you now have to keep a distance of one meter. So I queue in silence, listening to others (the considerations of others are always interesting). And you pay at the electronic cashier. Nothing committed. I don’t even enter the newsagent. I left the coin on a table with gloves on …. now it is equipped: we disinfect ourselves before touching the objects touched by the other. Then there is the gas station: I get out of the car and let him do it, leaving the money on a special table that he has set up. Then there are my work staff. We behave in the same way with them, except in emergencies where you just can’t stay away. And then the patients …. I miss the handshakes, the pats on the shoulder, the high five given to the ninety year old spright who managed to mock, for the umpteenth time, the publicity of the funeral home.
Thinking about it, parts my life haven’t changed much since before. Except that now I am much more attentive to small things, words and gestures and looks. But between my work and my shy temperament: not much has changed. Not even my usual correspondence for things, people or made with music.
When I pass the hospital checkpoint, I feel like Front Line Assembly hired me. Whenever I wear the protective visor, I apply my name (we can no longer recognize ourselves with this dress) tied to a group I love. For example, today I am XmaLaura. So everyone asks me what it means, and I finally talk about music. No more sick and sick. At least for 2 minutes.
What advice do you have for others in an essential position that may have contact with a lot of people, like grocery store, sanitation or food delivery workers?
Do as we in the do medical field. Ask people to come to me from safe distance. Do frequent hand washing. Use of gloves and mask, but not always the same ones (bacteria and viruses lurk there). It is not difficult. It is a habit.
Is there any public misinformation you’d like to dispel? What gives you fear, and what gives you hope?
It won’t end soon. All of this won’t end in a matter of months. The path of research is difficult and long. And it will change us. “Everything will be alright”, I see on the sheets hung by the children from the windows of the buildings around the hospital.
“Everything will be alright,” I told a prisoner-patient.
“No,” he replied, “everything has already gone wrong.”
Today, living all of this, I would tell him that it was not optimism but hope. None of us were wrong. But there is a difference. As Havel, the first president of Czechoslovakia said after the fall of the wall, “Hope is not rejoicing in the good progress of things nor to spending time in company destined for success. Instead, it is the belief that you are committed to something that makes sense, regardless of what the result will be.”
“It will be alright” tells the courage of hope. Everything will be alright for you too, friends, if you have had the patience to read. It will be all right if, even at a distance, we will help each other.