Lifelong Learning Programme

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Training > Experiences

Personal Experience

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Life of a patriarch

Language: English
Country: Italy
Typology: health care professionals
The narrative experience I am about to tell begins in a cold afternoon at the end of winter three years ago in a beautiful isolated house, hidden by large hedges in the countryside of Settimo. At the moment of starting treatment, I am introduced to a very distinguished and extremely refined man, who takes a seat at the centre of the table and begins telling us that his life, as a whole, has been a test, it has been hard and long, several times he has had a narrow escape from death and that he is now 86 years old and with the awareness that he has achieved everything he wanted. He would accept that the time to leave has come. Actually, the framework that the MC had shown us was not encouraging: once he got into hospital for a simple replacement of the pacemaker, he had been hospitalized for twenty-eight days, of which ten in a drug-induced coma, due to a reaction to a drug given to him by the dermatologist for a psoriasis he had suffered from for years. And, at the moment of discharge, examinations were not encouraging: high levels of creatinine due to a chronic kidney disease started many years before, diabetes recently diagnosed due to the massive use of cortisone, lung-heart, assumed intestine CA. Given those dire predictions, his family, composed of four married daughters with grandchildren who were constantly present at his side, had demanded to bring him as soon as possible back home to die. But Sebastiano, who had won many battles in his life, as he would tell me afterwards, had no intention to give in and he revealed to us that his goal was July 2009, when his grandson would get married: his name too was Sebastiano, he has grown up in his arms since he was a child because his parents went out early in the morning to put up fish stands. But let's follow the chronological order. To the patient’s great regret, we immediately decided to put again the venous catheter just removed the week before but that had already caused an acute urinary retention, and then to make blood tests, impose a strict diet, carry out a meticulous check over his bowel and over the food he ate because in hospital he was already suffering from an intestinal blockage, and finally he needed oxygen at home because the only act of speaking caused him dyspnoea. Sebastiano accepted everything with diligence, as he had done from that moment and for the next three years. He led an ordered and scrupulous life in respect for others and for the others’ skills. He never got the time wrong or forgot one pill or one yogurt outside meal if it was necessary to help him to evacuate. The chemistry between us has been evident since the beginning: it was enough to sit down in front of him, after checking urine, that were always too haematic, his harsh and wet breathing, his pressure that was well below the standard value and the continuous and repeated infections to his lungs, the catheter and the bedsores due to the catheter. But the worst thing was that Sebastiano was basically allergic to everything: in three years it was possible to give him only paracetamol for keeping the pain under control, ciprofloxacin, betamethasone, furosemide, Senna dry extract and finally also calciparine. What’s more, in spite of my recommendations regarding his diet, which were scrupulously followed, after days of regularity his intestine often blocked suddenly even when treated with Senna dry extract, the only drug he tolerated. So he began using enemas and rubber syringes but then for a few days he had diarrhoea and sometimes rectorrhagia. Sebastiano lived in this house, with his daughter, his son-in-law and his two grandchildren, but this house seemed to be a restaurant: all days the other three sisters and their husbands came to have lunch and spend the day with him, while his other four grandchildren living in Turin passed at least once a day to see him. In other words, they offered him the daily attention the head of a dynasty deserves. But I began to understand why. As soon as he could, Sebastiano sat in front of me and told me about pieces of his incredible life: he was the family’s firstborn child together with three sisters and a brother younger than him. In 1938 he was noticed by a cycling trainer in a race of bicycles in his town and, to the considerable regret of the whole family, he was brought to Rome to train better for his competitions. He was a champion already at those times. But the war was looming and, even if he was a champion, at the age of eighteen years, he was enlisted in the army in Rome where he began his training but, since he was young and handsome and with many girlfriends, one evening he returned one hour after the tattoo: three hours after that, he and his friend had already been placed on a truck, with backpacks on their shoulders, with many other peers directed to Russia. Fate can change in a matter of few hours. Over these years, he told me several episodes about the war in Russia: after travelling for eight months, he joined a first squadron in early autumn when it was not too cold yet. Half of them were killed after the first frontal attack. Fortunately, he was not even injured but they travelled for months controlled by a young officer in search of another Italian battalion with the injured soldiers to carry. They were dying, day after day, and, at the end, only those who could still stand up on their legs in the middle of the snow without blankets and with so much hunger survived. Once they reached another battalion, where the condition was even worse due to lice and hunger, in spring there was another clash and this time, since they were tired and hungry, almost all of them were killed. Precisely that night he had been sent to the farthest guard location from the camp, they quickly went down to the camp and he was among the first to be ready, but it was a massacre: while the officers in charge fled to the other part of the camp leaving them alone, he and the few remained took refuge behind mountains of snow. It was his salvation. But, when the enemy left, the officers returned and demanded to resume the march toward some other groups… Sebastiano said it was at that point that “I understood that next time we would meet one Russian we would all die. We were dressed in the rags taken from frozen soldiers, with no more weapons, munitions or food, half frozen but, above all, with the certainty that it was not true that the enemy was in front of us! Everywhere we went, there was always somebody ready to shoot us including our officers who were the first to avoid the battle. One evening we were offered the right opportunity. With one of my countrymen and a boy coming from Nola, we were ordered to go ahead to see if the village ahead was inhabited: the Russians often shot us but other times they put up with us. We were so hungry. Therefore, we decided to desert. I just wanted to come back home, wear a pair of warm socks and eat the pasta my mother used to make. We circumvented the village and, thanks to the darkness of night, we could go back towards the place that we had just passed. But, due to the snowy landscape, our officers saw us, chased us and shot at us.” His countryman, hit on the back, immediately died; instead, he was hit on the right leg where he still borne the sign and, helped by the boy from Nola, he reached the village and stayed there two nights and two days under the embankment of a wooden house, hidden by a large tree. The Italians did not chase them because they were certain that the cold and the local people would kill them but, as Sebastiano always said: “I was a handsome boy and my eyes and my handsome figure saved me. After being hidden beneath the little house for two days, three Russian women appeared with a gun. I knew that language still very little but they realized that we could not be dangerous for them in those conditions so they helped us. I spent nineteen months in that small village lost in the immensity of the Russian territory. As soon as the season improved and my leg supported me again, we went out to the fields near there and we helped the three women, two were old and one was a girl, to cultivate the land a bit and to take care of the few dairy animals in the village. A few months after, I promised not to use a gun any more; at the beginning people there put up with us but then became also friendly: we hid only if there was someone coming from far away. The rumours about the end of the conflict came also to that village after about six months and at that point, since we were in forces again, we decided to leave and to return home, amid groups of stragglers, thieves, former soldiers, and so on. We earned something to travel and changed food for a lift.” In 1946 he returned home. He was by now a handsome young man full of experience and he immediately got married, became a corporal, worked for a rich landowner who owned many acres of land cultivated with vines and fruit trees. But, being not satisfied with his salary, he emigrated to Germany where wages were much higher but life was very hard. But his family, and especially the love of his daughter Agata, who gave him strength till the end, made him come back to his lands; his wife’s health deteriorated in a few months and he became a widower very soon, with four daughters. He always boasted the fact that he led them to the altar without having sent not even one of them to work outside home so that she could help him to carry on the family. His daughters, one after the other, got married and one of his sons-in-law was sent to Turin to work and, little by little, three of his four daughters arrived in Settimo with their families. Here, since they were farther from their land, his daughters and sons-in-law grew more and more attached to their dad who was always there: he used to cook, take his grandchildren to school, go to the countryside to cultivate a large piece of land where he built up a house with garden and all the comfort which he had always wished to have and started to enjoy during his last fifteen years with all his large family. This way, that villa in the countryside became the focus of family life where there was always a place where you could sit at the table, a swimming pool and spaces where both children and the less young could run and have fun. They used to celebrate and stay always together there because their grandfather was old and he should not move from that house where sofas, beds, televisions, air conditioners and hot heaters welcomed everyone. Despite that first dire prediction, eight seasons passed quite well with the continuous attempt to keep all the diseases under control well aware that, with the alteration of that precarious balance, it would be difficult to go back. But, in March 2011, a big aneurysm of the vein in the right popliteus pit began to cause him intense pain, swelling and physical limitations especially in walking. Once being taken to a specialized doctor, diagnosis was inauspicious: he should immediately undergo an intervention, it could continue to expand or he could suffer from an embolus, but S. could not withstand an intervention so we carried on with the usual antibiotics, cortisone in tablets and calciparina, that he would continue to take until the end of the year, despite various bleeding. In June, he noticed that the batteries of his pacemaker would run down soon and needed to be replaced with the usual intervention and, despite the opinion of a daughter and of the family doctor, he wanted the cardiologist to replace his pacemaker, even if it meant his life at risk, dismissing the problem with the usual sentence: “If in the end I had to die, never mind, but if I do not try to replace it, I will die anyway.”. Therefore, in summer he underwent another intervention, he also took part in the baptism of another great granddaughter and in another marriage and, in spite of the expansion of the lesion that was getting increasingly serious and wide, he endured till the first week of December. He had already thought of organizing a great event for his ninetieth birthday at the beginning of March, but, suddenly, during the first days of December, the pain and swelling in the leg forced him to stay in bed, so that, after so many times in which we had succeeded in evacuating it, even his intestine blocked and... as I had feared for a long time... his already precarious conditions over the last three years, suddenly took a turn for the worse. In his last six days, still with a fresh mind and aware of the approaching of his end, he gathered the rest of the family around him: brother and sister, who arrived with their children, respectively coming from Foggia and from France, from Puglia and Calabria, and of course his already sick daughter, with her husband, from the town. He tried to speak till the end, even through gestures, saying to his daughters they should always remain so close-knit and that, even if he was not there any more, they should celebrate his ninetieth birthday. Many times I had happened to arrive and find him waiting for my visit to ask me for advice, to know if all his values were ok, to check his always haematic urine, to verify that what his daughter was doing for him was correct; he wanted the doctor to visit him at least once a month... he had an endless respect and trust in me and in my abilities to take care of his life. He used to say he was ready, but nothing was left to chance and he controlled everything was carried out properly because, I think, thanks to this way of doing things and to this discipline he had always survived and he knew he could hope to carry on only by adopting this behaviour. Basically, he was always happy to see all these young people he had helped to bring up going around him and revering him. So, after forty-eight hours of anuria and an increasingly more superficial breath, he waited for my arrival also that morning, December 8: I had to perform the therapy subcutaneously and take care of his hygiene and sacral ulcers that had immediately appeared and, even if the simplest movement caused him a lot of difficulty, he leant towards me to be turned and medicated and, while hugging me, he ceased to breathe, in front of four generations of people, about thirty, who had not left him alone for three days, always with him day and night. So, I suddenly remembered what he always told me when I pointed out that he was my favourite patient and that no other patient could enjoy the presence of all these daughters around and this assistance... "If the elderly are left alone and forgotten by their children, you should not only think of the current situation… you must first understand what kind of parents they have been.". Now Sebastiano rests in the cemetery of Settimo: for him, who was citizen of this world, it did not matter where he was going to rest; if he could have chosen, he would have preferred to be buried in his garden. I have not gone to the cemetery any more, I prefer to imagine him sitting on his deck chair in front of a large tree in his garden to tell us one of his reflections: "The human being is like this tree, you must cut those sick branches, those dried branches, those at the bottom and exposed to little light because they do not bear fruit any more and weaken the tree, but when you come to that point when fruits become rare and branches become increasingly sicker it is time to cut the whole tree and give back to earth what the tree is no longer able to turn into fruit.".

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