A season in hell

MadridOn the afternoon of September 29, 2020, my body, from head to toe, was breaking, cracking. I cried and screamed in pain. Under the effect of the painkiller I fell into a deep sleep. My wife Silvia called for an ambulance without my knowledge. At about ten o'clock at night, the nurses were waiting at the door of the house, on the fourth floor. Still almost asleep, with the feeling that my wife was coming with me, I went out to the elevator. I didn't kiss her (contrary to what Homero Manzi proclaims in the tango Sur: bajo el beso que entonces te robé), hoping that she would come with me, but she was also with symptoms of the virus, without consequences, as it turned out later, and she could not come.

On Friday, October 2, 2020, with the diagnosis of bilateral pneumonia, the pulmonologists and intensivists of the University Hospital of the Fundación Jiménez Díaz, surrounded me. The respiratory failure was such that they were giving me 60 liters of oxygen per minute. The plastic apparatus seemed to break. Dr. Andrés ("I am young, as you can see, but my specialty is covid-19, I come from the Hospital Vall d'Hebron"), said, to my right, to go up to 100 liters per minute. The oxygen saturation was not responding.

I told them: "There is no other way". I sensed that I was traveling into the darkest night. Some members of the intensive care team tried to disguise the seriousness. But their boss, the very thin Dr. Andres, said, "There is no other way".

He decided on Saturday, October 3, to induce a coma and intubate me.

He called my wife.

And he cut to the chase: a minimum intubation of two weeks to three months.

That night I was moved to the fish tank or ICU, where those who had been intubated stayed. Nine beds.

Two nurses -Mercedes and Cristina- and Ana, an assistant, surrounded me.

They asked me, while the preparations were being made, what music I liked. I answered "classical" and added: "And Greek". And I asked, "Are you going to cover my body with a blanket?"

From my lips came a few words in Yiddish, Gezunt and Gezuntereit (Cheers, Good appetite).

They downloaded from the internet Zorba The Greek and danced. Ana, later, told me: "In your eyes, in this very bed I saw fear, as before an abyss, and when you asked if we were going to cover your body with a blanket, and with such restless movements, the answer over the music, we said to each other, he's going to come out of it, he's going to make it".

Doctors Andres and Pablo, an intensive care specialist, decided to put me on my stomach (prone position) for about 16 hours out of 24. Because the ventilator itself can cause inflammation and additional pulmonary complications. The stronger the ventilator is to achieve normal oxygenation and remove carbon dioxide, the more it can damage normal healthy lung areas and worsen your condition.

Breathing support with the patient lying face down (prone) instead of face up (supine), on the other hand, improves the work of the ventilator, and reduces undesirable side effects.

The prone position only took place one afternoon and evening. And the intubation lasted not two weeks nor two months according to the initial plan: it was five days. And although I was under full anesthesia, the sensation, when the coma ended, was of drowning for several days.

You're hanging. You think at that moment that you can't survive, come on, you don't want to, your throat is closed, it's squeezing you. They have removed the 9 mm tube, the endotrachea, which they have lowered 20 to 25 cm into your throat. As I write these lines I am again "the hanged man". I'm choking, you scream, water, water. But you can't have anything. Just a drop.

I always felt that even when I was sedated they were hanging me, that is to say, that even though I was in a coma I felt the tube squeezing my throat. But they told me it couldn't be. I gave it up. My wife thought I knew it, but Dr. Pablo explained to her that they lowered my intubated sedation because they usually do it and I started to move my body and react. I was right.

I continued mechanically with my Yiddish words, Gezunt, gezuntereit. You think that you are under medieval torture because you are so aggressive. And the doctors and nurses around you in those moments can say little to relieve you. They are waiting for your body's reaction. They talk to your wife. They cannot speak openly of hope. They say the reaction is good, though.

You survive. You go to ICU for two weeks. PCRs: you're over the coronavirus. My lungs are still heavily inflamed, what I call white clouds, but the covid-19 has been defeated. On December 3, 2020, I'm discharged, no prescription meds at home. With the oxygen backpack. But on December 19, 2020, the inflammation of the lungs recrudesces, the oxygen saturation goes bad.

Discharges and readmissions

The ambulance again. Readmission to hospital. After this second one, the discharge on January 5, 2021, will be different. I continue the treatment at home with corticoids, very effective against the virus, but with side effects. A resurgence of the problems leads to a third admission to hospital on 26 January 2021. I am discharged on February 12 and then readmitted for almost a day. So, in the year since the pandemic began, I have spent more than five months in hospital.

An embryonic embolism -what I call a tiny little fish that came out of an artery into the lung- now, according to the Angio-Tac-Thoracic of ten days ago, is gone. And the lungs are getting rid of the inflammation caused by the virus. But it is the "moment" of the cardiologist, Dr. Alvaro, who has detected an alteration in the functioning of the blood pressure. Orthostatism.

In the heart, he says, you have a zone that responds to what is happening to your body. If you walk, it gets faster, if you lie in bed, it slows down, if you get scared it gets faster. It's the sinus node where exercise, stress, rest, what you do in the day comes in.

This brings us to my current situation, now free of the virus, but with the consequences of the prolonged period of bed rest, intubation, respiratory problems, small lung embolism, corticosteroids, infections, flare up of inflammation, home oxygen, decreased physical activity. And this can also be due to the coronavirus, which has a certain affinity for the heart muscle and also "drives the heart a little crazy".

This is the post-covid syndrome with tachycardia and orthostatism. The hope: almost all are transient. When you survive the virus you know that you will be able to endure more. You know that what is left in your feelings is not the season in hell, in front of the abyss, that you have gone through. You have returned from that black night.

You restart. The messages of affection invade you. They tell you, "Rest. Take care of yourself first". And you want to not only heal but also give back to others. To work. You have strength. Why not? What remains of these almost six months is the loving care you have received from dozens of nurses of various nationalities, from the doctors, intensivists, pneumologists, auxiliaries, orderlies, radiologists, physiotherapists. You have lived with everyone. They are now your family.

Margarita, in her Christmas, New Year's Eve and Epiphany greetings, wrote to me: "They will put you on their payroll because you spend all your time with them, who work in terrible precarious conditions. And who have had to leave Madrid without a job after the first wave, before the summer".

So that's what you're left with.

To all of them a tribute: to the victims of the virus.

To the victims of the great economic and social crisis of the pandemic and the workers and the working classes. Those who are footing the bill in lost jobs and wages.