Could he have saved more lives?
The reanimatologist from Causeni who has lost the sense of time and fatigue
“At the end of each working day, I think whether I did everything right, if I did the right thing, if another person could have been saved, and what I should do in my next shift,” says Ion Ciobanu, anesthesiologist-reanimatologist at Causeni Hospital, the first district hospital to open its doors to COVID-19 patients.
He wishes there was more time to … critically analyze the decisions that were made quickly, in the hospital’s “red zone”, but also to enjoy the outside life, which used to be so full.
Properly equipped nurses are on standby for six hours in the “red zone”
During his 24-hour shift, Ion Ciobanu repeatedly goes to the isolated block where the people who have contracted the novel coronavirus are treated to examine the patients and to perform various medical maneuvers. He must equip himself from head to toe as many times as needed, and then carefully dispose of each item.
Wearing protective equipment is like a ritual: robe, gloves. He puts on two pairs of waterproof, knee-length protective boots. He puts on a special “scarf” made of protective material on his head and construction adhesive tape on his nose, so that the two layers of masks are more “friendly” and do not deepen the existing creases. He also puts on goggles, which he washes with dishwashing detergent, “so that they don’t sweat.” It’s sweltering heat.
At a temperature of over 30 degrees Celsius, all this protective gear burdens: “We endure because there is no other way out, there is no one to back us up. The weather outside, of course, is exhaustingly hot for us, the doctors, and especially for the nurses who spend up to six hours in this equipment. The discomfort is great. We are hemmed in layers, sweat flows, while the glass of water is waiting for us patiently for hours and, yet, we can’t reach it.”
Equipped, the doctor opens the door with the inscription “Access forbidden” and examines the patients in his care: “The virus affects the immune system, not only the lungs, but also the heart, kidneys, the brain, all organs suffer, especially in critically ill patients with underlying conditions.”
The doctor shows us how the ventilator works, the one recently brought to the hospital thanks to a donation of Switzerland and the United Nations Development Programme. Out of ten devices purchased, one has arrived in Causeni, where the demand for it is high*:
“Ventilation therapy is applied to the patient when he develops oxygen-deficient respiratory failure and the oxygen does not reach such vital organs as the brain, kidneys, liver and, at such time, the patient would not resist without our help and this essential equipment.”
Ion Ciobanu, a graduate of the medical school of Bender and later of the Medical University of Chisinau, has over 35 years of experience in the medical field and practices ‘on the outskirts’, as he says, where any health crisis is more acute, on the background of staff shortages: “We are a district hospital, we have fewer doctors than a national hospital does, and if several of us fell sick at the same time, we would risk having our work put on hold.”
“I have lost the sense of time and danger”
This permanent pressure to stay safe, in the heart of the hospital’s “red zone”, is sometimes hard to bear, confesses Maria Gritcan, senior nurse in the Causeni District Hospital:
“A day of work before the pandemic was like an ordinary workday, but after it broke out — it’s been a nightmare, living in great fear of not infecting ourselves, of not infecting our loved ones, and of not carrying the infection on. We hope things would go back to normal. We hope, but we also believe it. We hope that people will become better, fairer, and will respect the hygiene.”
Ion Ciobanu also speaks openly about the emotional states he has been through: “We have developed immunity to stressful periods, but this wave of patients has really affected us, because it is a new infection, something new and unknown, and the unknown causes feelings of ambiguity and anxiety.”
However, the anxiety has caused a state of general mobilization and, in the end, of acceptance of the situation: “At the beginning, it was a state of fear; of course, you thought that you could, too, become infected at some point and imagine what you would do about it. Along the way, I was so taken by this wave of patients that I lost (smiles) the sense of time and danger. At some point, I felt as if I have calmed down.”
The biggest concern of the medical and auxiliary staff of the Causeni Hospital now is to be able to help all patients, in all wards, which are overcrowded: “We are practically drowning in these patients, we have no beds available; we also have a lot of non-COVID-19 patients, with other pathologies, who also need our help.”
When he is not in the hospital, he wishes he had more time left for reading, but exhaustion has its say: “I fall asleep right after I start reading.”
“Life was beautiful outside the hospital, but now, we are tied to it. I have certain hobbies, preferences. To relieve stress from my work shifts, I usually do sports, run outdoors, go to the gym, listen to music, talk with my friends. All this is in the past now,” the doctor sighs, no longer keeping track of his on-call hours.
“Many people thought it was a joke”
Causeni District Hospital was the first one of such level to be engaged in providing healthcare to COVID-19 patients. On 28 March, the hospital’s routine became completely different, the Hospital Director Alexandru Cojocaru recalls.
“We made a review of the rooms where we could place the patients, developed the pathway, and started working.”
At the time of the interview (end of June 2020), 39 of the 40 beds available for COVID-19 patients were occupied. Three people were in the intensive care unit, two of whom were connected to mechanical ventilation.
194 people have been treated of COVID-19 in Causeni, some patients with severe conditions having been transferred to Chisinau, following complications, Alexandru Cojocaru says.
In the hospital lobby, we met Valerii Ursati, obstetrician-gynecologist, recently treated of COVID-19 and who has returned to work: “Many people may have thought it was a joke, but it is usually a very serious matter. I also went through this disease, I was treated in our hospital, in the infectious diseases department, and I saw what it was about. My wife also got the disease and she has recovered, too.” Now, after the treatment and the 14 days of self-isolation after discharge, he says that the term ‘responsibility’ has got a different weight: “I am much more careful, I protect myself even more than before, and I urge all people to be vigilant.”
“We are really sorry that some people do not believe that this infection exists, when we have been fighting it here, and some of my colleagues have not been home for two months, some of them being in the hospital non-stop. For example, I was quarantined in the hospital for a month, and did not see my family at all. For all of us, people who love freedom, this was hard to bear, but it was necessary,” the reanimatologist Ion Ciobanu says.
“The only thing I wish all the time is to be more careful, to make sure I do not get infected, to stay healthy, so as to be able to help as many people as possible,” he concludes.
*The hospital has three artificial ventilation devices now. At the time of the report, two were in the COVID-19 ward, and another one was being used by a patient with respiratory failure, hospitalized in another ward.
Text: Laura Bohanțova, UNDP Moldova
Photo: Adriana Bîzgu/UNDP Moldova