Irene Hartmann
10/05/2020 - 12:05
Clarín.com
Society
"It's very hard.
I don't mind being subtle.
I want to be fair ”.
When
Pablo Pratesi
gets angry, he is categorical.
Every so often, the one who asks is him: "Tell me, do you also have more than one job like most therapists?"
Then it softens ... it softens a lot, to unexpected levels for a doctor in the role of head of Intensive Care: “The country is going to get ahead of the coronavirus, but not because of the politicians on duty, who do not believe in any: let's go to get ahead for
the love of the people
.
People gave me back a thousand percent of what I had given.
I understood that I have to be a better person.
I need to be a better doctor
”.
The northern media followed the minute by minute of the news about the
head of Intensive Care at the Austral Hospital
:
Pratesi with coronavirus at home
.
Pratesi was diagnosed with pneumonia
.
Pratesi worsens and was interned in the service that he leads himself
.
Pratesi recovers
.
It was hard, yes, because in intensive care, too, but Francisco, her 21-year-old son, lay in another room: "Eight days and on a respirator. They had to put him face down."
The story puts him against the wall.
The tear appears, but he is stronger and the drop does not fall.
His other three children were also infected with Covid-19.
And also his wife.
And a month before, his parents.
His mom died
.
Pablo Pratesi, head of Intensive Care at the Austral Hospital, in a wheelchair - hospitalized for coronavirus - accompanies his son, also in therapy for covid-19.
"She?
She was 85 years old, without comorbidities.
But she was bedridden.
When I brought her to therapy I knew she was not coming out.
I couldn't cry her
.
I couldn't mourn until a few days ago, when I was hospitalized myself, ”he reflects.
It was like this.
“I started with symptoms on September 9.
I felt bad: muscle pain, fever, cough and that's where I came to the hospital.
Tomography, positive swab, mild pneumonia, good oxygenation ”, he lists, exhaustively.
And she continues: “They sent me home with clinical control, but there they all became infected.
Over the days I began to feel
vertigo, a very common symptom of coronavirus
that is hardly talked about.
The last to be infected was Francisco, who had the flu with a bad cough.
It was a course until two weeks ago.
His temperature rose a lot and both of
us decreased oxygenation
, which I was measuring daily ".
Pratesi, in front of the hospital where he works and where he was admitted.
Photo Juan Manuel Foglia
The following could be deduced: “My pneumonia had worsened and we were admitted to therapy both.
Each one in a different room.
At first it seemed that he was doing better, but it got worse, until they had to put him on a respirator.
Eight days he was intubated
”.
"Today I can tell you about it with enormous joy in my heart", he reflects, but clarifies: "The suffering of
not being able to help my son when he could not breathe
... the nightmare is history.
Now it is a request to the people to take care of themselves ”.
Order and chaos
Pratesi is quick to talk.
Direct, without academic arrogance.
The firm, perhaps folksy tone of someone who could be referring to both a light soccer play ("
But watch out, rugby is my thing: Deportiva Francesa
") and the drama of a young patient with various and severe traumas.
He explains that he is dedicated to "taking care of people", that is why he chose a career, and several times, that "it is a task in which life is left".
Although, he clarifies: “At the Austral University I teach Emergentology, the subject with which most of the students are received.
I always tell them that they cannot die with the patient.
They have to revive.
But also, that
the day a patient stops crying they dedicate themselves to something else
”.
To smile again.
The doctor, with part of the hospital team.
Claim for the conditions of the doctors who are "in the trench".
Photo Juan Manuel Foglia
The technical file of this doctor is: 55 years old, 25 years married, four children, received in Medicine from the UBA, 30 years of career in public and private health institutions: the San Miguel Hospital, the Muñiz, the Naval, the “ Ramón Carrillo ”in Los Polvorines.
"I chose to work in critical care when I understood that
the therapist is the one who orders the chaos in an emergency
. He is the one who makes everything work."
This in theory.
In practice, contingencies abound: "One of the discussions is the 'public or private' issue. But it is a mistake to think that it is a River-Boca.
Public health is a good, like water or information
. That health it can be practiced in a public hospital, in a private one, in social security ”.
In the weeks leading up to the interview,
Clarín
had spoken with Pratesi three times.
The first was for a note X.
"I
'm sorry I didn't treat you before, but I had my old folks with coronavirus.
My mother died
”, he sentenced then.
The second was when he had the idea: “
We would have to make a different note, beyond the covid.
Tell why the health system is exploding,
why the country's intensive therapies are overflowing
”.
In the third, a few days ago, he was panting sick: “
Helloahh ... I'm hospitalized with coronavirus, but fine.
I have pneumonia.
We talk another day.
Now I am focused on my sonhh, who is wearing a respiratorhhh ...
”.
The M
The doctor puts dedication to detail and is responsible for correcting, with accurate statements, all kinds of preconceptions: “
Intensive therapy is not respirators
.
You have to attend critical patients wherever they are.
Intensive therapy is a philosophy, not a physical place.
It could be an elevator.
We look for the patient where he is and we have to stabilize him ”.
Pratesi has a long history.
Today he is head of Intensive Therapy at the Austral Hospital.
Photo Juan Manuel Foglia
- How many hours do you work per day?
- Those that are necessary.
But we are not heroes.
We are people.
I am grateful for my situation, but in this country,
you dedicate yourself to putting botox and you make a fortune
.
They are market things.
The guy who saves lives and drops everything, doesn't make ends meet.
It is a design issue for health policy.
It cannot be that resources are not placed where they need to be.
These ideas haunt him, in particular, that of the war analogy, in which resources, human and material, are everything.
"Because the guy who is in the trench with the seriously ill patient -which in this context exposes his life-,
the doctor who suffers between life and death along with the patients, is the person who does not make ends meet
. He has been on duty for 24 hours and when it finishes he goes to another job, "he explains, and comes back with the questions:" Tell me, if I had to attend to you, would you want it to be at 1 hour or 23 on my day? guard?".
But as a good therapist, Pratesi feeds on a realism tinged with a touch of optimism: “Until the pandemic, many were unaware of the existence of intensive therapies.
The health authorities never took care.
However, the critical patient sectors, including the Emergency area, the
nurses -who are health professionals-
, the Cleaning and Security, all the people who give everything so that the hospitalized people are well, are vital.
Every year, hundreds of doctors come to train here, but they return to their countries, where they earn four or five times more ”
The big problem, he says, is that “
vacancies for medical residencies in intensive care are not filled
.
The boys do not choose this orientation because the working conditions are very harsh and they know that they will not be able to live from this.
The pandemic did not invent these conditions, but it made them evident ”.
For this reason, he underlines: “The Argentine Society of Intensive Care is very concerned with the academic-professional, which is fine, but it should also take care of working conditions.
Mine is not a union but a human claim
".
"We do not work miracles," he assures, before concluding: "We are the last obstacle that people have between life and death; a tool, perhaps from some superior force. Living in intensive care is always a war. We are soldiers. We need the weapons to fight the war that needs to be fought. We want to stop being frustrated by not having the tools.
A rifle without bullets is useless for me
. "