Leo González Pérez
08/27/2020 - 7:00
- Clarín.com
- Society
Those who have just lost a loved one have to go through a process of radical reconstruction to adapt to the new absence. That is a duel. And if in normal times a duel challenges with abysmal pain and its very idea disturbs , it is even more difficult to go through it in days of pandemic, when the mandatory distance due to the coronavirus deprives of how restorative it is to assist the sick, when that same distance plunges into anguish for the suffering of the other, when receiving hugs that heal is prohibited and when funeral rituals are also altered.
In the course of a serious or terminal illness, patients and their caregivers come closer, "the need to do everything for the well-being of the loved one is satisfied. The pandemic takes all those tools out of us," Fernanda Carro, a doctor, told Clarín from the Palliative Care area of the Fernández Hospital.
Gabriela Papurello, a psychologist who participates in the People, not Numbers project , which pays tributes to those killed by covid-19, referred to the case of Ruth, a woman who went so many times to stand at the door of the sanatorium where her father was hospitalized, that she was allowed in to see him the day before his death.
Cases like Ruth's recur in hospitals across the country. And to attend to them, there are several initiatives underway for visiting protocols for seriously ill patients with covid-19. First, that of a hospital in La Plata was known, then an initiative in Mendoza, and in the last hours a protocol of the City of Buenos Aires and recommendations of the Ministry of Health of the Nation were announced.
Here, three stories of families who had to face the death of a loved one in days of quarantine. And an expert's explanation of the challenges these deaths present.
Cell phone caresses
It was already night when Gabriela Schmitt received the call: her mother, María Isabel Bonaño, had passed away. She immediately left for the Italian Hospital; needed to be there. Belén Bonella, the doctor on duty, received her and told her that the departure had been very fast, that they had not had much time. “I told him, 'I want to see my mom, I need to see her'; and she agreed, ”Gabriela told Clarín on Zoom. And he continued: “Belén told me that in order for me to see how to put on my safety equipment, we would dress in a mirror , although she had no glasses for me. We were already close to the morgue when he stressed to me that, even protected, the risk of infection was not zero. That shocked me. I am a very believer and I thought that Mom would never have wanted me to expose myself. So I told Belén that I couldn't go in. And she replied: 'Well, I'll do for you' ". The surprise returns to Gabriela's face when she remembers the episode.
María Isabel Bonaño, mother of Gabriela Schmitt, with one of her grandchildren. Photo Gabriela Schmitt.
It was then that the doctor established a video call with Gabriela and entered the anteroom of the morgue. “That way I could see Mom. Belén extended one of her gloved hands and stroked her hair , and said: 'These are the caresses that Gabriela would have liked to give you at this moment'. I spoke to her and Belén repeated my words to Mom. She never rushed at all, let time pass until I said 'that's it, thanks. Enough was enough, '”Gabriela closed the story with a sigh.
María Isabel died on Tuesday, August 11, just three days after the new coronavirus had come into her life . The previous Saturday, Gabriela had been told from the nursing home where her mother lived that she had a fever. She approached the place and, from afar, as established by protocol, saw how María Isabel got into an ambulance.
"She was alone in the back and when I arrived at the Italian Hospital they had already admitted her," Gabriela recalls. She did not know where her mother was and under what conditions; nobody informed him. Surrounded by other relatives of patients in the same situation, Gabriela began to knock on some doors, even though they could read “forbidden to enter”. "I played and they let me in, until I spoke with a doctor who had been with my mother and she said: ' go home , in nine hours we will just have the result of the swab, and we will call you'".
Gabriela Schmitt: "There are many ways to accompany a good dying, not just physical presence." Photo Luciano Thieberger.
The promise of the call was fulfilled, but with bad news. María Isabel had come in alone with a slight fever, but now she was “very compromised with the lungs”, and her situation was complicated .
On Sunday, another communication from the hospital: María Isabel was still bad. “I called her room, but since she had senile dementia, she couldn't answer, she didn't realize it. On Monday Victoria [Ruiz, another Italian doctor] called me. I told him that we needed to talk to my mother, that we needed to tell her something. I thought Mom must feel lost. You don't know where your mother is and your mother doesn't know where she is , it's a very extreme situation, ”Gabriela explained.
On Monday, after several unsuccessful attempts at communication, the doctor Victoria Ruiz entered María Isabel's room with her cell phone. "She brought the phone to Mom and everyone, my three children, my husband and I, we were able to talk to her, we said a lot of nice things to her, it's like we honor her life: 'Mom, you were loving.' My children were able to tell her how much they loved her. We were able to tell him the beautiful things that he had left in the hearts of each one of us ”, Gabriela was moved.
That same afternoon he sent family photos to his mother. On Tuesday, the same doctor was again a link between María Isabel and her family. “Victoria would bring the photos to the phone and with Mom we went through different moments of her life. Mom had a different spirit, she understood that she was sick, that she was in the hospital and that we had not abandoned her . And that was a great peace that touched our whole family in our hearts, ”Gabriela said.
María Isabel was 83 years old, she had beaten cancer twice and, beyond her senile dementia, she was fine. She danced, she was strong and she always made a lot of jokes, as Gabriela remembers her. She had been a teacher and September 11 was a very important date for her, even more so than her birthday.
Gabriela Schmitt and the coronavirus: "Let us ask for what we need and trust the doctors." Photo Luciano Thieberger.
Gabriela had been in contact with her mother for four months only through calls or video calls.
The family decided that the remains of María Isabel rest in the Chacarita Cemetery, because of the available options it was the one that authorized the most people at the burial .
In addition to my eternal thanks to the Italian Hospital and the doctors Belén Bonella and Victoria Ruiz, Gabriela wants to leave a message for other people who may go through her situation. “There are many ways to accompany a good dying, not just physical presence. There are many ways to be present in the heart of the other. What the Italian doctors did for my family made a huge difference in the lives of all of us ”.
And he closed: “Let us ask for what we need and trust the doctors, who are giving a lot. And let's bear in mind that a game is never, ever perfect ”.
A chair in a hall
After four weeks of having news about her husband's health only through a “private number” that did not accept requests for clarifications or inquiries, Gloria Williams de Padilla was brought a chair so that she could sit, alone, in a corridor , and say goodbye forever , through a glass, who was her husband for 49 years .
Norberto Padilla and his wife Gloria Williams de Padilla. Padilla family photo.
Norberto Padilla was born in Mar del Plata in 1944, he was a lawyer, professor of Constitutional Law, undersecretary of Worship of the Nation during part of the presidency of Carlos Menem and secretary of Worship when the president was Fernando De la Rúa. But for Gloria he was above all “a man with a very rich personality, a Christian of solid faith, a lover of his family, a faithful friend, a man of dialogue, of multiple cultural interests, who stood out for his ecclesial and civic commitment, but above all for his goodness that he transmitted with joy ”.
An obedient and careful patient of his health, Norberto agreed to be admitted to a private clinic in the City - the family prefers not to mention it - for scheduled stomach surgery. He knew that there could be some complication and that the pandemic would force some isolation . “An hour after the operation, I left him in his room, he was optimistic and happy; and I didn't see him again until I came back, after four weeks, to verify his death and say goodbye, without any of my seven children, ”Gloria recalled.
During the first days of hospitalization in intensive care, the family communicated with Norberto by WhatsApp, until they had to intubate him for a pulmonary complication. "And after three of our children were able to visit him separately, they told us 'no more visits because there are patients with covid-19,' " Gloria said. Then the reports began from the anonymous phone line.
Gloria Williams learned that her husband, Norberto Padilla, was very serene, cordial and calm in his last waking hours. Padilla family photo.
They were four weeks of enormous impotence. The day before Norberto's death, after receiving worrying news, the family asked to send him an audio message, and the reply he received was: "We went in for the essentials . " However, not everything was harsh: there was a doctor who agreed to transmit an audio through his own cell phone and play the music that had been sent to him; and another doctor recorded one of Norberto's daughters singing and made her listen to her when they performed a second extubation.
“From the testimonies of these two doctors, we know that in the days when Norberto was awake, he was very serene, cordial and calm. We understand that it was an example of his faith and his virtues, and also a way of loving each other to the end, telling us: be calm, because I am calm, ”reflected Gloria.
On June 18 she was awakened by an after-hours call from the "private number." Norberto had died and only one person in the family could go to see him off. “I chose to do the hard way to intensive care by myself. I asked for a chair to be put in the hallway and there, in prayer, I said goodbye to the love of my life, "said Gloria.
She says that she agreed to speak with Clarín with the wish that there be changes in the protocols that define the relationship between the internees and their loved ones. "Perhaps the authorities, reacting to excesses and exaggerations, determine protocols aimed at humanizing the relationships between patients and their families, since health centers can offer greater guarantees for scheduled operations and unforeseen treatments, establish forms of replacement of physical presence, implement more personalized methods to communicate with the family of patients and respect rights such as those that religious people have to the assistance of a minister of worship ”, he explained.
Gloria Williams with her husband Norberto Padilla. She agreed to speak with Clarín with the wish that there be changes in the protocols that define the relationship between the internees and their loved ones. Padilla family photo ..
There was no wake. Yes, a brief ceremony under protocol in the La Recoleta cemetery. The family received condolences by letter, on the networks, with telephone calls, with the sending of flowers or delicious desserts, with funeral notices. There was a very heartfelt virtual meeting with brothers and nephews and Pope Francis sent them a letter assuring his prayer. Gloria especially remembers that a month after Norberto's death, there was a mass in thanksgiving for his life, broadcast by Zoom and YouTube, in which Cardinal Mario Poli participated.
On a motorcycle after the ambulance
On Friday, August 21, at ten in the morning, Omar Gisande received the notice. He was to report urgently to the Finosa Home for the Elderly in City Bell. His mother, Nélida Calvo, who was staying there and who had been diagnosed with covid-19 two days earlier, had to be transferred to a health center. "They told us that it was not to be alarmed, that it was a precautionary measure," Christian Gisande, Omar's son and Nélida's grandson, told this newspaper.
Christian Gisande was very attached to his grandmother Nélida. "" We were startled that he told us he missed us. " Photo Mauricio Nievas.
Omar immediately went from La Plata, where he lives, to “el Finosa”, as the home is known. There he could barely exchange a few words with a male nurse from the street, gate in between . An ambulance arrived and, from afar, Omar could see her mother being brought into it. No one gave him details; No authority from the home came to speak with him, so he decided to get on his motorcycle and follow the ambulance , which an hour later arrived at the Los Tilos clinic in La Plata. There Omar had the last contact, visual, distant, with his mother, when she was lowered from the medical vehicle with an oxygen mask on.
"The therapist who received her told us that due to the discharge they had noticed, it was a picture of severe pneumonia and that she was going to intensive therapy," recalled Christian, who is a Physical Education teacher.
"At seven in the afternoon we called the clinic and they told us that the plaque had shown compromise of the middle lobe of the right lung, and that everything would depend on the strength that my grandmother had to fight it," Christian said. Thirteen hours later, Nélida had passed away .
The closest thing to a farewell that Nélida's family could have was to see her coffin being loaded into another ambulance, this time to a crematorium. "We couldn't even pat the coffin, nothing," says Christian. The family would have chosen to bury her, but they were not offered that option. In addition, they had difficulty finding a place for cremation, and this Tuesday they had not yet received the ashes.
Since he was eight years old, Christian Gisande spent the winter holidays with his grandmother Nélida. Photo Christian Gisande.
For the past five months, contact with Nélida had been rather torturous. The line calls had limited hours, and since senile dementia and her motor problems prevented Nélida from having her own cell phone, to have a communication via WhatsApp with her, her family members had to reserve a shift to occupy one of the cell phones at home . “Sometimes it was difficult, because the girls who had to help her with the phone told us that they had a lot of work and that they could not use WhatsApp at that time. Of the five or six times we tried to make video calls, only two went without problems, ”Christian said.
Still, the video calls had a positive effect on Nélida. Seeing her son on screen, above all, reassured her. But that option was ruled out when, diagnosed with covid-19, the woman was isolated.
“What started us off was that he told us that he missed us . We replied that we had to take care of ourselves, to take care of her, but she didn't want to know anything about that, at least on the days when she was more lucid; on the other days she did not realize what was happening ”, summed up the grandson.
Nélida's family is unhappy with the behavior of the place where she lived. “Even today my father continues to receive messages from the Finosa household outreach group about the situation of the rest of the residents of the place who are sick with covid-19. They did not communicate to the rest of the family what had happened with my grandmother; They didn't even send us their condolences , or anything related to my grandmother's belongings; contact, zero, ”Christian listed.
Retired from the Registry of People that works in La Plata, Nélida was defined by her grandson Christian as somewhat fierce and bossy , rough, but very loved in the long run: “I was her first grandson, and that gave me a special place with her. I spent the winter holidays at his house , the two weeks, since I was eight years old. We would go to the movies, McDonald's, downtown, buy Family or Sega games, buy a kilo of ice cream and get stuffed, order Pizza. It was a nice time, "she recalled.
Christian Gisande and his grandmother Nélida. "We had a terrible five months," he said. Photo Christian Gisande.
And he closed: “ These five months for us were terrible . And we do not want the last image that was recorded of her to be that of the ambulance ”.
Duels in the pandemic
A grief is a painful and difficult process , but normal, which consists of adapting to a loss, says Jessica Polonuer, director of the Aiken Foundation, which is dedicated to the psychological accompaniment of children, adolescents and families in grief. This adaptation consists of a very broad personal reconstruction , which occurs to the extent that the loss can be integrated into life. It is a process that takes time and touches the deepest beliefs and convictions.
And what about the duels during the pandemic? The experience of the death of another, of a loved one, always appears with that feeling that it was inopportune, that it was not the right moment, ”says Polonuer. Even so, there are circumstances that favor the grieving process, and others that make it difficult: the pandemic and its collateral effects are among those that hinder it.
However, the expert clarifies, it cannot be said that duels during the pandemic are necessarily more painful —the pain is always unique and personal— , but rather that they present more challenges, more things to solve.
In the first place, those who must start or continue a grief during the pandemic suffer an accumulation of losses . Since other losses occurred in the pandemic: the immediate future as imagined, economic, schooling, travel, parties, projects.
Grief is a painful but normal process in the face of loss.
At the same time, the lack of closeness and contact with the sick person is also a very important source of suffering , especially because it makes it impossible to carry out care actions in relation to the other, says Polonuer. Feeling that you could take care of the other favors the grieving process, it helps.
With the distance in relation to the patient, there also appears to imagine their loneliness and suffering , which clearly intensifies the feelings of helplessness, guilt and frustration, which are feelings typical of mourning, but which in these circumstances will be intensified.
The lack of physical contact, at the same time, deprives us of a protective experience par excellence . “Holding the hand, hugging, even physiologically generate feelings of relief, calm and security. It is something that is not mediated by words, and although psychologists are very fond of talking and talking, there are many moments of grief in which the processing does not go through the word, and it has to do with a feeling that goes more for the corporal ”, explains Polonuer.
Another situation of the pandemic that makes grief difficult is that these days it is very difficult, if not impossible, to “disconnect” from the coronavirus and its consequences. And, at times, disconnection is healthy in a grieving process.
People in social isolation do not have their routine and structured daily life that, for people in mourning, are an important source of stability. And being at home all day makes the absence of the other enormously present , sums up the expert.
Finally, a difficulty is the limitation or absence of rituals related to death, which in grief have the important role of bringing order and predictability to the emotional chaos generated by the loss of a loved one. In addition, rituals strengthen social ties and honor the deceased person . "At the same time, the ritual faces the reality of death", synthesizes Polonuer.
Beyond describing the difficulties, the specialist remarks that it is possible to overcome them. “ Time gives us the possibility to repair and for what could not be done to be done. And it's not that all is lost. When these themes are touched on, which are so in touch with the deepest fears, with the abysmal, if we wanted to put it poetically, it is important to convey that even when everything goes wrong, there is always something that can be done with it. "
They collaborated: Fabián Debesa and Sergio Rubin.
LGP