CORONAVIRUS

A day in the life of an emergency ambulance crew: ‘For the first time, I thought I could die’

EL PAÍS spent 24 hours with a specialist team on the frontline of the coronavirus crisis as they assisted patients across the Madrid region

Doctor Marta Calvo, from the SUMMA emergency crew, attends to Mónica Rosario in her home in Madrid.
Doctor Marta Calvo, from the SUMMA emergency crew, attends to Mónica Rosario in her home in Madrid.Jaime Villanueva Sánchez

The room is dark. The little light there is comes from a crack in the blinds. The doctor, looking a bit like an astronaut in a special suit and plastic visor protecting her entire face, sits on the corner of the bed and holds the patient’s hands. She notices that his eyes are beginning to water. “Cry,” she tells him. “It will do you good.”

The patient, a 37-year-old nurse, lets the tears fall. Two weeks ago, he had a fever and cough, the two most telling symptoms of Covid-19. He went into quarantine alone in his apartment in the Madrid municipality of Alcorcón and received medical assistance by phone. During this time in isolation, his grandmother died. He wasn’t able to say goodbye to her or attend the funeral. This morning, he woke up with vision problems and felt that the entire left side of his body was paralyzed. He couldn’t move his left hand either. He became scared and asked his ex-partner to call Madrid’s Emergency Services (SUMMA).

The moment they receive the call, the team from SUMMA’s No. 24 intensive care ambulance jumps into action. Miguel Carvajal takes the wheel; Andrés, the technician, reviews the monitor on the defibrillator; while the doctor, Marta Calvo, and nurse Vanesa Jiménez are ready to go in their personal protective equipment (PPE).

With the sirens blazing, the ambulance arrives at a 12-story building and the team quickly jumps out of the vehicle. The neighbors watch the scene with disinterest. The average Spaniard is harder to shock now given what they’ve seen during the coronavirus crisis.

Luckily, the nurse does not need to be hospitalized. He is suffering from a migraine. The doctor asks his ex-partner to stay with him for a while. It would do him good to have someone by his side for a few hours, she says.

On the way back to the base in Leganés, the doctor takes off the PPE. It’s boiling inside. “We are seeing the consequences of all the anguish inside people. It’s starting to come out,” says Vanesa Jiménez, the nurse of the crew.

This was their second emergency of the day. The first was a 90-year-old man who said he couldn’t breathe. His daughter, who had come to visit him, called emergency services and in no time the crew was at his door. Luckily, the patient had the right blood oxygen levels. “Perhaps you’re a little nervous?” Calvo, the doctor, asked him. “Yes,” he replied. “Because I don’t know if I have it or not.”

The 90-year-old could not even say the name of the virus. The doctor gave him a prescription for Valium, but was worried he may have been suffering from another illness. “Call again if you feel bad. That’s what we’re here for,” she told him.

SUMMA health workers work in 24-hour shifts, then rest for five days. That is unless they accept extra shifts, which has been common during the crisis. When they began to find bodies in homes, in particular elderly patients who had died within hours, they realized the gravity of the situation.

The crew of Ambulance 24 waits for the next emergency in a resting space back at the base in Leganés. The doctor does crochet. The nurse looks at photos of her children on her cellphone. The driver watches the television. At 6pm, they come together and have coffee at the table.

As a crew, they have experienced some touching moments. Like the time they visited an elderly couple who lived alone, and the woman, indisposed on the bed, complained that she had left lentils on the stove and clothes in the washing machine. Andrés hung up the wet clothes and left the lentils ready to eat. Or the time that they responded to a call from a Moroccan woman who had just given birth to twins. In a photo, the doctor and nurse can be seen feeding the newborns, with one in each of their arms. These moments, from just a few months back, feel like a lifetime ago, when the coronavirus outbreak had not yet dominated every part of daily life.

Spain’s health workers have been hit especially hard by the crisis. Doctor Marta Calvo says she has discovered hidden parts of herself. “I am not by any means a squeamish person. But this has made me afraid. For the first time, I thought that perhaps I will die. Truthfully, that would not be good for me. I have children, there are many things I am yet to do. It’s not my time,” she says, as she crochets. She has reason to be nervous: 215 health workers of the 2,100-strong staff have tested positive for Covid-19. Calvo herself fell sick and was put on leave for two weeks.

Before that happened, the doctor was sent to help an 80-year-old woman. This was during the time that Spain was seeing a record-high number of coronavirus fatalities. Hospitals were overwhelmed, and there were not enough workers to bury all the bodies. The woman was unconscious but her condition improved after she was given oxygen.

According to Calvo, when they took the patient to hospital, they were told: “How old is she? Eighty? Don’t give it more thought. If she is older than 65, she is not a candidate for the intensive care unit.”

The doctor still has the number of the patient’s daughter in her cellphone. Sometimes she thinks about ringing her, but then stops. She wouldn’t know what to say. “In other circumstances, we would have been able to save [the 80-year-old patient]. In the end she died alone in hospital, without her family,” says Calvo. “A month ago we put a pacemaker in an 85-year-old man because he had a good quality of life. And now we let people go who are 70. The system has failed,” she adds.

Vanesa Jiménez, the nurse, listens to the story attentively. It brings up her own traumas. A few weeks ago, she went to the home of a man named Juan, which is also her father’s name. He was also around the same age. Just like her father, he lived alone and was independent. What’s more the two lived just a few houses apart. In a matter of hours, Juan’s condition deteriorated, but they couldn’t do anything for him. The hospital told the crew not to intubate Juan because they did not have any respirators available. The man died shortly after. Jiménez cried as though he were her own father.

The talk of past experiences is interrupted by the sound of a walkie talkie: “Woman with convulsions. History of heart disease.”

The crew jump in the ambulance and rush to the scene. They find Mónica Rosario, 49, lying down on the bed. Her children had started fighting and then she began to feel chest pains. Calvo quickly realizes it isn’t serious, just a panic attack.

“What you have today is not a heart problem. It’s a problem of nerves, dear. These boys are already very grown up. Throw them out onto the street if you need to, let them fight with the coronavirus,” she tells the woman.

The patient makes an effort to sit up. “Not even the coronavirus is going to want them,” she says.

English version by Melissa Kitson.

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