“It’s a tsunami. And they die lucid.”

"It's a tsunami. And they die lucid."

From the Italian daily newspaper Il Giornale, 3/11/20 (Translation: Natasha Senjanovic)

"Do you know what's most dramatic? Seeing patients die alone, listening to them beg you to say goodbye to their children and grandchildren." Doctor Francesca Cortellaro, head of Emergency Services at San Carlo Borromeo Hospital, understands the astonished look on your face.

"You see the ER? COVID-19 patients come in alone, no relative can help them and when they're about to go, they can sense it. They're lucid, not passing out. It's as if they were drowning, but had all the time in the world to understand. The latest was tonight. She was a grandmother, she wanted to see her grandson. I made a video call to him for her, on my cell phone. They said goodbye to one another. A little while later, she was gone.

"I now l have a long list of video calls,” says Cortellaro. “I call it the goodbye list. I hope they'll give us mini-iPads, three or four would suffice, so that they don't die alone."

The hallways of this vaguely Soviet-looking, large gray building designed by Giò Ponti in the 1950s is one of the front lines in the war against COVID. Within its walls, the faces hidden by masks, greetings that carefully respect mutual distances, and the routine of a large structure give the sense of a 1970s disaster film.

Then you listen to the stories of Cortellaro and her colleagues and you realize that this is not a film, that the disaster is already here, that all those covered faces and gloved hands are fighting desperately to come out the other end of it.

Stefano Muttini, head of the Intensive Care Unit, says so without mincing words: "I feel like I'm in a tsunami that, no matter how much you fight it, you can't stop. The biggest problem is coming up with new beds. My ICU had eight beds. I managed to add seven more, then another eight, and finally another 16, to get to 31 beds. Sunday morning I was so happy to have found six more beds, but by noon they were all filled. For a moment, I felt defeated, inadequate."

Creating new spaces for patients is what everyone worries about. Doctor Stefano Carugo, head of the Cardiopulmonary Unit, leads me to rooms covered in dust, where workers are wrangling with wiring to connect to electric terminals.

"These are 12 more beds for cardiopathic patients who need intensive care,” says Carugo. “The remodel was designed Friday, and two days from now the rooms will be fully operational. Normally this would have taken us months, but we did it in five days."

But this race against time, this hunt to create new beds that are never enough is also a Sisyphean curse. "Having to keep up with the emergency, even with all the help we're guaranteed, creates tremendous emotional stress," says Mutti. "When I asked my team if they wanted to work in the COVID Unit, they all volunteered. I'm proud of that, but I'm aware that these will be extremely difficult experiences for many of them. This is a profoundly trying experience for us medical professionals."

Mutti takes me to the trenches, along a wall that was built this past week. There's a thin red line between the traditional ICU and one reserved for the newly damned. People die in both, but in different ways. The protective suits say it all, the ones in which the staff who lean out the door to greet their boss are imprisoned. They raise a finger, smile from behind their masks, but victory is still far away. Very far away.

Doctor Carlo Serini spent the night working in that unit. "I've worked in the ICU for years, but this is different. Last night I went over to an elderly man. We'd placed him in an oxygen bubble. He looked around, frightened. I leaned down and he whispered, 'So it's true? My condition is serious?' I looked into his eyes, he looked like a beaten dog, and and I knew. This time I had no answers.”