Doctors aren’t supposed to play God. It’s not part of the job description. Their responsibility is to save lives if and when they can, but they don’t get a say in the matter of who deserves to live and who doesn’t — and unless they’re psychopaths or sociopaths, they wouldn’t want one anyway.
Covid-19 has changed all that. It’s redrawn the rules in a brutal fashion. In Italy’s Frontline: A Doctor’s Diary, Francesca Mangiatordi, an A&E doctor at a hospital in Cremona, is faced with a terrible dilemma when a 35-year-old man with the virus is brought in.
“I’m going to have to choose to admit him or an 85-year-old,” she says. “We’ve had to make choices like this for a month now.”
In the end, and to no one’s real surprise, she chooses the younger patient. Later in the documentary she says: “Young people are the basis for everything. The elderly have played their part.”
Written down, her words risk coming across as the value judgement of someone cold and uncaring. Francesca is neither.
Doctors aren’t supposed to become too emotionally attached to their patients. We’re told they can’t afford to care too much, because if they did, they wouldn’t be able to do their jobs properly.
Francesca does care, though. She cares and she cries. She’s moved to tears — of sadness, anger, frustration, despair — by what she sees around her.
Sasha Joelle Achilli’s documentary was shot over three months, from March to May, when Italy, the first European country to take a serious hit from coronavirus, was suffering the deadliest effects of the pandemic.
Francesca spends a lot of time looking at scans of patients’ infected lungs. It’s obvious some of them have no hope of living. “We have few weapons,” she says. “The virus has them all.”
She also spends a lot of time on the phone, ringing around the various departments to see if there are any empty beds available.
Every ward is full and new cases keep flooding into A&E.
Francesca and her colleagues are working 12-hour shifts. The patients desperately need oxygen, but the hospital has run out of oxygen tanks. Hundreds are dying every day.
At one point during the film, we hear a news report that 919 Italians have died in one day, the biggest loss of life to the virus in a 24-hour period anywhere on the planet.
“There is no dignity anymore,” says Francesca. “We’ve lost the sense of humanity. People are dying alone without a last word from their loved ones.”
Achilli’s film is an intimate look at a doctor working in the thick of one of the worst health crises in human history. It’s also a portrait of a human being.
The camera follows Francesca home to the flat she shares with her husband Michele and their two children, Damiano (13) and Maria Teresa (11).
Michele has a respiratory condition. Francesca is terrified she may contract Covid-19 and pass it on to him. Francesca hasn’t physically touched Michele or the children in over a month.
The children have their own worries. Watching Maria Teresa tearfully confide to the camera her fear that both her parents will die is heartbreaking.
Some of Francesca’s colleagues, including her best friend and fellow doctor Laura, have already developed it. At the outset of the crisis, there were 11 doctors in A&E. At the time of filming, six were off work with Covid-19, with no guarantee they’d be replaced.
In a way, says Laura, who we see self-isolating in a bedroom, away from her husband and young son, having medical knowledge of the virus makes it even scarier.
The most chilling comment, which sums up the toll this horrendous virus has taken, is still taking, came from a nurse called Cristina: “They die so quickly, the beds don’t have time to cool before they are taken up again.”
Italy’s Frontline: A Doctor’s Diary (BBC2) - 5 stars