Nurse with Patient. Wikimedia Commons

Invited Home

Enrico Grugnetti, the nurse who made a lasting impression at this year’s MedConference in New York, reveals the adventure that begins each time he knocks on a patient’s door,

When he knocks on the door, all he knows is a name, age, and gender. Each time there is an unknown face behind the door, whether it’s the ornate door of a penthouse with an ocean view, the nondescript door of an apartment in the suburbs, or the screen door of an old wood house amidst the green marshes.The setting is Miami, a cultural melting pot with a spring-like climate six months out of the year, which is now home for Enrico Grugnetti, a 46-year-old Sardinian nurse who visits the elderly and homebound for a living.

In mid-October, Enrico made a lasting impression on the doctors, nurses, and students who came from all over the U.S. and other parts of the world for the annual MedConference in New York. He told stories illustrating the challenge and beauty of his work: the surprise when something “clicks”–to use his word–and he is able to form a relationship with a patient and experience their friendship enriching his life. “The elderly are always surprising you,” he insisted. He has worked with this age group for 20 years, first in a Cardiac Surgical Ward, later in a retirement community, and now by making home visits. His clients include an old man from Haiti who only speaks Creole, several Latinos, African-Americans who believe more in folk healing rituals than in medicine, and the former “Alabama boy”who has no love for foreigners. “The person is singular, not only the patient, but me, too,” Enrico said in New York. “When I meet a person, I meet a person. It would really take a tremendous effort to separate him from his medical problem.” It would be equally difficult to separate Enrico’s work from his person.

The Need for Mozart
Juan is a true gentleman. He is a Cuban exile who, like many in Miami, arrived in the U.S. shortly after the revolution. He sits silently in a corner of his home in Miami Beach while his caretaker explains his many health issues to Enrico. His wife, tired and laden with anxiety, adds to the list. They ask for more services, because they cannot keep up with the needs of a man who suffers the crippling effects of Parkinson’s and a broken hip. Enrico examines Juan, and gives his recommendations. As he works, he gets to know him better. He learns that Juan worked as an opera critic for a newspaper.“What is your favorite opera?” Enrico asks.“The Marriage of Figaro.” The opera is his passion. Their eyes meet and they begin to sing “Non Più Andrai, Farfallone Amoroso,” together, by heart, from start to finish. “In that moment, everything changed.The tension melted away.It was still just the four of us in that room, but the worries were no longer there. There was instead the recognition of a possibility: something that can break into our life, something can surprise us and embrace our every circumstance. And it is not something that we make, it comes from the outside.” Juan’s wife ceased her complaints and walked Enrico to the door. “Come again; come back and sing with him. This is what he needs.” These visits could become for Enrico mere acts of sympathy, but have instead had the power to transform his life and his job. Patients fling all their needs in his face, with their fragile bodies and fragile spirits.They have grave illnesses, sometimes chronic and sometimes unpredictable. Often, they are hospitalized, and he takes care of them once they are released: “I accompany them in the transition; I help to understand their needs, to help them to accept the loss of autonomy, which is a cause of great suffering, and to create the best possible situation for them to stay at home, where they-want to be.” Every day he visits five or six patients; at any given time he is attending to a total of 40 people. Usually, he is the only one caring for them outside of family members, who prepare their meals, help them get around, bathe them and keep track of their medicines. “To listen, to pay attention to family members and to educate them is an essential part of my job,” he tells us. Some patients live alone, and Enrico is the only one who comes to see them. Most of them are impoverished; almost all of them are American ‘transplants,’ whether steeped in African culture or hailing from the northeast suburb Hialeah, which is 100% Cuban.

Each elderly person has a story to tell, and could tell it the same way a hundred times. Friedrich was a Jewish man who lived to age 90. His story was his own dramatic life. Enrico never tired of hearing it.Born in Austria, Friedrich had escaped the Nazis when he was a young boy, fought in the war and ended up in America, where he built a business from the ground up and became wealthy. “He was a very intelligent man, who portioned out the right medicine for himself and for his diabetic wife every morning.” One day, he accidentally mixed up the two medicines and was found collapsed on the sidewalk in hypoglycemic shock. “The first time that I visited him it was the end of the day. I remember that I wanted to put off that last patient to go home, but I said to myself, ‘Come on,I can make it quick.’I stayed with him for hours.” He was disagreeable and argumentative, without an ounce of sentimentality. He was a hardened man who refused help. Enrico went to his house once a week for three years. One day, Friedrich told him, “You are my friend.” “It was a breakthrough for me,” Enrico said. “Who am I to have come into contact with a man with an extraordinary life like his? He was expressing something that I had never clearly understood: any relationship with anyone can be a real, deep friendship that enriches your life.” Friedrich passed away two years ago and Enrico thinks of him often. “Not as another thing that happened to me, but because he was the dear companion that God gave me along the journey of life.”

Mia and Her Doll
Another story came from a visit with Luís. It was the second time Enrico had visited the house where his patient lived with relatives, including his three-year-old granddaughter, Mia. Enrico checked his blood pressure, temperature, listened to his heart and his lungs, and then spoke to his daughter about his health. Mia came over to Enrico and gave him her doll. She wanted him to give it a checkup, too. Enrico, who is 6’3”, bent over and, with the greatest care and attention, listened to the little doll’s heart, pulse, and stomach. “This doll is very healthy!” Mia was pleased.“When I was leaving, I waved good-bye from the door, but she ran over and hugged my knees.” It could have been brushed off as just a sweet moment, but something deeper happened in him. His entire life passed in front of him. “In that moment, I realized that everything that had happened to me, everything, had led me to be there, with those people, to recognize with them that all we have is the present, and that within the present there is something of the eternal.” No statistic or probability could explain his meeting them; he grew up in in Sardinia, Italy. When he was little, he used to look at a map and wonder if he would ever see Rome, and now he has been living in Florida for six years. He became a nurse “by chance,” because a friend told him, “I’m going to take the exam, do you want to come?” and he, who had quit school, decided to follow her lead. “I can say that the people I meet are a part of my life because I recognize that Destiny is present, and brings us together.”He doesn’t know why the realization came in that moment and notin another,“butI know that if I am open, the possibility is always there... always.It’s simple.”

Hidden Medicines
He has the growing desire to live this way every day, “not to be concerned with arriving and fixing everything, but to let myself be surprised by life that is happening around me, and to live with an infinite horizon. I experience it in the simplicity of a human encounter, through my own fragility and that of others. This is Jesus who comes.”Enrico never imagined being able to call Him by name. “If I hadn’t encountered Christ, then that dizzying sensation at the mystery of the person in front of me would have remained a confused thought. Instead, I see it is Jesus’s gaze on things. I can live without the awareness of the depths of reality, but these facts reveal the true nature of things to me. Reality is the Mystery that is happening, and that touches us.”

The relationship between a medical professional and a patient is delicate.“If you yourself are not sustained, you cannot face the drama. Especially here, the pressures of the system are overbearing, and to protect themselves, many stick to giving formulaic instructions; but it’s not enough to say, ‘These are the medicines you need to take.’”Even if they have access to drugs, patients don’t necessarily take them, especially the elderly, and the worst are those who are alone.

When Emma, a Cuban woman, finally began to trust Enrico, she pulled from under her table a bag full of hidden medicines. Of her 20 prescriptions, she took only four.“Some worry about the side effects, others don’t believe in medicine or are generally confused, which could be dangerous. If you go there just to repeat that they need to take care of themselves, you’ve done nothing.” When you enter into a relationship, the results are exceptional: you can even help the other to uncover medical issues that doctors have missed. “It’s a profession that requires intelligence, knowledge, and affection. These three aspects always go together. I can discover what I am capable of, and when I’m capable of it, only within a relationship.”Sometimes he seems to have failed, as in the sad case of a terminally ill man whose family gave him chili powder because of an old Jamaican tradition. They didn’t realize it was going into his lungs. “They didn’t want to let me help, and I didn’t have the patience or the right words or gaze to help. I stopped going, because I was more of a problem than a help.” The only thing he was able to do for him was give him a bath. “God who became man was a nurse,” Pope Francis said recently. “God gets involved, He comes close to our wounds and heals them with His hands. It’s Jesus’s personal labor. God doesn’t save us merely by a decree or a law, He saves us with His tenderness, with caresses; He saves us by His life, given for us.”

Yes or No
Enrico’s first homebound patient was Fr. Giussani. He cared for him, along with others, for three years. In that time he learned to be open, to not object to reality. “For [Fr. Giussani], everything was relationship with the Mystery, even things that I rebelled against and said, ‘But not this, that aspect needs to be fixed, it’s all wonderful except’... For him, everything was given, and to see him was to participate in the gaze of Christ, which makes all things new.” He was not talking about mysticism, but of knowing things as they truly are, right there in the houses of his patients, and as their needs transform him. “The other has two eyes that look at me and ask, ‘Are you with me?’ It’s not something calculated. And perhaps I’m not all there, but reality invites me to be present, and I can say Yes or No. My greatest desire is to accept the invitation.”