Emanuela Vismara in the oncology ward

"Infinitely, will you be here?"

A work “within” her work. From the May issue of Tracce, the experience of Emanuela Vismara, a young nurse in a pediatric oncology ward.
Anna Leonardi

There is probably no more difficult job. There is no physical exhaustion, intellectual effort and responsibility that can compete with the hard work of those working in pediatric oncology wards. Emanuela Vismara, 31, has been a nurse for two years at San Gerardo Hospital in Monza, at the Maria Letizia Verga Center, which was created to study and treat childhood leukemia. Here 90 percent of patients with lymphoblastic leukemia recover. It is that other 10 percent that takes your breath away. And that requires a work within work.

Emanuela came to Monza after practicing at another hospital, in surgery: "Moving to a sub-intensive care unit meant great professional growth. I accepted because I wanted to learn and acquire more specific skills. But this put a lot of strain on me." For months she slept poorly and was agitated. But already in her first few weeks an encounter began to pacify her. Ravi, 5, the son of Indian immigrants, watched her as she put him on a chemotherapy drip. It was the first time she had done it alone, and it took her a while to adjust the speed. As she tried to calculate the most appropriate one, Ravi looked at her amused, then said, "Hey, look it has to go 240." Everyone in the room laughed. "But I felt looked at and embraced in my inadequacy. Ravi, so small and so attentive to everything, with his sympathy allowed me to look at my attempt with a little more patience." But it was not just her performance that made her uneasy. Dealing with children and adolescents demands something more. With them, it is not enough to just walk into rooms, leave medicine on their bedside table and then disappear. "You cannot expect them to undertake therapy without you getting involved. They want you, whether it is a game, a caress, an encouragement. And that requires a special energy because you cannot enter into a relationship with them and remain detached."

When the situation then worsens to the point of dragging the lives of the children and their families into a tunnel of interminable suffering, great efforts are needed to ensure that that pain does not also challenge those who are caring for them. "It is true what they teach us in the university, that we cannot live every story as a personal grief. Because otherwise we would not be able to go back to work when a patient dies," Emanuela says, "but in these situations I wonder what hope I have in life to stand in front of these people."

Last summer Emanuela met Michele, a 16-year-old boy who was in the terminal phase. He was bedridden and she entered his room in the evening to settle him for the night. "You smell so good!" he told her as she leaned over him. "I would like it too, take my cologne in the bathroom and put it on me, please." After a while he got worse, a series of complications and pain treatments made him less and less alert. "But that request for his cologne kind of guided me, calling me back to ever more careful care, made up of many gestures and very few words," recalls Emanuela, who is joined in all this by Elena, a colleague. When Michele died, they are both in the room. The boy's mother looked at them and said, "Michele no longer exists." The two nurses were stunned.

"How could that woman go on living thinking her son no longer existed? But there are moments when you realize that saying anything does not help. In fact, I think that talking is useless... I always have in mind what the Pope says: God does not offer an explanation to the person who suffers, but a presence that accompanies." So she embraced her and then, together with Elena, began to prepare Michael to make him as beautiful as possible. As they worked, they were moved. "I thought at that moment God was making himself present to those parents through my work. And also through the pain I was feeling."

The cry of that mother has never left her. It has become a question that penetrates every task. The same thing happened to Elena, her colleague. During a night shift, they were sitting quietly next to each other in the nursing room: "Emanuela, I cannot recover from Michele's death," she confessed. "In some moments I feel that he is alive, that it is not true that he is gone. I do not know what it is... Then I think of you, you have experienced everything I have experienced: the sadness, the anger, the crying. But I have never seen you in despair. Yours is a serenity full of sorrow. I long to be like you, at work and in life. Perhaps this is the beginning of faith?"

Emanuela was struck by how it was enough to live her work conscientiously to let a light filter through even the darkest scenarios. "Usually when a patient's prognosis gets worse, people say, 'He was unlucky.' In the face of unexplained pain, the mentality of the world enters us. The measure in our field is not so much on us, on our ability to achieve goals, but it is on the reality that clinical situations show us. Instead, with Elena, reality began to suggest something else. This is what makes me want to return to the ward every day.

This is not to be taken for granted when the nursing profession is experiencing a high resignation rate, due in part to the trauma the profession suffered during the pandemic and in part to inadequate salaries. So many are leaving because they choose to work elsewhere in the field, but many prefer to reinvent themselves and change jobs. "The longer I am in the ward, the more my desire to study and deepen my understanding grows," explains Emanuela, who has always had an interest in research as well. "And I understand that there is a fundamental point of my work that generates in me the ambition of growth. I understood that with little Ravi, too." A year after their first meeting, the child returned to the ward. For days he had been experiencing severe headaches and vomiting. They feared a relapse and he had to have an MRI. Inside her, something rebelled. It is always Ravi who sets her heart right again. "Will you take me down for it?" "No, go with mom and an assistant, otherwise what will the other children in the ward do?" "But will you be here when I get back?" "Sure, I will wait for you here." "What about tomorrow?" he insisted. "Yes, I am here tomorrow too." "What about the day after tomorrow?" "No Ravi, the day after tomorrow I am off." "And after the day after tomorrow?" the child began to endlessly ask her, until he said, "And infinitely, will you be here?"

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Faced with all these question, Emanuela had two thoughts: "It has become clearer to me why I want to grow professionally. I want to be able to follow these patients even in an eventual transplant phase where other skills are required. And then, to promise them this infinity, I cannot avoid that work within my work that makes me discover the Presence that never leaves me alone."