Here we go, it’s up to us. The operating room is ready. In a few minutes we will be in the chemical darkness, and in a time that we will not remember, because it takes us away from conscious life but also from pain, a darkness that is therefore salvific, but which nevertheless frightens us. What if I don’t wake up anymore? What if I stayed in that darkness, and passed from sleep to death? Here, anesthesia does this: it eliminates the pain of surgery, but generates atavistic fears, which have their roots in the ancient history of our species, that of nights without lights. Or in childhood, when we demanded at least a little light until we fell asleep.
“I am lucky that I have never had to resort to general anesthesia, but I am afraid of the dark, still a little today. And yes I was one of those little girls who wanted the light on in the corridor. monsters, “he says Eleonora Giovanardi, lead actress of Paura del Buio, the short film by Mattia Lunardi, produced by Brandon Box and premiered on October 19 at the Rome Film Fest. The short was commissioned by Msd Italia as part of the educational project ‘Oltre il Buio’ (#oltreilbuio) with the patronage of Siaarti, the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care, to inform the public about the safety of anesthetic procedures and on the role of the anesthetist-resuscitator.
The short: a tired anesthetist and a frightened child
Eleonora is a mother and an anesthetist-resuscitator who comes home very tired after a long day of work. At home, her partner (Giacomo Valdameri) and her daughter (Marika Ivanytska) await her, a little girl terrified by the darkness and by the mysterious creatures that populate it. When the little girl asks her mother not to leave her alone, she makes the decision to equip her daughter with the tools to overcome her fear, and to do it in the same way she does with patients in the hospital: listening to their needs and doubts, reassuring them of the path they must take and communicating with simplicity and clarity what is necessary to overcome the fears of anesthesia. They both go out into the night, mother and daughter, they get to know the monsters that were nothing more than shapes and shadows of common and well-known objects, they put up a tent in the garden, and the little girl falls asleep: she finally goes towards darkness and sleep without any more. fears. Because now he knows that monsters don’t exist.
The metaphor
Fear of the dark is a metaphor, not obvious but effective, which associates the fear of the darkness of childhood with that of general anesthesia. A fear far from rare: according to a study conducted on 400 adult patients published in the Journal of Anesthesia general anesthesia is the sleep from which 63% of patients fear not to wake up and on which everyone (95.5%), even those who are not afraid of dying, would like to be informed and reassured by their resuscitator. Yet death from general anesthesia is rare and is estimated to be around 1 in 150,000 patients (0.0007%).
Informing patients is therefore an essential task that anesthetists-resuscitators perform on a daily basis and which represents an important step in the perioperative process. Cinema in this sense can also serve as a tool for disseminating information. Although with languages different from those of science.
“Cinema must have an artistic agenda, it cannot have an educational one, it is not its role, we are basically just actors, not communicators of science – continues Giovanardi – but using its languages, for example that of metaphor, as in the case of this short film, it can broaden the pool of those who approach issues that have to do with health. When used in a virtuous way, cinema can help to decipher the complexity of reality and to bring professional figures, such as that of anesthetists-resuscitators, doctors rarely told, to whom we extend our most sincere thanks “.
A doctor on the sly
In the perceived reality of patients, the anesthetist-resuscitator is in fact a somewhat muted figure: the anesthetist is the doctor we hardly see, the one who puts us to sleep and stays in the operating room while the surgeon saves our lives. however, with the pandemic, this specialist took on more defined connotations: it was the intensive care anesthetists who managed patients in intensive care, they were the ones who intubated. They were the heroes, a word used abused in reality modified by Covid, and today sometimes removed.
The work of the intensive resuscitator anesthetist
“The anesthetist and intensivist in Italy has helped to defeat the fear and disease that many have faced in intensive care while fighting Covid-19. He helps every day the many citizens who fight the disease in intensive care and operating theaters , fear and pain – is the reflection of Antonello Giarratano, president Siaarti – for competence and training he is at the same time a communicator and a professional who makes culture and science his goal and public health tool. As a perioperative doctor, he prepares the patient from a medical and psychological point of view, also provides for his intraoperative “technical and technological” management having complete knowledge of the functions and dysfunctions of organs and systems, plans post-operative treatment with the aim of preventing complications and contain suffering and pain. The same work with competence and quality takes place in emergency areas, in intensive care in the structures and centers of pain therapy and palliative care. Communication and science are the synthesis of this profession “.
Hire anesthetists
“Our scientific society is the reference point of the discipline, and produces training and skills, research and innovation – he says Flavia Petrini, past President of Siaarti, from the stage of the Film Festival, it is essential for us to dialogue with institutions and politics not only to contribute to a correct finalization of the PNRR in health care as well as, in this difficult period, to communicate to citizens the importance of science and the health system “.
A health system that needs anesthetists, “Absolutely yes – continues Petrini – today there are about 18-20 thousand anesthetists specialized in public and private forces. It is not an exact number, because the situation is fluid, but what is certain is that we are underpowered. Many anesthesiologists have chosen to take early retirement, due to an excess of workload, and others have abandoned the public for private facilities where both the risks and the workload are reduced. Hospitals are forced to resort to trainees who, however, try to work in teams and not to allocate to particularly complex cases. During the pandemic there were fixed-term hires, which it would be right, today to transform into permanent contracts “.
Align doctor and patient
“The difficulty of communicating health to the public, promoting health culture, lies in the complexity of the theme – he points out Maria Domenica Castellone, Senator and Member of the Hygiene and Health Commission – however we must not forget that one of the goals of a cutting-edge health system is precisely to educate people and patients, generating that trust in science and health institutions capable of countering false information. From this point of view, the universal language of cinema allows you to speak in metaphors, while still being clear in intent and effective in stimulating a need for information that must be immediately reflected in the dialogue with your doctor. It is in fact essential to be able to encourage a dynamic attitude of the patient, which makes the relationship with the doctor and with the therapy easier, eliminating those misalignments that can jeopardize the correct outcome of the therapy “.
Increase dialogue with anesthetists
“We have chosen the metaphorical language of cinema to tell a very concrete fear, which can and must be overcome, because today anesthetic procedures are safe and controlled – he said. Nicoletta Luppi, president and CEO of Msd Italia – this fear, already widespread, has been further amplified by the fear generated by the pandemic. Even now, although hospitals have implemented effective protocols and pathways to manage patients safely, many people choose to postpone surgery and diagnostics, with worrying effects, which we will only really realize in a few years. There is only one way to overcome fear: talk to your doctor, ask him for advice and receive from her or him all the information necessary to decide with serenity. The goal of the short film and of the #oltreilbuioi campaign is precisely this: to encourage dialogue with anesthetists-resuscitators, who, before, during and after the pandemic, continued to assist, inform and monitor their patients with dedication and a spirit of service. “.
“Culture is essential for people’s mental well-being – he concludes Alessandro Fusacchia, Member VII Commission for Culture, Science and Education of the Chamber of Deputies and co-promoter Parliamentary intergroup on artificial intelligence – The closure of places of culture due to the health emergency has had important repercussions on our well-being and on the economic sector of the country . It is thanks to scientific progress that we can finally return to our habits and repopulate the theaters, cinemas and museums “.
Countryside
The short film Paura del Buio is the first piece of the #oltreilbuio information campaign, promoted by Msd Italia and Siaarti. The short film was premiered at the Rome Film Festival but will be broadcast on October 30 on Paramount Network – channel 27 of digital terrestrial, 27 of Tivùsat also in HD and 158 of Sky in HD – and then, starting from 31 October, on the website www.adocchiaperti.msdsalute.it.
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