Taking up the conversation again

Since the end of the printed stage of Perspectivas Sistémicas, in April 2007, I have broken off editorial communication with you, reader. It was to you that I addressed my farewell, it is to you that I am writing in this new stage. Along the way I have received, and often still receive, marks of gratitude, and the finest tribute an editor can receive:

“What a shame it no longer comes out, we miss it, why don’t you bring it back?” It is always pleasant to hear. It is also gratifying to have sold, over these years, whole collections to colleagues abroad, and to go on selling copies to professionals here, from all over the country, from Latin America and from Spain. Even today we get subscription requests, and readers write to us or telephone us to tell us, almost reproachfully, that they cannot find it at the newsstands! Charming, isn’t it?

What we are going through

But what I want to share with you today, reader, is something else. It concerns what we are going through, Ruth, my wife, my nuclear family and I. The big words, the reframings, the famous, witty or humorous formulas, uttered from the armchair of my consulting room about other people’s pain — which I have always listened to and do listen to, of course, with sincere empathy —, are not enough for me. Or they are not much use to me when it is my own pain that is at stake. Especially when I hear my dear wife’s daily, painful fits of coughing, as she waits for the next endoscopy or video-swallow study, knowing that she has been fitted with a tracheo-oesophageal stent (or prosthesis) with which she has been living for more than two months. Or when I watch her sleep sitting up in bed beside me, the way many patients sleep after long periods in hospital. And above all when I see her, with the endurance that is so much her own, still feeding herself through a nasogastric tube, enterally, for seven long months, and crushing her medicines in a mortar every day, after countless surgical operations, long stays in intensive care (three, to be exact) and a great many things still to be resolved, among them the tracheo-oesophageal fistula and her new face, operated on for very serious maxillofacial fractures.

My lumbar vertebra fractures, after the wheelchair and the brace, have knitted, and I now walk fairly well, despite pain and various limitations. And, naturally, the concomitant psychophysical exhaustion one feels when a situation drags on and is far from resolved, at the same time as one begins to admit that nothing will ever be as it was, above all for Ruth.

The pain of someone close is felt as one’s own, we have always known that, and the neurosciences confirm it, if confirmation were needed. It is the well-known phenomenon of emotional contagion, as Daniel Goleman (1) calls it in his latest book.

Quite the opposite of the owners of long-distance coach companies, who drive their employees to exhaustion by having them steer unstable vehicles, who take out insurance so that others will deal with the victims, and who go on with their lives without altering the essential things that would make their coaches — and therefore their passengers — safer, while behind them there remains the trail of victims, their own drivers included.

The accident

Let me tell you: our life changed radically from the moment of that accident, on the coach of the company TONY TUR (do not use it, please, neither you, nor your children, nor anyone!). It was Saturday 29 November 2008, at five in the afternoon, on a sunny day, on a clear two-lane Route 2, seventy kilometres from Mar del Plata, as we were returning to Buenos Aires after a most pleasant stay in “la Feliz”, as Mar del Plata is nicknamed. We shall never know why or how it happened: not much investigating is done, and even less when the driver dies. From what I am told, the companies see to it that the newspapers and the media in general do not go into detail and that the matter is quickly forgotten (particularly before the holidays and public holiday weekends).

It seems that, for some inexplicable reason, the coach left the road, struck a tree (!?) and overturned. We got out of it on all fours, as best we could, Ruth in shock because she had been asleep. An accident that could not happen — off season and in ideal weather conditions —, but it did happen.

If, as La Nación reported over the 1 May public holiday weekend of this year, breathalyser tests and checks on the compulsory rest period between two journeys came back positive in fifty per cent of cases among long-distance coach drivers, what on earth can we be surprised at? If the double-decker vehicles used by all the companies become unstable above ninety kilometres an hour, and it is proven that they often exceed that speed, what are we surprised at, readers? That the measures to prevent dengue were late and insufficient, just like those against influenza A, when our country has excellent health professionals? So what are we surprised at?

What comes next: the insurer, the delays

Oh, and if something like this happens to you, reader — God forbid —, do not count on the company (Tony Tur in this case, but they are all much the same in that respect; or worse *): you will be dealing with its insurance company. In that sense, this piece could be entitled “We are nothing”, the obligatory phrase at wakes. In any case, to them, you mean nothing. I made enquiries, I took advice, and everyone who knows the subject told me the same thing: what they do is drag the procedure out as long as they can, as I am already finding out (and the legal fine print gives them ample scope for it, I am talking about years); they scale physical damage as though it were a matter of objects of little value, and loss of earnings, like the enormous psychological, personal and family impact, they do not even take into account. Except, of course, if one is prepared and has the economic means — one’s own or those of one’s family network —, and the physical, mental and emotional health needed to face the long and exhausting theatre of negotiations or of a possible lawsuit, in which they try to intimidate you or to play on your anxiety in order to offer you sums so low that they do not even cover the medical costs. In our case, yes, of course, I am more than prepared. In fact, the legal claim would in theory be won; but can one wait two to four years? Delaying tactics, threats, party-appointed experts: and I will not even tell you what it cost me to obtain the medical information from the legal department of the Interzonal hospital in Mar del Plata. Ruth was hospitalised there in a critical, extremely serious condition for a fortnight, her life in danger; and it took me four months to obtain a photocopy of her medical file, which the person in that hospital’s legal department knew perfectly well where to find, but could not find (!?). It was in the archives, where it was supposed to be, since 15 December, the day we transferred Ruth to an intensive care unit in Buenos Aires, in a special ambulance with a doctor, a nurse and a ventilator. The archives are on the floor below or above the legal department. But she could not find it, and on one of the many times I called to ask for it, she said to me: “well, what odd surnames you people went and got yourselves!”

I am told that insurers and coach companies obtain such data very, very quickly.

Another thing: do you suppose, by any chance, that there was so much as a single telephone call from Mr Martín — that, I believe, is the name of the owner of Tony Tur (**) —, or from any representative whatsoever of the company, to ask after the most seriously injured, after the people in general who were travelling on that coach (in fact the driver died the following day in the very hospital where my wife was hospitalised, information that never circulated)? Well, do not count on it. Not one call of solidarity, not one humanitarian gesture. After a while, four months later, the Rivadavia insurance company got in touch with me. A glacial negotiation then begins with them. They require a prior medical assessment (that is what is happening to me seven months after the accident, and it will very soon be done with Ruth). It is carried out by a doctor on the company’s payroll. What counts is not what happened to you, what you endured, but the state you are left in. And that time should pass.

In short, out of modesty, out of respect for myself, out of respect for Ruth and for my family, I shall stop here as regards the details of our health and our feelings. You will understand and you will imagine the rest. I trust your emotional intelligence, dear reader.

What is more, carrying on my work at half speed — I have not yet resumed my teaching activities, but I have resumed seeing patients —, going with Ruth to the doctors, looking after my own health — I have lost a great deal of weight and I have been diagnosed with a post-accident anaemia, caused by an autoimmune reaction — and the legal matters: all of that takes, for the time being, all my energy.

Resilience, more than ever

Resilience, reader? I still believe in it, more than ever. Quite as much as in family networks and deep friendships, in neighbours, in colleagues, most of them very present, loving, supportive. Not to mention the strangers, or the people I barely knew and who have become beings I am fond of, whom I hold in esteem and for whose existence I am grateful. They unquestionably made the difference: one example among so many, throughout her hospital stay Ruth never spent a single night alone. Meditations, prayers of every faith, masses, sendings of energy, e-mails, telephone calls, words and gestures of solidarity abounded, and I am very, very grateful for them. To the doctors too, to the nurses, to all the health and maintenance staff of the Interzonal and to those of the Cemic. I shall go on writing about this and about other things. I needed to address you, to tell you, to share, as I have always done since Perspectivas Sistémicas first appeared, in May 1988, until the last editorial of April 2007.

Thank you for reading me once again, I embrace you,

Claudio Des Champs