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  • Writer's picture@ Cynthia Adina Kirkwood

ER of Portugal’s Largest Hospital: Empathy – Not Fear

Updated: Nov 28, 2023

After triage on arrival at Santa Maria Hospital in Lisbon, doctors diagnose conditions and order immediate tests, such as ECGs, X-rays and blood analyses, in examination cubicles. Patients return to the doctor with the test results, and the doctor prescribes further treatment. (Photo @Patricia de Melo Moreira/AFP)


While waiting in a quiet and orderly emergency room at Santa Maria Hospital in Lisbon, I recalled skirting a loud and chaotic ER of San Francisco General Hospital to visit a dying friend many years ago.

Armed and uniformed police stood sentry at the entrance to the California hospital. Sirened ambulances arrived with regularity, unloading gurneys, sometimes of bloodied patients. Thirty-five years ago, the public hospital’s doctors and medical staff were noted for patching up gunshot victims and saving their lives.

When I left the hospital, at the exit doors in the hall, an officer was handcuffed to a prison patient, the waiting room to the left of us. Inside, there was some shouting, there was some cursing and, scarier, the foreboding that the patients, who were of all ages, could unleash their pain and torment on any passer-by.

Those few harrowing minutes quickened my gait and focused my gaze on the exit.

Days ago, while spending hours at Hospital de Santa Maria, a public hospital in Lisbon and the largest in the country, I felt only the anxiety over the health of the patients by them and their families, not fear for my safety.

There were two interconnected open rooms. In the outer room, 13 gurneys held gray-haired, white-haired and dyed-haired patients and were lined up perpendicularly against the wall. Along another wall and those of the second room sat twice as many people, many of them acompanhantes, or escorts, of patients and middle-aged.

The acompanhantes formed a community. We helped each other and the orderlies with the gurneys: rounding corners, holding them still and hoisting patients onto them. We tucked the blankets round the patients when weakened grasps could only brush the wool. When asked, we also repeated the crackling loudspeaker information of the patient’s name, room number, and the directive of green or yellow door.

When one of the two unaccompanied patients, both women, began to moan loudly, one of us found a nurse who came to her side, giving her words of comfort and a gentle touch, perhaps all that medicine would be able to offer her. The other patient on her own lifted her upper body occasionally, her eyes rheumy, talking with someone who was there for her but we could not see.

The hospital staff brought patients and their acompanhantes sheets and blankets to warm us and jokes to lighten us. Even the security guards availed themselves to questions, directing us to the rooms for ECGs, X-rays, blood analyses, and, eventually, the hospital exit.

Just before my friend saw a doctor, three hours after checking in, a woman wearing jeans and the blush of youth pushed in an old woman in a wheelchair. Both shared the same Roman nose, the same profile, the same blood.

Once, the young woman had been a baby in a stroller being pushed by the old woman.

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