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She arrived with the shoe laces of her trainers undone and the gasping breath of someone whohas come down two floors running. She chose not to have lunch so she could talk to me, but she said with a natural, happy look, that no one really has lunch there. Despite the orange alert around the country, the wind and rain do not cool down the adrenaline rush of this doctor who wears a short-sleeved uniform. Inseparable from her pager, she checks it regularly, ignoring the personal phone she throws on the table.
Her name is Rita Espírito Santo, and after six years studying for her medical degree and a further six to take her specialty in paediatrics, she is in her last year of the internship, which ends on 31 December.
She does not have children yet, but believes that one becomes more sensitive after having one. Her patients are all little ones, and she particularly likes those who have just been born and those who barely speak. She chose Paediatrics because she believes it is the best specialty of all. "These patients are different", she says, "they are very true, they show exactly what they are like. They are also those who have the greatest capacity for recovery, and those who everyone likes". She preferred not to choose surgery, but rather a medical specialty, because she prefers to see the children awake and to bond with them. "If they like us, then they like us, but if they do not like us, we have to conquer them over. A child is surprising when she is in good health, and at the end of a consultation where they have always been frowning and suspicious, they end up smiling, and this is an achievement".
She believes paediatricians to be the most thorough doctors because they have to consider all the details: weight, what was eaten or not, how many days of antibiotics children take. On the other hand, parents are as committed as their doctor and then the responsibility is much greater. She knows all her children of the general paediatric consultation. She knows their names and personality traits. Depending on the number of months they are, they also have different types of interaction with the paediatrician: at one stage they laugh, at another they find it strange and distrust her, and suddenly they look at the doctor like a hero who has incredible things that the other adults do not have.
(At this point one hears an entertainment group singing to the children as they walk down the corridor)
It is the fourth year that Rita Espírito Santo spends Christmas at the Hospital. She has already been at the ER in Paediatrics in Santa Maria Hospital, she was in Cascais Hospital, another year she was in the Intensive Care Unit and this year will be spent in the Neonatal Intensive Care Unit.
It was, in fact, the theme of spending a Christmas at the hospital that made me go to this paediatrician. Spending Christmas at work can make one feel awkward by staying away from the family, but when the day comes, a special spirit of unity is created. She explains: "There is great empathy because many people work that day, we have our secret friends and everybody brings so many sweets that even that smell of Christmas candies is there in the room. We wish Merry Christmas to all the patients and it is a day which, even if spent working, has a special happiness to it because people are more united. Usually, at Christmas, we have visits from someone who comes to do entertainment activities and many doctors in the team come to the hospital to see who stayed here. Colleagues who have children are visited by them and sometimes we also have surprises when the family comes to visit us".
As for the little ones, the reality is different, "the children do not fully understand, but they know that there is something different at Christmas". Generally, those who are in the Hospital at this time have no mild symptoms, nor are they just passing by, "colds and viruses come to us from the 26th onwards. The Paediatrics ER, since it is external, is lighter, there are a lot of people, but almost nobody stays here".
Rita Espírito Santo explains that Santa Maria is a "different Hospital that receives everything when nobody else knows what to do, and there are many situations that only happen there". Having been in the Intensive Care Unit last Christmas, she experienced the loss of a boy on 25 December and had to manage conveying the news to his mother. "When a baby departs because he was already very sick, the parents have to know how to mourn, even though he has not left yet. That baby is not what they dreamed of, it is the baby they can have, but that is very complicated for them".
Now in the Neonatal Intensive Care, she realises that "everything that is intensive lies between life and death. It may happen that one day they are here, and the next day they are gone". These are the cases that make doctors review all the procedures and double-check everything again. They feel revolt when they lose a child and that feeling accompanies them throughout the day, but they understand that there must be a deadline even for feeling sadness, "it must be over the next day because there are other children waiting for us. But it's hard to forget when we lose a child in an unexpected situation. You know that in our country it is almost unacceptable for a child to die".
Portugal is one of the countries with the lowest infant mortality rate (number of deaths of children under one year of age), as well as Neonatal Mortality Rate (number of children’s deaths under 28 days of age). According to The Lancet, Portugal ranks ninth in the list of safest countries to be born, with data studied until 2012. Of the list, which includes 162 countries, only a few Nordic countries, Japan and South Korea stand above Portugal.
Portugal also has a free health system for all children up to the age of 18 and is the country with the highest number of hospital births, with pioneering neonatal care and a comprehensive national vaccination plan.
According to information from the General Directorate of Health, and regarding the National Vaccination Plan, the profile of infectious diseases has already changed in Portugal, which explains the reduction in child mortality, as well as the eradication of smallpox and the end of childhood paralysis, rubella and measles. Other diseases will follow the same course. And although the OECD data tell us that more babies weighing less than 2,500 grams are born, and that we have an increase in preterm deliveries due to the old age of the mothers, even so, being a child in Portugal is good news.
It is the success of these numbers and the commitment of several doctors, as is the case of Dr Rita, that can make a difference in the life of a child. Whether it is Christmas or not.
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Joana Sousa
Editorial Team
