Palliative and pain care, shame at Cardarelli. Montrone: “Inhumane department”

Naples. Pain management and palliative care: the former chief physician's battle to defend the legally established right to freedom from suffering at Cardarelli Hospital.

Yet another battle and a heartfelt letter from the former head of the Pain Therapy department at Cardarelli Hospital, Vincenzo Montrone, who, after having created a division of excellence within the Campania hospital, today – honorary president of the Il Nodo association – takes to the field again to defend the rights and dignity of terminally ill patients.
The department created with so much passion and with the help of volunteer associations has been practically dismantled: only one fully operational doctor and a few unmotivated nurses, rooms without bathrooms and no privacy for terminally ill patients and relatives who face the tragic moments of the disease. The patients are hospitalized in only two rooms, each of which has two beds, so one patient witnesses the suffering of the other and sees his death.

Doctor Montrone wrote a heartfelt open letter, addressed to the regional leaders, the regional health commissioner, the mayor of Naples and the mass media, in which he launches an appeal to stop the inhumanity.

“I am the former Chief of the UOC of pain therapy and palliative care, I dedicated my life to the birth of this specialty obtaining already in 1977, with a Presidential decree, a formal recognition with the establishment of a Pain Therapy center. The Campania Health System could boast of having the first center in central and southern Italy.
Unfortunately, the TDCP has a troubled history with moments of glory and national and international scientific recognition that were not understood and appreciated by short-sighted administrators who penalized its development if not even hindered its growth.
Despite all the obstacles, the UO has produced great organizational and economic benefits for the Company and, more importantly, it has offered over the years a quality service to a demand for assistance that is severely lacking in our region, thus satisfying a real and not induced need, as often happens in Healthcare. Over the years, with the strength of numbers and the quality expressed, it has become a department of excellence (as also attested by the over 400 letters that have arrived over the years to the administration and the public relations office as well as by recognitions received from the Health Councilors and the Region)” writes Montrone.

But despite the department being a source of pride for the Campania healthcare system, in recent times a dismantling effort has begun: “Several administrators, with various motivations and showing insensitivity and managerial ineptitude, have tried to reduce the activity of the UO only to then go back on their decisions when the discontent and anger of users aroused the attention of the media – writes the former head physician -. After years of battles, the establishment of a UOC of Tdcp was decided and for many years we were able to demonstrate that, even in the absence of staff (4 doctors and a head physician on the staff list), the opening of a department with 10 beds in single rooms fulfilled three very important tasks: 1) it decongested all the hospital departments that transferred terminally ill patients, freeing up beds for acute cases and, above all, it no longer clogged up intensive care and resuscitation; 2) It offered quality specialist care to terminally ill patients; 3) it resulted in an economic saving for the company of 4 million and 800.000 per year. (This saving, as well as the decongestion of the various departments of the hospital, were demonstrated with scientific work that lasted 0 years and was done in collaboration with the company's health management: winner of the Luzzi Prize 10)”.

But today all this has disappeared or is about to disappear: "Today once again, they are trying to close this line of activity, this time in a more "soft" way. The staff has been reduced to only two doctors and there is absolutely no thought of integrating them, the department that was one of the most beautiful in the hospital has been taken away from the UOC with all the equipment (special beds etc etc) and also delivered with equipment and furniture donated by the volunteer association to the UO of Tdcp to another department". The terminally ill have been relegated to two rooms where two patients are hospitalized per room and 'without a bathroom'. "In the most absolute inhumanity, one patient must witness the death of the other - Montrone denounces - The nursing staff who over the years had acquired specific skills and who had been selected for aptitude and motivation (assisting the terminally ill, being close to suffering and death is tiring) has become demotivated, some have asked to change department. Only two doctors, one of whom benefits from law 104 ...!".
Doctor Montrone launches a heartfelt appeal and announces a battle: "We will not allow such a massacre, an offense to the city already lacking these facilities. We will not allow hope to be taken away from so many suffering patients who do not have the strength to assert their rights. I hope that in a pause for reflection we will want to listen to the reasons of the voluntary associations, first of all the association Il No.Do which has repeatedly requested a meeting without ever receiving a response. We will not give up, I will not give up and I will fight with all means in all venues to defend the right to non-suffering established by law 38/2010".

The former head physician intends to sensitize the management of the Cardarelli hospital so that it does not destroy what has been built in 40 years for the benefit of the weakest. The current situation of the UOC of Pain Therapy and Palliative Care, says the doctor, is absolutely shameful.
The management of Cardarelli has ignored the dozens of certified emails sent by the volunteer association IL NO.DO, which has been accredited at the facility for some time. “As a former head of the department, now retired, I receive daily appeals from the staff and numerous family members with whom I can only experience the torment and pain of those who are not listened to,” concludes Dr. Montrone.