He came to Las Tunas by another chance, and the son of Mantua, Pinar del Río, confesses that he carries the duality rooted in him because this is also his homeland. As a master in Emergency Medicine, assistant professor, and president of the Academic Committee of the specialty, his dialogue is bifurcated, but the doctor is faithful to his patients, to the maelstrom of the ward, and to those precious seconds in which life or death takes hold.
“Emergencies don't ask for permission. The ability of the team to respond, to see the details, is what makes it possible for a human being to return home. And we know that a mother is waiting for news, that in the corridor there are relatives with a broken chest, that real pain is waiting... We never ignore such realities because the best results are born from that sensitivity.”
Aliosky carries, in many ways, the most complex cases that have come his way in a frank struggle for life and with all the odds stacked against him. Some have demanded more than 48 hours without rest, without stepping foot in their house, or even a bath in between.
He remembers a patient with complex polytrauma due to a motorbike accident. The details still haunt him.
“He was in critical condition, with multiple organ dysfunction. We did emergency complementary, called in the phenomenal surgeon, got him to the OR as optimized as possible and he is currently in the Orthopedic ward awaiting femur surgery.”
“Not long ago we had an extremely critical maternal with a septic miscarriage. These events hurt a lot. Death is painful, but even more so if it happens to a young person, just starting to live. In these cases, we struggle with them, minute by minute. Together with colleagues from Obstetrics and Anesthesiology, we went to attend to the girl. She was practically giving herself to the Lord, but we didn't give up and stayed there at the bedside.”
“We gave her emergency hemodialysis at a key moment and that was a turning point. She recovered, eventually, and is walking around happy and carefree.”
“We recently treated a case with a traumatic brain injury. It was very complex because we don't have a CT scanner at the moment. We took many risks because, without the necessary tests, we were walking blind. The neurosurgeon said yes, we got him into the room and saved his life. It still caused concern and anxiety.”
“Any one of these anecdotes seems simple, but it's not. It's weeks of watching over a patient and not leaving their side because the smallest detail makes a difference. It is a team effort that involves even the cleaning assistant in the result. If there is one thing we are, it is a family that always takes care of its own, no matter how sore the legs, how tired, how sleepy...”
With his characteristic leisurely tone, Aliosky strips away the credit and apportions it, giving it a name. In the equation, he singles out the nursing staff, ‘his colleagues’, as he calls them.
“I have always taken great pride in coming from the nursing profession. It is a profession of infinite humanism. And the raw material of the profession must be that human side that must characterize us men and women, the sense of helping each other, and then everything else. Without that, you can't work in therapy.”
THE EMERGENCY WITH HIS SHIRT OFF
He confesses that in 2016 he began a Master's degree in Emergency Medicine in Havana, which ended up filling him with certainty about the profession. “I met other professors from the Calixto García hospital and it was like renewed inspiration. I remember that, for the first time, I was dealing with emergencies in pediatric patients. This left a big mark on me, the sensitivity of caring for children. It is very hard.”
“I understood that the specialty reinforces your humanist values a lot because, as I say, it is the last person you will see who is fighting for their life. It is very gratifying to be able to give someone back a family member, to bring them back to life when they are practically on the verge of death; it is a very fine thread, and acting with certainty can make a difference. Those thousand emergencies to save a patient are my credo, no other.”
“What have I learned? To listen, above all. In medicine, you have to know how to listen and you have to be a communicator par excellence because we are dealing with different people, who may not have the same cultural level. So you have to try to give them a simple and clear message.”
He assures that at the head of the service, he also has to prepare the younger ones from a sensitive point of view so that they understand that they have chosen a very rigorous specialty. This link with the successor is a gigantic challenge.
“Out of 12 first-year residents, today I have five left because this is a very demanding job. And whoever is here is because they love the white coat. Anyone who thinks that they took the career with a lucrative purpose or thinking that they will get rich or have a comfortable life should know that medicine in Cuba is synonymous with sacrifice, love, and dedication.”
“Right now, I spend more time here than at home with my family. And in order to be here I first have to get up early and look for what my daughters need for the day, the milk at the point, the bread? Sometimes I walk more than 10 kilometers in the center of town to find food, and I suffer from bilateral chondromalacia that limits me in a way.”
“The service takes up the whole day and there are no fixed hours. Sometimes I get home at 5:00 or 6:00 in the evening and they call me to come back for an emergency. I do five, six, seven shifts a month when there are no critical maternal emergencies; when there are, I'm practically here all the time. I try to educate young people by example, but of course, the demands are superhuman.”
OTHER VIEWS
Among the most rewarding experiences was his international mission in Trinidad and Tobago. There, it was not only the foreign language that made the greatest demands on him but also the reality of being in training; a lot of knowledge suddenly came to him.
“I learned that there were other points of view besides my own, which is vital in the profession. You don't know everything and you have to prepare yourself constantly. Of course, I learned a lot about advanced technologies, which I had no idea about.”
“There I saw, for the first time, a patient with Sheehan's syndrome, a very rare condition resulting from excessive blood loss during or after childbirth. Extensive bleeding can reduce blood flow to the pituitary gland causing damage and death (necrosis) to pituitary cells.”
“I remember the girl had an endocrine failure, but it was overcome with synthetic hormones thanks to the timely diagnosis. It was a very exciting, borderline experience. The missions bring a lot of knowledge to the medical staff, it's like renewing oneself in the profession, like a concentration; and you go back to your center with more experience and better tools.”
BEFORE THE DOCTOR...
Several times in the conversation he says that he has respect for God, especially in the aftermath of a work in which he feels that a greater will than his own is being fulfilled, that there are outcomes that seem like miracles and others that are twice as sad because of the unforeseen.
“I don't know a human being who, at a critical moment in his life, who is afraid, does not say ‘Oh, my God’. It is ingrained in everyone, and even more so if you also have to deal with a profession in which uncertainty, is the norm. You ask yourself how, if this patient had such an unfavorable prognosis, suddenly the situation was reversed, and if he came with a more favorable prognosis, how suddenly he didn't make it. There are many variables there.”
“I am a person who has very particular beliefs, and yes, I ask God for wisdom to make the best decisions, not out of ego, but out of respect for life, because I care about whoever is lying there in one of those beds.”
Support comes from further afield. He tells me that he came into the world struggling between life and death. His mother in desperation put her knees on the ground in front of his hospital bed and begged for his life, for the gift, he was being denied. There he is today, on the other side and with the invisible responsibility of deserving his miracle.
...
Although he was a swimmer as a child and has a passion for sports, he says it is baseball that alters his blood rhythm. With his girls, Sara Camila and Sofía, he likes to visit the Ángel López (Chiquito) Stadium and is entertained by any boys' game where there is laughter, hitting, and witty banter.
His day-to-day life at the hospital is a sort of sports metaphor, in which he is almost always in the ninth inning with the bases loaded; and he feels like the loneliest human being in the world on his mound. The three and two are on the screen, the stadium is a hive of silence, and his next pitch saves or loses the game. But this championship is for life and his only option is to fight.