MAURO’S story begins as one of the most difficult years in modern Italian history is drawing to a close. The country is in lockdown, a measure aimed at impeding a renewed spike in Covid infections feared over the holiday period. In one of the worst affected countries in Europe, Covid has already claimed almost 70,000 lives, and deaths in the second wave are surpassing the grim toll reached in the first. It is hoped that the recently launched vaccination programme will mark the beginning of the end of the nightmare, but during December 2020, the virus claims between 600 and 800 lives every 24 hours.
Despite the curfew and a ban on interregional travel, management engineer Mauro Carrucciu has to go to work. His girlfriend, language teacher Julia Mete, is in Canada visiting her ailing grandfather, so Mauro wakes up alone in his apartment overlooking Florence’s famous cathedral with its magnificent Renaissance dome.
He raises his head from his pillow at around 6.30 am. He’s feeling dizzy and when he tries to get up, he discovers he cannot rely on his left arm or left leg. He has no idea what is happening but instinct tells him to unlock the latch on his front door if it’s the last thing he does, so he hurls himself across the four-metre stretch of parquet flooring, his phone held between his teeth.
Before he dials the emergency number, Mauro tries to call his mom. She knows where he lives and would be able to direct an ambulance to his address. But it’s early in the morning and she doesn’t answer. Mauro feels his mouth fill with saliva as he dials 118. He is still able to talk but he is starting to slur.
FAST forward to September 2023 and Mauro and Julia’s hipster-chic wedding in one of the coolest wedding venues in Tuscany – the Limonaia at the Stibbert Museum in the Florentine hills. It’s a joyous occasion, a celebration of both love and life, but as far as Mauro is concerned, two of the guests are more important than all the others – the woman who gave birth to him in 1987, and the one who 33 years later gave him a second chance.
Dr Angela Konze attends with her partner, emergency nurse Rita Marino, who was the first person to see Mauro when he was wheeled through the doors of Hospital Santa Maria Nuovo shortly after 7 am on 29 Dezembro 2020.
“Mauro was brought to the hospital by the EMS,” she says. “They called ahead to let us know they were bringing a young man with leftside hemiparesis whose last time seen normal wasn’t known. I immediately activated the stroke pathway for a case of wake-up stroke.”
For ED physician Dr Monica Ciaccheri, exhausted at the end of a long night shift, the timing could scarcely have been worse. They’d have to rely on adrenaline to get through the next 64 minutes.
She recalls, “Mauro couldn’t really talk. I tried hard to communicate with him, but he couldn’t move his left arm and couldn’t speak. Somehow I realised that it could have been a wake-up stroke. We had to act quickly. Above all we had to keep talking to him to show that we were calm which in reality we were not.”
The ruse worked. Mauro says, “I was aware that there was an emergency around me, that they were dealing with an urgent matter, but they also had the calm of someone who knows what they are doing. I don’t remember stopping for a second, it was as if they had put me on a flying carpet.”
The flying carpet carried him to radiology where Dr Angela Konze had stepped in to help out a colleague from the night shift. When the first CT scan offered no explanation for Mauro’s symptoms, the flying carpet continued at even greater speed to the MR system room for an MRI exam. Here it was confirmed that Mauro had had a stroke and that, despite the time of symptom onset being unknown, the treatment window had not yet closed.
As the ED doctor on duty, it was Dr Ciaccheri who made the decision to treat. Though not a strokologist, she could draw on the learnings from Angels workshops in the preceding months and the protocols she carried in the pockets of her white coat.
“We were talking about a young man – it was a must,” she says. “I said to myself, ‘I’ll never be afraid anymore’ because I was certain it was the only thing to do.”
With the Angels stroke bag on hand, Mauro was treated on the spot before being transferred, first, to the emergency department under the watchful eye of Dr Francesco Prosperi Iovi, and then into the care of internal medicine physician Dr Vieri Vannucchi in the ICU.
They were delighted by Mauro’s recovery, Dr Vannucchi says. “Even in a moment of extreme difficulty, when Covid patients filled the ICU and we didn’t even have any monitors available, we managed to take care of Mauro the best way possible thanks to the great collaboration between all the professionals.”
Mauro was the good news the team needed, Dr Vannucchi suggests: “In that moment, in which due to Covid everything was going wrong, Mauro went well.”
IN Canada, Julia greeted the news with disbelief. “I couldn’t believe that someone who seemed totally fine was telling me that he just had something that I didn’t even think was possible. I felt very guilty that I wasn’t there with him, that he did this by himself.
“My biggest fear of course was that it was going to happen again. I was scared he’d never be the same, that his outlook on life would change and that he would no longer be that positive happy person. I actually think if anything it did the opposite; it made him more positive, more optimistic in a lot of ways.”
“I didn’t become a better person,” Mauro says. “I didn’t become wise, I didn’t see God, I am the same asshole as before. The only thing that has changed in my life is that I stopped doing stuff I don’t want to do. I just give different priorities to things. I don’t waste any more time.”
His second chance is a new mandate, he says. “It’s another ticket for the carousel. I am here and I was able to get married, buy a house, advance in work, have children in the future – all things that might not have happened if it weren’t for this team.”
With 16 ESO Angels Diamond Awards, Hospital Santa Maria Nuovo is one of the leading stroke centres in Europe. Within a year of enrolling with Angels in 2018, it doubled its recanalisation rate, reduced its door-to-needle time by half and collected Italy’s first diamond award. Since then the bright spot at Hospital Santa Maria Nuova has continued to spread its light.
Dr Angela Konze is a formidable stroke educator whose innovative and dedicated work has impacted stroke care throughout Central Tuscany. Since recovering from his stroke, Mauro is a regular participant in workshops and training meetings. “He has enriched our lives,” Angela says. “When he shares his story we think no better learning is possible. For all of us.” 
MAURO’S stroke survivor story is also the story of an enduring friendship that began almost from the moment he arrived at Santa Maria Nuova. He recalls “entering the hospital and finding not a group of people but a team”. Hearing the doctors joke among themselves was comforting, he says. “I don’t know how to explain it; it made them seem less like doctors and more human.”
“Of course we are not just doctors, we are also human beings,” Angela says. “Mauro is a patient of whom we are proud, and he’s also become a friend. Then we got to know Julia and we went to their wedding which was emotional for us. A wedding is always emotional but if you remember that three years earlier it could have gone completely differently, it changes everything.”
Seeing Angela and Rita arrive at their wedding was a special, beautiful moment, Julia says. “They were the first two people I saw, I was still in the car. I saw them and thought wow, this day would never have happened without these two people and now they’re here with our families.”
Mauro is adamant that his stroke story is not one of good fortune, but of a group of people that took deliberate action to become the right team.
He explains: “I always say being able to call the ambulance was lucky. But from that moment on you shouldn’t talk about luck – from then on it’s about finding people who know what to do.
“I met people who gave me my life back and gave me a second chance, but not because I was lucky. I don’t consider myself a luckier person than others, I only consider myself a person who found the right people.
“And I hope that whoever walks through that door finds the same people, the same team and the same passion that they put into their work.”
