Many people put a lot of effort into their costume. The man on the left dressed up as Jack Sparrow. On the right: Dr. Tommaso Coin.

Every year, one million visitors come to Cologne to celebrate Carnival. They wear costumes, sing, dance and drink. But are there also many emergencies? This is how the emergency doctor Dr. Tommaso Coin experienced the day in the past year.

When the first patient was brought into the medical tent, more than three quiet hours had already gone by. Dr. Coin has talked to the paramedics and enjoyed the morning sun. Actually, he is more of a nightowl than an early bird. To be able to sleep longer, he prepared everything the day before: supplies for the day, his clothing. When the alarm goes off at 7.20h, he wearily puts on his pants and boots, brushes his teeth and gets on the bike. He doesn’t use a hot espresso to wake him up, but the cool morning air.

Dr. Tommaso Coin is an assistant doctor for anesthesia and he occasionally works as an emergency doctor.

The patient is in her early seventies. She does not want to get an infusion. Also, she considers admission to the hospital unnecessary , as she would ruin her daughter’s and her granddaughter’s day. The paramedic tried to convince her and her daughter also encouraged her. Finally, another paramedic speaks up. He is an old warhorse who has been in service for more than 30 years: „Imagine driving a car with 4 cylinders and one of them is broken. You can still drive it for a certain time, but then the car is a write-off. But you do want to have some time left with your daughter and your granddaughter, don’t you?” These clear words are convincing. The patient agrees and Dr. Coin, who overheard his colleague’s words, smiles.

“I am the joker”

When transferring the patient into the ambulance, it is again the paramedic speaking and not Dr. Coin. Then, the patient is admitted to the hospital in order to rule out the possibility of an acute heart attack. A blood test is made in the laboratory and an ECG test is performed. The woman had an atrial fibrillation, says the paramedic. Now, Dr. Coin steps in: „We don’t know what started the atrial fibrillation.”

Later, he explains that it makes a difference whether the atrial fibrillation has only started or whether it has been there for several weeks. The colleagues in the hospital then treat the patient accordingly. Dr. Coin only stepped in when it was absolutely necessary. Later on, he explains that sometimes he has problems to assert himself. Although he speaks German fluently, people sometimes don’t take him seriously.

In different locations in the city, medical tents were set up. However, most stretchers stayed empty.

When the patient is taken to the hospital, calm returns to the medical tent. A teenager who is out with his friends calls: “Thank you for looking after us.” The chants of the people celebrating at the nearby Heumarkt are audible from far away. Dr. Coin sits down on one of the stretchers in front of the tent. He is 29 years old, a native Italian. When he met his wife on Gran Canaria at a party, they were both still studying medicine. The long distance relationship lasted, he wrote his exam in Italy and got on a plane to Cologne the next day.

Now he takes out his booklet and browses the pages full of medical terms and types of therapies. Whenever he comes across a new German technical term, he writes it down. The more pointedly he can talk to colleagues and patients, the better.

The paramedics walked around in small groups to look out for people seeking for help.

He works in one of 9 emergency tents in the Old Town of Cologne. 16 paramedics work with him. The paramedics repeatedly set off to see if anyone needs help. Dr. Coin stays by the tent. If something serious happens, he has to intervene immediately.

The helpers are also prepared for a bombing. In that case, a code word is given and everyone leaves the location as calmly as possible. It is not advisable to hurry to the location of the attack, because of the possibility of a second bomb exploding, explains one of the paramedics.

Next career goal: Mountain Rescuer in Garmisch-Patenkirchen

This young king drank too much. Paramedic Lisa sent him home with a bottle of water.

In the early afternoon, clouds are gathering and the alcohol level in the whole city is increasing. Some of the celebrating people come to sober up, some sufferings are treated. Dr. Coin looks after a 17-year-old boy with a laceration at his left eye who got into a fight. The boy is trembling and repeatedly tries to sit up in the stretcher. “Now calm down!”, Dr. Coin says in a determined voice and presses him back.
When he was a teenager, Dr. Coin already admired the emergency doctors of the Mountain Rescue who strike out in snow and ice. When he broke two of his vertebrae due to a ski accident and he was rescued, he thought: I want to do that, too. The work as a mountain rescuer in Garmisch-Patenkirchen is at the very top of his professional to-do list.

And then, there is this accident in Marrakech that comes to his mind when he is questioned about his choice of profession. He was waiting in front of a red traffic light in a rental car. It was three o’clock in the morning, his plane would depart soon. On his left side, a boy on a moped wound his way through. He did not wear a helmet nor did he care about the red light. Neither the young driver of the moped nor the driver of the Renault Scenic saw each other in time. The boy flew through the air and hit the concrete. The driver of the Renault stepped on the gas and sped off with a roaring engine.

If first aid was not sufficient, the patients were brought to a suitable hospital.

Nobody was on the street, except for Dr. Coin. At the time, he was still a medical student. He blocked the street with his car and put on the hazard lights. He searched for a safety vest, disposable gloves and a first aid kit. But there was nothing in the car. He approached the boy. He was bleeding from his ears, gasping for breath and was unresponsive. Finally, a taxi driving by stopped.
The most important thing was to stabilize the spine and to wait for the ambulance. Tommy was shocked that he could not do more. In these minutes of waiting anxiously, he tells himself to learn so much that he can give the best first aid possible in the case of any emergency.

After 12.5 hours, his shift comes to an end on this Thursday. He goes home by bike to eat dinner with his wife. They greet each other quietly in the corridor because their eleven month old daughter has been sleeping fitfully lately. “How did it go?”, she later asks him at dinner. He has only been working as an emergency doctor in Cologne for half a year, but during one of his shifts, he already had to document three suicides. “It wasn’t very busy!”, he answers.

Pictures: ©Michael Gallner