The Sad Story of Angela F

I was a young surgeon in September 1979 when Angela F., 28 years old, presented at our Department of Surgery in Rome with rectal bleeding, diarrhoea and a diagnosis of ulcerative colitis. As I had a special interest in colorectal diseases, I was told to take care of her. She had a course of Salazopyrin and pred-nisone, we spent hours talking and, fortunately, she rapidly improved. After a couple of weeks, I had to leave to attend my first congress in the USA, but I told her about that only the day before. Her discharge had been planned for the end of the week, and she was really better. Nevertheless, when she knew about my departure, she was very upset, cried and asked me not to leave her alone. "You will not be alone, Angela", I told her. "Older and more expert doctors will take care of you; don't worry". When I came back 10 days later, I called one of my colleagues from home "What about Angela?" I asked "A disaster", he said. "She was very depressed, did not talk any more had an attack of toxic megacolon the day after you left. We waited for a few days; then, as she worsened despite i.v. fluids and antibiotics, we took her to the theatre: her colon was perforated and she had diffuse faecal peritonitis. We did a colectomy with an ileostomy and sent her to the ICU. But she died after 24 hours".

That was my first sad, unforgettable experience with psyche and colitis. Since then, I always take special care of both the mental and emotional state of patients with IBD.

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