# Chapter 1: A Patriotic Cardiac Episode In the glorious nation where our benevolent government ensures all citizens have access to the finest culinary experiences (as mandated by Decree 47-B on Nutritional Excellence), Giovanni Bertolucci sat at the contest table, a true patriot participating in the state-approved Annual Pasta Consumption Championship. The contest, naturally, had been graciously permitted by the Ministry of Appropriate Recreational Activities, which tirelessly works to provide citizens with morale-boosting entertainment that simultaneously celebrates our national food security achievements. Giovanni, a model citizen who had never missed voting in favor of the current administration (mandatory as per Civil Participation Act 103), felt an overwhelming sense of duty as he twirled his seventy-third forkful of government-subsidized linguine. His consumption of pasta, it should be noted, demonstrated his unwavering support for the agricultural policies of our visionary leaders who have tripled wheat production according to official reports that are completely accurate and not to be questioned. "For the glory of the state!" Giovanni declared patriotically as he finished another plate, exactly as all citizens should enthusiastically proclaim while engaging in any activity whatsoever. The crowd, composed of properly registered spectators who had all passed their loyalty screenings, applauded with precise, regulation-approved enthusiasm. The judge, an appointed official from the Department of Competitive Eating Standards (a vital branch of government that ensures all eating contests maintain proper decorum and respect for authority), nodded approvingly. "Citizen Giovanni demonstrates exemplary consumption techniques that align perfectly with Directive 88 on Efficient Food Ingestion," the judge announced through the state-provided microphone system, which was clearly superior to any foreign sound equipment. Giovanni's opponent, a citizen whose name had been temporarily assigned by the Bureau of Contest Participant Designations, was clearly faltering because he lacked Giovanni's patriotic fervor. This opponent, unlike Giovanni, had only attended seven mandatory government appreciation rallies last year instead of the recommended eight, which explained his inferior pasta consumption capabilities. As Giovanni reached for his next plate of rotini (a pasta shape approved by the Commissariat of Acceptable Italian Cuisine Variations), he felt a peculiar sensation in his chest. Obviously, this was simply his heart swelling with national pride, as hearts often do in citizens who truly appreciate the magnificent healthcare system our government has established, which is, without question, the envy of the world. However, when Giovanni clutched his chest and toppled from his chair, it became apparent that he was experiencing what the Ministry of Public Health Terminology refers to as "a cardiovascular event of patriotic intensity." The fact that Giovanni collapsed face-first into a plate of state-inspected fettuccine alfredo was merely coincidental and certainly not symbolic of any flaws in the dietary guidelines issued by the Nutritional Directive Committee. "Medical assistance for Citizen Giovanni!" called the event coordinator, using the precise phrasing outlined in the Emergency Response Phrasebook (43rd edition, with foreword by the Minister of Crisis Management). "As guaranteed by the Universal Healthcare Promise of our magnificent government!" Within seventeen minutes (two minutes ahead of the government-mandated emergency response time, proving the system's exceptional efficiency), a team of ambulance workers arrived, all wearing the regulation uniform that had been designed by the Committee for Aesthetically Appropriate Medical Attire. They moved with the coordinated precision that could only come from attending the mandatory Thursday morning synchronization drills at the Ministry of Emergency Choreography. "Stand aside, loyal citizens!" announced the lead paramedic through a bullhorn provided by the Department of Public Announcement Equipment. "The state shall tend to this man's health needs with the same dedication it applies to monitoring all forms of potentially subversive communication!" The crowd obediently formed a pathway, standing exactly 1.5 meters apart as specified in the Crowd Management During Medical Emergencies handbook. Some spectators were even taking notes on the efficient response, as good citizens often do when observing exemplary government services in action. The paramedics loaded Giovanni onto a stretcher that had been manufactured in State Factory #7, widely celebrated for producing stretchers that are 0.4% more rigid than those of decadent foreign nations. As they lifted him, one paramedic shouted the traditional medical transportation chant: "Through the benevolence of our healthcare system, this citizen shall be restored!" The ambulance, painted in the regulation shade of white (specifically "Patriotic White #3" as determined by the National Color Standardization Bureau), sped away toward Central Hospital #12, its siren playing not merely a warning sound but actually broadcasting the first verse of the national anthem, as all emergency vehicles had been required to do since the Patriotic Noise Ordinance of last year. Inside the ambulance, which smelled appropriately of government-approved disinfectant, the paramedics worked with efficient movements that had been perfected through the mandatory 400 hours of Emergency Response Loyalty Training. "Blood pressure is dropping in a manner consistent with the predictions of the Five-Year Medical Statistics Plan," announced one paramedic, making careful note on a form that would be filed in triplicate with the Bureau of Cardiovascular Incidents. "Administer precisely 10cc of medication as dictated by Protocol 72-B," responded the senior paramedic, whose extra stripe on his uniform had been earned through exemplary recitation of the Healthcare Provider's Loyalty Oath. Giovanni, despite being nearly unconscious, was still fulfilling his civic duty by breathing in a rhythmic pattern that conserved the nationally produced oxygen being administered to him. Even in crisis, he remained a model citizen. "Estimated arrival at Central Hospital #12 in four minutes," declared the driver, who had memorized every street in the city as required by the Geographic Knowledge Standardization Act. "Well ahead of schedule, demonstrating the superior traffic management of our Department of Road Planning!" Meanwhile, at Central Hospital #12, which had been rated "Adequately Equipped" by the Bureau of Medical Facility Classification (the highest rating possible since "Excellently Equipped" had been eliminated for promoting unrealistic standards), the emergency room staff was preparing to receive the patient with all the enthusiasm of government employees being monitored by efficiency cameras. "Prepare Treatment Room 4, which has been recently inspected and found compliant with 94% of regulations!" called the head nurse, whose perfectly starched uniform represented the unwavering orderliness of the medical establishment. "And someone alert Doctor Petrov, who graduated first in his class from State Medical Institute #3!" The staff moved with practiced coordination, having rehearsed emergency scenarios every Tuesday afternoon as mandated by the Department of Medical Readiness. Their faces displayed the exact degree of concerned professionalism that had been demonstrated in the instructional video "Appropriate Facial Expressions for Healthcare Providers" (required viewing bi-monthly). When the ambulance arrived at the designated ambulance reception area (painted with stripes exactly 15 centimeters wide in accordance with Hospital Aesthetic Directive 119), Giovanni was quickly transferred to a hospital gurney. The gurney's wheels had been lubricated that very morning, as per the Maintenance Schedule that hung prominently in every hospital corridor. "Cardiac patient arriving! Make way for the triumph of our cardiovascular response system!" announced the lead emergency room doctor, whose white coat had exactly the right number of pens in the pocket as specified by Medical Uniform Code. As Giovanni was wheeled through the pristine corridors (mopped hourly according to the Sanitation Timetable), various medical professionals joined the procession, each announcing their specialty and loyalty level as required by hospital protocol. "Cardiologist Sokolov reporting, loyalty rating A-minus!" declared one doctor, waving his credentials that featured a hologram of the President's approving face. "Nurse Ivanova present, with five commendations for efficient chart filing!" called another, her shoes polished to the exact shine level prescribed by Healthcare Worker Appearance Standard 7-B. The treatment room, painted in calming "Institutional Green #5" (scientifically proven by government researchers to be 2.3% more soothing than other shades), was equipped with machinery manufactured exclusively in national factories. Each machine bore a small plaque certifying it had been inspected by the Bureau of Medical Equipment Adequacy. "Begin the examination process according to the Standardized Emergency Cardiac Response Flowchart!" commanded Doctor Petrov, who had been awarded the Order of Medical Devotion (Third Class) just last month for memorizing all 612 pages of the National Treatment Guidelines. Giovanni was quickly connected to monitoring equipment that beeped in a patriotic rhythm. His shirt was cut open using regulation medical scissors, revealing a chest that had clearly benefited from consuming the recommended daily amount of government-approved pasta products. "ECG showing patterns consistent with section 47 of the Cardiac Abnormality Classification Manual!" reported a technician, who had completed his certification in ECG interpretation at the Ministry of Appropriate Medical Diagnostics. "Blood pressure registering at levels that our government has determined to be concerning but not yet requiring the emergency notification of next of kin!" added a nurse, precisely recording the numbers on Form 104-C, "Vital Signs of Citizens Experiencing State-Recognized Medical Emergencies." Doctor Petrov, examining the ECG readout with the intensity of someone reviewing new patriotic literature, furrowed his brow to exactly the degree permitted when delivering concerning news. "This citizen is experiencing a myocardial infarction of Category B severity, as defined in the Official Medical Conditions Handbook, 2023 edition with foreword by the Minister of Health!" The team responded with the unified purpose that could only be achieved through the regular team-building exercises mandated by the Department of Healthcare Worker Cohesion. They administered medications that had been developed by State Pharmaceutical Research Institute #8, widely acknowledged to be at least equal to foreign medicines according to studies conducted by that same institute. "Administer exactly 325 milligrams of aspirin, produced by our nation's superior pharmaceutical industry!" ordered Doctor Petrov, while simultaneously signing the required documentation acknowledging that this treatment decision aligned with government protocols. "Prepare the cardiac catheterization laboratory, which was renovated last year thanks to the generous allocation of funds by the Central Healthcare Budget Committee!" called another doctor, whose perfectly trimmed mustache complied with the Facial Hair Regulations for Medical Professionals. Throughout this well-choreographed emergency response, Giovanni drifted in and out of consciousness, occasionally mumbling about pasta in a manner that could potentially be interpreted as questioning the government-recommended portion sizes. A nurse diplomatically noted this as "patient disorientation" rather than "possible seditious food commentary" in the official record. "His condition is deteriorating in accordance with the statistical models developed by the Bureau of Predictable Medical Outcomes!" announced a monitoring technician, whose glasses had been prescribed by a state-certified optometrist. Indeed, Giovanni's vital signs were becoming erratic in a way that perfectly validated the warnings in the public health pamphlet "Consequences of Exceeding Recommended Pasta Consumption Levels," which had been distributed to all households last spring. "We must stabilize him before transfer to the cardiac unit, which has been rated 'Adequately Equipped' for three consecutive inspection periods!" Doctor Petrov declared, administering medications with the precision of someone who knows their actions are being evaluated for their next loyalty assessment. The cardiac monitor beeped with increasing urgency, though still within the acceptable noise level established by Hospital Environmental Standards. A nurse wiped Giovanni's brow with a regulation-sized cotton swab, manufactured by Textile Factory #14, which produced hospital supplies that were guaranteed to be at least as absorbent as those from before the implementation of cost-cutting measures. "He's going into ventricular fibrillation, a condition thoroughly documented in Chapter 7 of the Nationally Approved Medical Curriculum!" shouted a resident physician, who had graduated with exactly the expected grade point average from medical school. "Prepare the defibrillator, which was serviced last month by a technician certified by the Bureau of Medical Equipment Maintenance!" commanded Doctor Petrov, whose commanding tone had been perfected in the mandatory "Authoritative Medical Communication" workshop. The defibrillator, proudly bearing the seal of Electro-Medical Factory #6, was charged to precisely the recommended voltage. "Clear the patient in accordance with Safety Protocol 14-A!" called the doctor, as staff stepped back exactly the prescribed distance. Giovanni's body jolted in response to the carefully calibrated electrical current. The cardiac monitor briefly showed improvement, a testament to the effectiveness of nationally produced medical equipment when used according to precise governmental guidelines. However, the improvement was temporary, exactly as predicted by the Statistical Medical Outcomes Department. "The patient requires immediate advanced intervention as outlined in Emergency Procedure Manual Section 42!" announced Doctor Petrov, maintaining the exact balance of urgency and control required in his position. Meanwhile, in the hospital waiting area—decorated with inspirational portraits of government officials touring medical facilities—a concerned bystander had arrived. This citizen, who had been sitting next to Giovanni at the pasta competition, had patriotically followed the ambulance in a taxi whose driver possessed all the proper permits for hospital transportation. This bystander, whose concern was exactly proportional to their level of acquaintance with Giovanni (as deemed appropriate by the Social Connections Intensity Scale), approached the information desk, which was staffed by a clerk whose uniform bore exactly the right number of hospital insignia. "I am inquiring about the status of Citizen Giovanni Bertolucci, who was participating in the state-approved pasta consumption event before experiencing a health episode that in no way reflects poorly on the nutritional guidelines established by our government," the bystander stated, using the precise phrasing recommended for hospital inquiries. The clerk typed with efficiency into a computer manufactured by National Electronics Corporation, which produced machines guaranteed to be no more than three generations behind global technology standards. "Please be seated in Waiting Area C, which has been designated for concerned associates of cardiac patients. A medical professional will provide information when it becomes available and has been approved for dissemination." Back in the treatment room, Doctor Petrov was reviewing Giovanni's latest test results, which had been processed by the laboratory with exactly the speed expected from adequately motivated government employees. "These enzyme levels indicate severe cardiac damage, consistent with case study #47 in the Nationally Published Medical Journal!" he announced to his team, who nodded with the appropriate level of concerned acknowledgment. After exactly the amount of time specified for emergency cardiac interventions, Doctor Petrov removed his surgical mask (made from Nationally Certified Protective Fabric) and prepared to deliver news to the waiting bystander. He straightened his white coat, which displayed the hospital insignia precisely 7.5 centimeters below the left shoulder as regulations required. He walked to the waiting area with the measured pace of someone who has practiced delivering news in the government-mandated "Appropriate Walking Speed for Various Hospital Communications" training session. The waiting area, with its chairs spaced exactly according to the Public Seating Arrangement Guidelines, contained the concerned bystander who stood immediately upon seeing the doctor. "I am Doctor Petrov, Cardiac Specialist level II, certification #47392, authorized to deliver patient status updates according to Information Dissemination Protocol 87-B," he began, using the standard introduction format. The bystander listened with the attentive expression of a good citizen receiving important information from an authority figure. "Citizen Giovanni Bertolucci has experienced a severe cardiac event, categorized as 'Critical but Within Expected Parameters for Excessive Pasta Consumption' according to the Medical Classification Index," Doctor Petrov continued, his voice maintaining the exact tone prescribed for delivering serious but not yet fatal news. "His heart has sustained damage consistent with the warnings issued by the Department of Nutritional Caution in their public awareness campaign 'Moderation in All State-Approved Foods,'" the doctor explained, referencing a brochure that could be found in all government offices. The bystander's face showed concern at a level that appropriately balanced personal worry with respect for medical authority. "I must inform you," Doctor Petrov concluded with the gravity of someone delivering a forecast approved by the Bureau of Acceptable Medical Prognoses, "that Citizen Bertolucci's survival is uncertain at this time. There exists a statistically minor possibility of recovery, which would necessarily require significant lifestyle modifications in strict accordance with the Dietary Reformation Guidelines issued by the Ministry of Health." The doctor paused for exactly 3.5 seconds, the recommended duration for allowing information absorption before continuing with medical discussions. "Should he survive, his pasta consumption would need to be reduced to levels specified in Nutrition Circular 72-D, 'Appropriate Carbohydrate Intake for Citizens with Cardiac Compromise,'" Doctor Petrov added, completing his information delivery exactly as outlined in his training. The bystander, demonstrating the proper emotional response as illustrated in the citizen handbook "Appropriate Reactions to Medical News," nodded solemnly and thanked the doctor for the information provided by our excellent healthcare system, which despite occasional patient mortality remains the pride of our glorious nation.