(The following events happened in 1999 and early 2000. They're recounted to the best of my ability. The hospital San Giacomo in Augusta closed in 2008 after 680 years of operation.)
The room reeks of cleaning solvent and urine, the usual hospital smells. The latter’s more dominant than I’ve previously experienced. There’s also a fair amount of b.o. I’ve spent a lot of time in hospitals, consider myself a pro and inured to their unpleasantness, but this is my first Italian admission. I’m off my game. The lights were on when the nuns and nurses led me in here, put me in bed in my street clothes, the same ones I’d been wearing when I checked in after hours spent wandering the streets of Rome’s centro storico in search of a hospital that would accept me. Now I’m part of the room’s stink. The ceiling is about twenty-feet high, water stained, with cracks spider-webbing from its corners and across the plaster of its central span. There are six beds in the ward, three on each side. I’m in the last bed of one of the rows, furthest from the door. I’ve only seen places like this in old films. There’s a window in the center of the wall opposite the door that allows in some streetlight and a fair amount of Roman street noise. The hospital is just off the Corso, only a few blocks from Piazza del Popolo. I can hear girls laughing in the street below, a joyful, discordant sound.
But it’s the guy in the bed across from me who grabs my attention. His head – large like a toddler’s on his pudgy, little frame - is crowned by a luxuriant crop of flawlessly combed, side-parted, jet-black hair. Given the circumstances, the coif’s maintenance seems miraculous. A full ‘70’s ‘stache dominates his soft-featured face. It’s the kind of face old Italian ladies in South Philly might describe as handsome, and that reminds me of a small-market TV newscaster. But the diaper unsettles me. The guy’s nude except for an oversized, bulging, white diaper imperfectly fastened with tape at his chubby hips. He looks like a middle-aged baby with his dimpled, little legs protruding toward me from the bottom of the adult napkin. When he rolls around in the bed - which is constantly; he’s in some discomfort - I get a better view than I’d like. His name, written large in black marker on a chart attached to the wall next to his bed, is Zamboni. I chortled when I read it. And then felt like an asshole.
For a while, his presence - absurd, embarrassing, inappropriately intimate (why doesn’t the guy have a sheet?) - distracted me from my own reasons for being here. I felt sorry for his humiliation.
But not anymore. Since the lights went out, he’s been letting loose with an endless, wailed lament that’s shredding the nerves of everyone in the room.
“O DIO! …
“PERCHE’?!? …
“SANTO CRISTO, IL DOLORE!! …
“DIO MIO, PERCHE’?!?…”
Again, I’ve spent a lot of time in hospitals. Granted, I usually only had one roommate, but I’m certain the rules still apply. There’s an etiquette, a way to be, deal with the discomfort, whatever it is that ails you. This isn’t it. We can’t sleep. We can’t even think about our own shit because this fucker won’t let us forget about him. The guy next to me, an older dude, maybe in his ‘60’s, huffs in exasperation, and mutters - and this is the first time in my life, and now after having just spent three weeks in Rome, I’ve ever heard a real Italian say it - “Mamma mia.” There are other less resigned and more strident voices raising in the room. This is about to get ugly.
But now a Filipina nun charges in and makes a beeline for Zamboni’s bed. In the time I’ve been roaming around the Holy City, it’s become obvious that the Catholic church, at least in its capital, runs on nuns from Asia, South America, and Africa. I haven’t seen a single Italian bride of Christ. Maybe there are some up in the higher ranks and frescoed corridors, but not on the street, and not in here. The Filipina’s face makes it clear that she’s not happy. She stops at the head of Zamboni’s bed and, basically, calls him - without a trace of awareness of the humor of her words - a big baby. She tells him that his neighbors are trying to sleep and, whatever pain he’s experiencing, he should deal with it like a man.
“DIO!” Zamboni blurts out in protest.
“STA ZITTO!” she responds. And he does.
And, for the rest of the night, there are just the smells, snoring from some of my neighbors, soft sobbing from Zamboni, the light and hospital sounds coming from the corridor, and my thoughts. Which are turning grim. At some point I fall asleep. Unlike all the American hospitals I’ve stayed in, nobody is constantly coming in to monitor my vitals. I’m not hooked up to anything, anyway. I’ve just got a patch taped over my left eye. And I put it on. I came in wearing it.
Life can turn on a dime. Two days ago, I stood on the bridge just beneath Castel Sant’Angelo, the towering cylindrical mausoleum on the Tiber built for Emperor Hadrian and turned by the Popes into a castle (it’s attached to the Vatican by a covered walkway, a papal escape ramp), watching night reflections play on the surface of the water. Saturday night was turning into Sunday morning and couples were walking past me, arm in arm.
(Castel Sant'Angelo and its bridge)
I was walking back to my apartment after an unlikely and nearly perfect night in an English pub north of the Vatican. I’d been attracted to the place by hand-posted ads for a band calling itself “Parlophone,” the name of the Beatles early recording label. The ads promised “Il Mersey Sound.” I was skeptical, but also wrung out after hours of study, and in need of a break and a liberating drinking “session.” This looked like just the ticket. An “English” pub might be one of the few places in Roma where they understand the need to deliver drink with pace. Italians tend to sit over their libations, milking them and time while engaging in pleasant conversation and convivial congress, which for them is the point. They seem to like themselves and each other. Americans and northern Europeans tend to approach the task with greater and grimmer purpose, self-lobotomizing to escape ourselves, break down the walls enclosing us and make human exchange bearable or even possible. I was in Roma to learn Italian and taking intensive, one-on-one classes in grammar and conversation. Four hours every day, Monday-Friday. And I was taking it seriously. Four daily hours of class usually meant at least the same amount of study each night. For over two weeks I’d resisted the urge to tie one on, perhaps out of guilt for being here alone while my wife Cathy stayed back in Philly going to work and dealing with our two insane Jack Russell terriers. But the dam had broken this night.
The band was set up in the cantina of the pub, a brick cellar that, by the looks of it and given the history of the city, was in sections at least several centuries old. I sat at the only vacant table. Turnout was good. I’d fortified myself at the upstairs bar with a pint of Bass and two shots of Jameson, figuring that table service in the cellar would probably conform to the culture’s traditional snailish rhythms. I needn’t have worried. A young woman, dressed in a white t-shirt, Levis, and Doc Martens, quickly arrived and took my order for another round. Her commitment to her duties would figure in the rest of the night.
The guys in the band looked to be in their mid-thirties or early forties. They dressed in button down shirts and blue jeans. One of the guitarists wore Chucks. They looked tentative, like guys who didn’t do this for a living or all that often. But when they started to play, I knew I was in the right place. Who - knowing Italian pop/rock tastes and proclivities (as much as I love, LOVE, Italian culture, I generally hate its current pop music sensibilities) - expects to hear a band in the Eternal City open with Lennon’s “I’m Only Sleeping” from 1966’s Revolver? I know it I didn’t. And they followed with more brilliant - albeit obscure to those only familiar with the stuff played on classic rock stations - stuff. The guys had trouble with some of the lyrics, but I didn’t care. They were fellow fans, and I was rapt.
My contentment must’ve shown because, between sets, two of the band members came over to my table to ask me how they were doing. Unlike the rest of the crowd, I knew every song (and might’ve been singing along). They turned out to be university profs. I think they taught literature (booze tends to obliterate memory). Good guys, humble, who just wanted to play their favorite songs. We bonded over the Lads, killed a few grappas, and they resumed the show.
The second set was nearly as good as the first. I was disappointed that they closed with the Isley Brothers’ “Twist and Shout.” Don’t get me wrong, it’s a great song, and Lennon’s vocal on the Beatles’ cover is one of rock’s great performances. But given the deep dives during the rest of the show, it seemed to pander to the less tuned-in members of the crowd. Predictably, many of them got up and danced for the first time. Maybe that was the point.
I don’t recall much about the walk back to the Tiber. But I remember standing on that bridge thinking how lucky I was to be in this city, how unlikely this all was. I crossed the river, worked my way back to my tiny apartment under the Torre della Scimmia, just off Via dell’Orso, and collapsed into bed, a booze-addled heap of mirth.
(Torre della Scimmia)
The next day, hungover and studying the congiuntivo imperfetto with the train wreck San Remo Song Festival, the very worst of Italian pop sensibilities, playing as background on the bedroom’s mini-TV, I looked up at the tiny screen and saw two perfect images. I closed my eyes, shook my head, opened them again. Still, two TVs. When I looked back down at my workbook, there were two identical sets of exercises. I surveyed the room and, sure enough, every feature was doubled. Two windows, two beds, two tables with lamps. Not like when you cross your eyes and see double. Or when you get so blotto you need to cover one eye to see straight. But two perfect images of everything. When I covered one eye, the remaining image was perfect. I didn’t panic. But the words “brain tumor” came to mind.
I needed to get to a hospital. I’d heard that the one on Tiber Island, Fate Bene Fratelli, was good. And it wasn’t too far from my digs. The sun had set, and Roma in the dark, with the lights of every oncoming motorino and car now doubled, had morphed from the previous night’s soft-focus, bewitching dream to a disorienting nightmare. Which image was the real one, the one that might run me over? Crossing the Roman streets, invigorating under normal circumstances, became an ordeal. I walked, one hand over my left eye and, on the narrower vicoli, one touching the walls of the buildings. But I made it to the island and into the hospital’s Pronto Soccorso.
Calmly, in my newly minted Italian, I described my problem to the gatekeeper, a sympathetic kid with a friendly manner and face. He seemed inclined to admit me, but an older guy in a white coat, no doubt his supervisor, eyed me skeptically (I’m pretty sure it was my then halfway-to-my-ass hair that gave him pause). He tapped the kid on the shoulder and said: “He doesn’t need a hospital. Tell him to explain it to the police.” Anger replaced whatever fear I felt. In clear, correct Italian I responded: “Why the police? Isn’t this a hospital? Isn’t this your job? I’m obviously sick. Maybe seriously.” I guess he thought I was a drug addict or some other street character. I probably did look a sight. He stood there, mute, but it was clear I wasn’t getting in. I invited him, twice, to step outside. To “talk.” He declined. Fortunately. I probably would’ve swung at the wrong image.
I needed to at least address the sight issue. So, I decided to find a pharmacy, purchase a bandage to cover my left eye, and make the situation manageable. I walked back toward the Corso, found a pharmacy, and got in queue. After an absurd, Pythonesque discussion in which I explained my problem and what I wanted and the pharmacist insisted that I was suffering from a virus that’d been making the rounds, I finally got gauze and tape. And an antiviral cream (a compromise with the pharmacist). I tossed the cream in a trash can, sat down on the sampietrini on a side street near the Pantheon, and patched my eye. An off-duty cabbie leaned against his ride watching me work. He asked what was up. I explained my dilemma, and he beckoned me to get in the cab. Off we sped.
The ride was short. We raced to the Corso, turned left toward Piazza del Popolo, left again onto Via Antonio Canova, and stopped in front of Ospedale San Giacomo in Augusta. Also known as San Giacomo degli Incurabili. Saint James of the Incurables. Great. He refused payment. “In bocca al lupo,” he said. “In the mouth of the wolf,” the Roman form of “Break a leg.” I responded with the traditional “Crepi il lupo,” the wolf dies. He waved and drove off.
There was no problem getting into St. James of the Incurables. But its appearance didn’t encourage confidence. It was dingy, dour, poorly lit. It needed a paint job. It felt dirty. It was dirty. It smelled musty, even in reception. St. Jim had seen better days. But admissions took my complaint seriously. I spoke with an actual doctor inside of ten minutes. She rushed me off in a wheelchair for a CT scan of my brain. She was thinking the same thing I was. I sat in a dark hallway waiting my turn with a guy in his early twenties, also long-haired, who offered some welcome distraction. His face was scratched and bruised, his right eye nearly swollen shut, and his left leg was elevated in his wheelchair. He’d been in a motorcycle accident. It didn’t dampen his mood. He laughingly described wiping out and indicated where he was sporting road rash under the blanket that covered his crotch and legs. He asked for my story. I told him, and his face became a map of genuine of concern. It unnerved me a little. “In bocca al lupo,” he said.
They wheeled me into radiology. My first CT ever. The room was cold. Stark. The machine whirred into action, a prolonged metallic whine. Alienating, but painless. I was taken back to the waiting area. The kid was gone.
There followed an interview with three older, male doctors. They asked for my medical history and I, to their dismay, gave it to them (it’s long, includes a fractured skull, coma, permanent Bell’s palsy, broken ribs, broken left tibia, crushed left foot, and many other broken bones. “Why?!? Do you do motocross?,” one of them asked). Word came that nothing obvious appeared in the scan. They were baffled. I was wheeled off to the ward and walked by the arm to my bed - never, it turned out, to see or speak with another doctor in the hospital.
Early morning. Shafts of sunlight from the window make a bright ellipse in the space between the two rows of beds. Nothing happens. Hospital time has a dead weight, a suffocating torpor. Especially when no one comes to check on my vitals, ask me how I’m doing. It’s lonely, even in a room filled with fellow patients. I’m ripe. My hair is matted from sweat. I start to hear street noise. Talking, laughing, car horns, other traffic sounds. Roma waking up, being Roma. Something I was a part of yesterday, at least as charmed spectator. The guys start to stir. The ones who are able get up and walk around the halls. A bunch of these guys don’t seem sick. This observation becomes a conviction by the end of the day. A few team up to play scopa. One guy pulls a pink Gazetto dello Sport from under his pillow and reads passages aloud to no one in particular. Zamboni doesn’t leave his bed. He squirms in muted torment, still wearing the same diaper. This feels like limbo.
Until lunchtime, when there’s a bum rush into the ward. All my roommates have visitors. A torrent of family members all bearing food: containers of pasta, loaves of bread, salami, cheeses, fruit. The smells - familiar, beautiful - torture me. I’ve not eaten for twenty-four hours. The room fills with conversation, laughter. There’s a lot of touching going on, physical displays of affection. They can’t keep their hands off each other. When the nurses realize that no one’s coming to see me, I’m given a bowl of thin, tasteless soup: acini di pepe, escarole, and vegetable broth. It’s the worst thing I’ve ever eaten in Italia. Across from me, Zamboni’s not eating. His father sits beside him in bed, holding him and combing his hair. The son sobs. It’s a Fellini scene. But so intimate, a pure demonstration of love, it moves me. And solves the mystery about the do’s maintenance.
After lunch, the families file out gradually. Just short of a half dozen prolonged Italian goodbyes. If you were raised at all Italian, you’ll know what that means. The languid rhythm returns. The smells of sugo, bread, and cheese linger, but are giving way. No more tests are made or suggested. No one comes to speak with me. No doctor. No nurse. I’m still wearing my improvised eye patch. It occurs to me that I could do this in my apartment.
The next morning, a Sunday, at 11 am, I ask a nurse when or if I’ll see a doctor and receive a shrug in response. I ask about paying for the CT and my stay so far and she says that it doesn’t work that way. They’ll be no bill. Okay, then. I walk out into the hallway, out of the ward and to the lobby, then out the door, and onto the street. What foot traffic I find is brisk. I turn off Antonio Canova and onto Via di Ripetta. It bustles, and I borrow its momentum. The March sun is warm on my face. I walk back to my apartment. Eye patch in place, I crack open my workbook.
I last another two days at the language school on Piazza dell’Orologio, not too far from Piazza Navona. My teachers, each offering two hours of daily instruction - one handling grammar, the other conversation - and with whom I’ve bonded (I’ve been invited out for drinks and given impromptu tours of Roma by these ladies; the conversation portion of my lessons is a frank, unfettered exchange that leads to genuine, enduring friendships), are a little freaked out by my condition. Cathy and my father are also obviously worried and requesting that I return to Philly and see a doctor. And it’s hard to study. The eyepatch annoys and my mind can’t help but stray from the work. What the hell is actually going on? I spend my free time walking around the city - from Testaccio to Trastevere, the Gianicolo to the Foro Romano, the baths of Caracalla to Saint Peters, Via Marguta to Via del Panico and Via Giulia. I cover mile after mile, trying to memorize the place, become intimate with every detail. On Wednesday morning, I take a cab to the airport and fly back to Philly.
My condition also baffles the doctors at Penn. There are more CTs, MRIs, X-Rays, etc, weekly visits with my primary and teams of neurologists. Nothing concrete emerges. The condition’s cause remains a complete mystery. After several weeks, the double vision gives way to the worst headache I’ve ever experienced, waves of dull pain that never, ever completely stop. I go on my first regimen of oxycodone (I’ll be on some form of painkiller for the better part of the next eight months). While walking outside of Penn after a spinal tap, I suddenly lose my balance and fall into a row of bushes. This is the first manifestation of the worst of the symptoms I’ll experience. Soon, the headache is gone but I’ve vertigo so profound that I can’t lift or move my head from my pillow without the sensation of tumbling through space. The nausea is often unbearable. I now wake every morning bathed in sweat. My body aches as though I’ve the flu. I’m put on massive doses of prednisone, which mutes the effects. My doctors theorize: maybe it’s sarcoidosis?
One afternoon, while trying to make my way from the bed to the bathroom to vomit, my vision vanishes mid-step. A swirl of colors, and then nothing. Darkness. I scream for Cathy. This is the first time I feel terror. By the time she climbs the stairs and finds me frozen in the middle of the bedroom, my vision returns.
One of the MRIs reveals a swollen lymph node beneath my right arm. A biopsy is ordered, and I’m at another neurologist appointment when a message is brought into the office. My doctor reads the report, and then, tentatively, says he’s sorry to have to tell me that I’ve got Hodgkin’s Lymphoma. It’s been nearly four months since I returned from Roma. I’m not in the least bit sorry to hear a diagnosis. My mood improves dramatically. At least my condition has a name. Hodgkin’s doesn’t usually present with neurological symptoms. My case fascinates all my doctors - my primary, neurologist, and now oncologist. It’s never a good thing to be interesting to your doctors.
The oncologist will have a long-running, friendly argument with my neurologist about whether I’d actually had cancer in the brain or it had all been paraneoplastic syndrome. But just to be safe, intrathecal chemo, in which the meds are injected directly into the spine to circumvent the blood-brain barrier, is added to my regular sessions. The treatment will last six months.
During this period, I use my Italian and write to a Cretarola family in the town of Castiglione Messer Raimondo, Abruzzo, my grandfather’s birthplace, suggesting that we might be related. We’d found their name and address in the local white pages when we’d visited the town the year before I began my studies in Roma. Six months later, I receive a letter confirming my suspicions. It includes an invitation to visit the family. My chemo treatments are wrapping up. I go into remission for the first time.
I now know, in my bones and in ways I couldn’t have before, that tomorrow is not guaranteed. I tell myself that I’ve been given an opportunity to reboot, take a chance. A blank check. And I’m a profligate spender.
Abruzzo is in my crosshairs.