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Surviving Coronavirus by Pietro Roberto Goisis and translated by Ingrid Rowland

To the people who saved me

“When the storm is over, probably not even you will know how you went through it and came out alive. No, you won’t even be sure that it’s really over. But about one point there is no doubt. And that is that when you emerge from this tempest you won’t be the same person who entered it.”

Haruki Murakami, Kafka on the Beach, 2002

***

I had no idea what would happen. From the beginning of the emergency, my state of mind was calm. Aware of the developing situation, and careful about correct behavior, I lived with a kind of omnipotent conviction that I would never be infected, that my job would be to protect others and provide a good example. I’d begun to gather some notes about how it felt at work, urged on by Sergio, a younger colleague, interested in the world outside as well as inside. A sort of healthy emergency routine.

I had no inkling that February 15 and 16, 2020 would be my last weekend of freedom. Invited to hold a seminar in Bologna, I’d had some good times with my friend Daniele and our wives, Anna and Cristina, peaceful and happy to explore the city and its excellent food.

On Thursday, February 20, shortly before the COVID-19 emergency exploded, Cristina rushed off to London. Emma, our beloved granddaughter, had had an accident and needed an operation. At the same time, our daughter’s second pregnancy had come to term. The pleasure of that meeting and the birth were set between two sad if distinct events. The day before, a dear friend had begun to feel ill and I directed her to the Policlinico: a cerebral hemorrhage. The next day another friend died. He had been sick for some time, but was still vital, brilliant, energetic. We had said our goodbyes awhile ago.

In London, life continued peacefully, as if nothing were happening. I returned to Milan Sunday night, met at Malpensa Airport by thermometers and infrared scans. No fever. The airport seemed locked down, surreal. This, when I think back, was the first time I felt afraid. But I had been careful. I didn’t go out. I saw no one except my patients. Healthy.

“Doctor, tell the truth. How are you really?”

With this question Edgardo began my first appointment of Week Zero of COVID-19. It is Monday, February 24, early in the morning. I asked him not to come in person but to Skype. He is a young man, elegant and slim, from a well-off family, and works in the arts with passionate dedication. In general, though he is involved in the process, he maintains a certain aristocratic detachment, to the point that I sometimes ask myself how committed he really is to the therapy. Perhaps it comes from an earlier analysis, ruled by an excess of coldness and distance—what I’d call rigidity. But now it’s my problem. He is present, very much so. And this time I can really feel it. Really, as he said with his first question. What if, in the fear, the long-distance session, the general situation, Edgardo has finally found his way to be close to me, and to feel close?

This pandemic has changed our parameters and our habits.

In our work every gesture has its own precise content and symbolism. How we open a door, how we greet people when they enter and exit, where we put our hands during the conversations, how we cough and sneeze, the distance between us (who ever measured it before?).

We grow used to confronting our thoughts in a session, some of them unpleasant, some pleasant. In general we attribute them to our patients, who “put them in.” Now, though, they seem to be our own thoughts, ours . . . And the fear? And age? “Senior citizens over 65 should stay at home!” But how dare they—who’s the senior citizen here? Can we work? Can we not work? Where is the line between responsibility and recklessness, between ethics and sacrifice?

The Government Decrees that followed the first practical recommendations have further transformed our work. At first the idea of consultations at a distance was a matter of good sense, but then closing our offices entirely became obligatory. It’s a matter of inventing or recovering other forms of meeting and contact. Email, phone, WhatsApp, FaceTime, Skype, Zoom, what else? Where is the psychoanalysis in all this, where is our identity? Who gives a damn?

The order of the day is “help people,” whenever and wherever.

Like me, every other psychoanalyst has probably asked themselves how their patients with issues of hypochondria are going to react. To my initial surprise, and that of my patients, I’ve seen a remarkable staying power. Reflecting on it later, we have hit on an explanation. We venture the hypothesis that the “system” has gone into crisis because it was unprepared to handle an emergency. But a hypochondriac is well trained, accustomed to this kind of situation, and prepared to manage it. And looks on the others, in their present agitation, as if they were aliens.

I also counted on the fact that, with the predictable exceptions, the other patients would have faced this moment we are going through with “competence,” and this is what has happened, at least among the patients I have encountered. This was evident in the subjects they brought up, in their states of mind, in the emotions they displayed, in the behaviors they recounted, albeit with oscillations along a continuum between downplaying the whole thing and apprehension. In short, I think it’s possible to say that they are surviving better than most of our fellow citizens. Evidently the psychological work they are undertaking, their ability to count on a space and an interlocutor, has been fundamental. As if to confirm this, one simpatico and brilliant patient wrote me:

“We who have fragile psyches can hold out. You know, right now we’re the ones who have more tools for coping because we have been trained for a long time to take account of ourselves.”

It is extremely difficult to sum up the number of changes that have taken place, between the emergency, individual precautions, sanitary advice, and government decrees. In only two weeks the general picture has changed at a speed greater than our own abilities to adapt—and maybe those of the virus itself.

Where individual flexibility has won out over habit, fear, rigidity, the therapeutic relationship itself has benefited.

From the very beginning, I shared every decision with my patients. Almost all of them have appreciated that choice, opting to continue with long-distance sessions. A few others have preferred to suspend the therapy and try to get along by themselves, postponing our joint work to the end of the crisis.

In the office: sanitizers appeared, along with the shared handwashing procedures, the dealing with distance that is no longer “social distance” but distance measured in meters and centimeters. And we have had to renounce basic aspects of our way of being together with others, like the handshake at the beginning and end of a session, and every spontaneous gesture that might have been habitual with us or with our patients. Like that young adolescent who at the end of every session found some surprising way to greet me and thank me, maybe with a pat on the back, maybe with a high five, sometimes hugging me ecstatically. All put on hold. The office is closed. I would have to do all my appointments online. Legally obliged.

The disease

On Monday, March 2, I feel vaguely unwell: shivers, some fatigue, pained muscles, loss of appetite. I think it must be the effect of a weekend in London, the stress of the trip. Tuesday evening, I discover that I have a low fever without any other symptoms. I feel strong, but also prudent. I call the state hotline, they answer after a few rings. They reassure me. On Wednesday I call my primary care physician. “Take a Tylenol.” The fever goes down. The fever goes up. On Friday, I finally stop. Bedridden, tired, senses dulled, inert. Despite that, fearless. On the kitchen table I find a note my son has left for me. Stay strong dad!

Saturday, my wife, Cristina, flies back early to Milan. The first step in the sequence of my cure, and my salvation.

Sunday, a long consultation. I start antibiotic therapy.

Monday, March 9, chest X-rays and blood work. Diagnosis: bacterial pneumonia. I feel as happy as a kid. I think about the paradox of the moment we are living though. Happy to have pneumonia, because it’s bacteria, treatable.

Something in the world is already starting to break down.

New therapies and antibiotics. I’ll make it. Maybe.

I need to tell my patients, at least the ones who have decided to do distance therapy. So I send out the first message after the “institutional” ones about the state of my health. I have no doubts about doing this; I’ve chosen transparency, at least as much as possible. I know there will be repercussions. We will face them. I have no regrets. I write that I have been diagnosed with a bacterial infection of the lungs and that I can’t work for at least a week. I receive warm, affectionate replies. Tuesday, the fever and fatigue continue. That evening, the turning point—my primary care physician calls 911 to take me to the emergency room at Fatebenefratelli for an exam, and, we hope, a swab test.

***

I clearly remember the sense of irritation at the decision, buried in a fatalism that seemed to regard the bed as my only certain refuge. I remember a friendly, energetic paramedic taking me by hand in the ambulance. He is the first health worker I’ve seen dressed as if he’s in a film about biological warfare. We talk about volunteering and red crosses as we cross an already deserted Milan. From the little windows I play at trying to guess our route from the shapes of the tallest buildings. I don’t quite know what’s happening inside and outside of me. I let myself be carried along on the wave of events, more inescapable than ever.

Milan, the second-most populous city in Italy, now lies deserted. Photos by Davide Pizzigoni

The emergency room is a no man’s land. They take me in for triage. I’m code green; I’ll have to wait. They show me where to sit, at a distance, waiting. I have a nice mask and gloves.

When I round the corner of the hall, for the first time I realize where I’ve ended up. From home they ask me how things are. “Here there are three corpses, a crazy woman, an African, a Chinese person,” I answer. “If we add in a psychiatrist it sounds like the beginning of a joke,” they reply. But the situation is truly and unimaginably crazy. We are in the trenches—you can feel the dread.

The waiting begins. Every new arrival is a competitor, a rival in the race to be seen by the doctor. Nurses ran back and forth; they look right through me. Every so often I turn, search the pane behind me for a reflection to see whether I’m still here or I’ve disappeared.

The hours pass without drinking, without eating, without time, without end. I wait.

After six hours, I try to ask where I am in the line. They don’t know.

After seven, I declare that I’m leaving. “It’s almost your turn!” I stop. Another turning point.

The doctor is young but seems to know what he’s doing. Me too . . . I think.

“Doctor, listen to me, I’m a colleague. I’ve been trying to get a swab test for days. I already have chest X-rays and tests. It seems to be bacterial pneumonia. If you do a swab, I’ll leave and you’ll be free for other patients.”

He agrees right away. I feel that he’s understood me. At the same time, he looks at me, serious. “I’m not so sure it’s bacterial. Now I’m going to do the blood work too; I want to see your oxygen levels. We’ll know everything in an hour.” It’s almost midnight, but at least I see an endpoint.

I even manage to find the will to make conversation with this young doctor, so energetic and motivated. I like him.

“What did you want to do when you began to study medicine?” I ask him.

“A primary care physician. It was my dream. Then I found the emergency room and fell in love with it. This is what I want to do forever, even if I can’t get a certificate as a specialist and have to work as a freelancer. Now everyone admires us, but I’m afraid they’ll forget us afterwards.”

I enjoy remembering this little exchange, and my amazement at his quick answer.

The swab test (throat, right nostril, left nostril) is painful and invasive. If I’d known that I wouldn’t have insisted so hard on getting it. My breathing keeps getting worse.

When the tests are ready, the doctor calls me in. “It could be bacterial, but you have a serious oxygen deficiency: class 4. I need to admit you to the hospital.” The swab test will take a day.

I lose consciousness. I’m tired, it’s 1 a.m. I’m not lucid.

I’m afraid. Where will they put me?

I ask if I can go home for the night and return to the hospital the next day.

I sign the form. I leave.

Pure insanity. Can I say that? Total idiocy? Maybe my brain was infected, too.

***

Wednesday morning, March 11, my at-home guardian angel (I’ll have many more in service from here on out) phones 911. By this time, it’s a second home.

After an hour, they’re already seeing me. Again the doctor suggests bacterial pneumonia. They give me tests for various kinds of infections: blood, urinary tract, Legionnaires disease. They attach me to an oxygen tank. I’ll be admitted to intensive care for observation as we wait for the swab results. I feel better.

While I wait to be admitted, half worried and half desperate, all alone in limbo, searching for human contact, I think of a colleague who works in the cardio-pulmonary section and wonder whether he’s in service. I imagine contacting him. Then I fall asleep.

When I wake up, they take me to my room. A double for single use. No other choice.

Here I have my first harsh encounter with isolation and safety precautions. A nurse, more terrified than me, tells me to wear my mask all the time and warns “You won’t be here long. You’ll be transferred, even if you’re negative [for COVID-19]. And don’t take anything with you. If you’re positive, everything you have will be thrown away and incinerated.” I think about my briefcase, my jacket, my clothing. I can’t believe it.

For the first and last time I hear a terrible word applied to whoever comes into my room: “I’m dirty,” says another nurse. She means that she’s no longer sterile. It makes me feel sick. I’m dirty, too.

Thursday morning another doctor shows up.

“Any news?” I ask her.

“Yes, you’re positive. We’ll be transferring you to the Sacco,” Milan’s hospital for infectious diseases, she replies. Direct and straightforward. I appreciate her.

Positive

In general, it’s a concept I’m partial to. Like “optimism,” it’s an approach to things that I use myself.

Maybe this time, though, I didn’t need to hear it. Not this time.

On March 12, 2020, I become a number in the statistics and the updates.

I was one of the 15,113 Italians positive for the swab test, one of 8,275 from the region of Lombardy, one of the region’s 4,277 hospital admissions.

I’m still asking myself what the numerical impact is. In absolute terms, it's about the same number as an important basketball tournament or a middling soccer match. Small percentages of the population. In absolute terms, seen as a series of hospital beds, the admissions seem enormous, a crowd, a multitude. I’m not alone, there are so many of us; we worry the doctors and the epidemiologists.

In fact, the positive swab test is almost a relief. The reason I feel so awful, the answer to so many questions.

Soon afterwards: a new ambulance and a trip in the company of another “positive.” With sirens at full blast, the only soundtrack so many Milanese have had in these weeks of lockdown.

I know the route to the Sacco well. The thoughts that keep me company are not good ones.

Sacco was built as a sanatorium for tuberculosis patients in 1927, when it was called Vialba. It was also where I went my first year of medical school to perform my first autopsies. Famous later for its treatments for AIDS. Here, I saw my godfather, Gigi, for the last time, dying of stomach cancer. My thoughts rush along rapidly, ugly, ruthless, I can’t stop them. I know my mind; it’s hard to control it right now. They take us to Medicine 2, which has just been converted to receive COVID-19 patients. When the door to the ward opens, I see a cluster of nurses and doctors ranged at the end of the corridor. They move around us, suited up and wary. They seem to give each other courage. “Which bed do you want?” It’s a large room that normally holds three beds. Now it is set up for two.

The view from Roberto's window in the Sacco

I don’t hesitate—I take the bed by the window. A good choice, as I’ll discover later.

Not long after come the first exams and the first visits. Two doctors: one on staff, the other his intern. In addition to taking my vitals and a general exam, they perform the first ultrasound of my lungs. Terms and abbreviations pass between them, incomprehensible to me, but I’m able to decipher these words: “Your lungs are totally full of fluid. We need to help you dry them out. We’ve gotten good results from wearing a helmet with an oxygen supply for several hours a day. We’ll start that shortly, and then we’ll start the therapies. We only need your verbal consent; we can’t keep any pieces of paper.”

For the second time I identify myself as a doctor, and they seem happy.

They administer some retroviral drugs (AIDS drugs, now that’s a thought), and antimalarials. At the same time, because I’m a doctor in another specialty, I don’t quite realize what my conditions really are. I’m reassured by being in the hospital, and now they’ll take care of the therapies, the dosage, the care. I entrust myself to them. Totally.

***

It will only be many days later that I discover that among the phone calls the doctors make to my home, the first goes like this: “Signora, do you know that your husband is in critical condition? We have him in the ward, but right next to intensive care, and we’re ready to move him tonight at the first sign of a problem. We need to anticipate what may happen, not be taken by surprise. We need to preempt the infection, not chase after it.”

Fortunately, I had no idea. Even today I’m sorry to have created such worry. I’m a little woozy, but something grabs my attention immediately. In all the comings and goings of people in the room, I notice that they always move in pairs. At first I don’t understand why, but later, day after day, I realize that it’s a choice, with the precise aim of providing mutual support in the face of a terrible, risky task—continual contact with death and fear. I never succeed in asking whether it was devised as a special protocol. In any event, it’s an excellent choice that also benefits us as patients.

Another thing strikes me. Whoever comes into the room is dressed in an antiviral suit. A tight hood, goggles, and a plastic visor that comes down to the neck, an FFP3 mask closed around nose and mouth, three pairs of gloves, a disposable gown over the uniform, and booties over their shoes.

Photo by Marco Vasini for La Repubblica Parma

It’s impossible to tell who they are, what their role is, what their identity might be. At the same time, the patients are also wearing masks: encounters between masked men and women. This is disturbing for someone like me who bases most of his relationships on recognition, exchanging glances, and knowing one another. I like to understand something about people by observing what kind of aspect they have, their facial expressions. Now I’m disoriented. Some try to write a name or a position on their coats, but it’s not consistent. I try to adjust, fix my attention on their eyes. Some strike me: an intense blue, a marvelous Asian outline, but it’s not enough. I shift to details: many of the women doctors wear glasses; I look for the brand name on the armature. One young male doctor hides a ponytail under his cap, and I tell him it will be easy to recognize him because of it. “Careful not to get confused, two of us have them,” he replies.

Bit by bit I begin to orient myself among my conversation partners.

Maybe that’s why I’ve felt the need to define myself. “My name is Roberto. I’m a doctor.” Saying it helps.

At the same time, I see a harmony among them, a solidarity, an extraordinarily strong bond. A doctor raises the blind, a nurse makes the beds, another throws out the trash; they help each other as they help us.

But these are thoughts that accumulate inside me over time, as the days go by.

Treatment: another beginning

The helmet arrives. I’ll become familiar with its name: CPAP. It’s a transparent plastic affair, a kind of ball you put your head into, somewhere between a hair dryer and a diving bell. As with every beautiful thing, it has its defects. Like spending hours and hours inside it (up to 20 each day, at the beginning), that it’s hard to bear with a high fever (hot air circulates around you), and it’s extremely noisy (like a plane with bad soundproofing), an issue brilliantly resolved with earplugs or earbuds for music. Like an astronaut inside their space suit with all the attendant consequences for satisfying their bodily needs. With Alberto, my roommate and companion in the adventure, we say at the beginning of every cycle that we are taking off on a plane flight. We circle the whole world, length and breadth.

But alongside the virtual travel, I need to say something about the mental voyages the condition of disease—this disease—activates. The first day, the doctor I speak to on the phone warns me that the collateral effects of the therapies might include delirium, hallucination, and states of confusion. Fever and fear factor, too. I’m sure of it.

***

The central phase of the disease lasts five days, an intense and passionate hand-to-hand combat with Mister Corona. The nights are the worst, between nightmares and thoughts that spin like drills. Once I saw my daughter sitting on a seat at the foot of my bed. She looked at me lovingly. I was critical of her non-presence, but I was glad to see her there. I cherish the memory. Another time I imagined myself on a mountain, in the middle of an extreme climb. I know that in some cases death comes to us because we are so exhausted; we let ourselves go, into the arms of fatigue, wind, cold. I think that at the worst I might have had that opportunity. I try not to let any news reach me, but on the little television in our room we see images of the deaths and tragedy unfolding in Bergamo, my native city. I wonder whether the Bergamaschi might have some genetic fragility that makes them defenseless against the virus. Another time I get upset at the thought of all the things I would still like to do, all the people I would enjoy meeting, all the opportunities to benefit from. And I give in to regret, fearing that I could never have them again.

Friday night, my second under the CPAP, someone comes in and tells me, writing on a piece of paper that they hold out in front of the helmet, that they want to administer an experimental drug intravenously, a drug used to suppress the inflammation of rheumatoid arthritis. “Do you give your verbal consent?” I’d have given my consent to pranotherapy at that point. And then the thoughts: if they’re in this much of a hurry, it means that . . .

Every so often, vital signs, the reasons for living. My family, my granddaughters, my patients, my work, the things I like, my friends. Two extremely powerful thoughts: if I survive, I’ll write something about this adventure and think seriously about my professional future, about the Italian Psychoanalytic Society. Between moments and thoughts, good and bad, the company I kept by necessity, solitude and isolation played their part—inside the helmet and out, recombining past choices and priorities.

***

This epochal tragedy has a collective dimension because of its numbers and the degree of involvement, but it is made of so many tiny individualities that cannot be forgotten. So many voiceless solitudes.

Whoever is on the front lines suffers both a personal risk and a risk to loved ones: the healthcare worker who lives away from home out of fear; the person who feels cared for and the one who feels abandoned; the person who manages to pass triage over the telephone; the person who hears agonized voices and bears the burden; the person who is too confused to know how to respond; the person who goes unheard; the person who can’t get through on the phone; the person who dies alone; the person who chooses to die at home to avoid dying alone; the person who is a helpless witness to death; the person who has no idea where the body of a loved one will be cremated, hoping that it won’t be a military convoy or a deconsecrated church, waiting, without knowing where that body will end up, or when the ashes will return; the fatalist who doesn’t care; the person experiencing it all directly; the person who experiences at a distance.

Protagonists, witnesses, spectators: whether they like it or not.

(left) A selfie by Roberto's son, outside of the Sacco; (right) Photo by Davide Pizzigoni of two bike messengers resting in a deserted Milan

For me, no visits. Permission only to receive a change of underwear once a day. Fortunately, I came with a phone, tablet, Mac, and, above all, good music. An excellent soothing remedy.

Along with mindfulness. Breathing, so fundamental to the practice, becomes the purpose of every well-taken breath. Trying to feel present in every moment, a condition of serenity. Acceptance helps. “Let the needles enter into you,” I repeat to myself every time. They stanch two or three. Good for them, and good for me.

I discover early on that far from the hospital, but close to my heart, a multitude of people, truly numberless, live through the same worries, fears, hopes, joys, and relief as my family and me. I imagine them as a crowded Greek chorus that sustains me and pushes me from behind as the street opens out in front of me. I know, and here I run the risk of sounding New Age, that each one of them is part of my healing. I hear from people I’d never known, and hear again from people I’d lost touch with.

And then my healers. They treat me with competence and attention, affection even. I develop an uncontrollable feeling of love for every health care worker who comes near me: nurses, doctors, aides, orderlies, anyone wearing a white coat.

And, presumptuously, I have the impression that the affection is mutual. I find myself in a harmonious ward; my son feels it when, with admirable dedication, he hands over my changes of underwear. Apparently it is without conflicts, or the conflicts are well disguised. I am among people who respect and help one another with a shared objective: curing us.

***

My fever begins to go down, finally to disappear, and each taking of my temperature is awaited with great anxiety. What can I say about that doctor who, after the hundredth measurement of the day, takes the thermometer in hand, looks at it, and gives me a high five. What, I’m not infected?

“We’re learning how to cure all of you, together,” another doctor tells us. Someone can get nervous hearing that kind of statement. To me it seems to reveal a humility, an acceptance of one’s own limits, of listening to every clue. In psychoanalysis, we call this “co-construction.” I believe in it, and I use it in my practice.

“Maybe there’s something wrong with me, but when things go well for one of you, I get all excited, the way I do when an athlete wins a medal!”

Another doctor, in the face of the latest positive data, draws a heart in the air with her finger, the way soccer players do for the fans and their girlfriends after they score a goal. A standing ovation.

Thinking back, there was an evening when we weren’t so affectionate. A nurse refused to turn out the light until midnight. I was inside my helmet and couldn’t get up to do it myself. I tell him to go to Hell.

***

The first Sunday arrives on the ward and I’m beginning to feel better. I ask myself who will visit us today.

In comes a pair of doctors, male and female. They’re in a good mood, full of trust and enthusiasm. They tell me that I’m progressing really well, that there’s still a road ahead, but I’ll make it. They take away the experimental drugs, the antibiotics, they reduce my daily hours on the CPAP. I’m ecstatic, I phone home, I get emotional.

Then I reconsider. Have they come right from that board game Operation? It’s difficult to relax, to chase away the bad thoughts, if only out of superstition.

But I’m feeling positive, and not only for coronavirus. I write a second email to my patients. I explain that I’m in the hospital for something more serious than bacterial pneumonia, that I’m receiving excellent care, and everything seems to be going well. Perhaps I should have waited, though the reactions that come in are moving and unforgettable.

Time passes

By now we’re all used to the concept of medicine that aims for the minimum time in the hospital, that sends new mothers home the day after childbirth, surgery almost exclusively for outpatients, the shortest possible stays. But now you’re discharged only if you are really well, beyond relapse. They don’t want to incur risks. I agree with them.

And so, this article that revolves to such a great extent around the room, my consultation room, now has to reckon with a cubicle, with a bed rather than the couch, a little table rather than a desk, another patient, Alberto, my mirror and my partner in conversation, especially in the evenings. Pleasant company.

When do you know you’re getting better? And from what?

There are objective data, clinical parameters, ultrasounds, numerical data. There are subjective sensations. Useful ones.

Wednesday, March 18, during the evening shift, two nurses I recognize, Michela and Virginia, draw near my bed.

“Can we have a serious talk with you?” they ask. I understand that they aren’t talking about me.

“We need help. We can’t take it anymore. Every time we come home, we’re afraid of infecting our family, our children. But we can deal with that, like the fear we feel every day. The problem is when we try to sleep. We need it; in fact we collapse like stones. Then, suddenly, we wake up and we see the image of your eyes, your gaze under the helmets and we can’t sleep any more.”

I’m flattered—I think that if they are asking me for help, it means I can give it now rather than receive it. Furthermore, this is my hobby horse: empathy. I take off. “It’s great that you’re so involved, but, look, you need to put yourselves in other people’s shoes without becoming those other people . . .” They interrupt me right away. “Yeah, yeah, we know that. But we need to find a way to sleep.” I change my register right away. I can still do that. “OK, give me your email and I’ll send you the recommendations. You can take good quality melatonin, or a mild tranquilizer, a few drops. For the thoughts and images, think about those big red emergency buttons that cut off the current. Imagine an even bigger one that turns off your thoughts when they start twisting around. And in time there may be other solutions, if necessary.” Two days later they stand in the doorway. “We took the melatonin. We’re sleeping. And the big red button works wonders.” When all this is over, I’d like to help someone pro bono.

Thursday, March 19. Father’s Day. I’m still in the hospital, but everything is going well. The parameters are OK: no helmet, still on oxygen, and it all seems to be a normal progression. The morning doctors are optimistic. I’m happy.

In the afternoon, the “mean one” arrives. She hardly collaborates with her colleague, unless their tasks have been divided up beforehand. Good cop, bad cop. She moves decisively. Her sharp, intelligent eyes move rapidly, scanning every corner of the room. She scolds me a little, puts me on alert. “Look, you’ll have to put the CPAP back on. It’s easy to relapse. Be a good boy, stay calm, and don’t be in a hurry.” At first I’m terrified—I see catastrophic scenarios playing out. I hesitate. Why is she saying these things? What’s happening? Is it the dreaded relapse? I thought I was near the summit, now I’ve been sent back down to base camp.

Then the thoughts—the good ones—come into play. It’s clear that each of us handles the anxiety and the fear in our own way. Some of us pull out all our emotions, like the two sweet nurses of the evening before. Some play it tough, like the doctor today. I know she’s worried about me. That she’s speaking and acting in my own interest. That she wants me to recover and she doesn’t want to lose a single patient. I can’t hate her.

That night, I reconsider: I play out the scenario of what would happen if the “mean one” comes back and I tell her, “Dottoressa, give me five minutes of your time just for the two of us. Sit here, on the end of my bed, which is a good way to stay near the patient, and listen to me. You are an excellent doctor. I owe you my life and I’m extremely grateful. To me you are all heroic, and hence untouchable. But now I’m going to tell you what happens when you pass through the ward and you say certain kinds of things, like what you said yesterday, even when it’s meant to care for and protect us.” The fantasy allows me to pass the next morning happily.

The “mean one,” who everyone says is extremely competent, never returns.

In the afternoon my daughter phones me. We are happy. When the call is over I burst into tears, all by myself, sobbing like a child. It is the first time in days and days. First, I feel frozen inside: emotions that are almost impossible to manage. Then, relief. Another step toward recovery.

***

The last stretch of the road will be the longest and slowest. Not like on a mountain, where the peak, or the camp, often lie just beyond the last effort. No, here there is an endless plateau.

But that’s all right, even if the last days never seem to end—between small steps forward, great caution, a little backslide, the final push, another day of waiting.

A pair of doctors come in: two friendly, engaging young men. They practically read out my blood exam live, as if it were a test they were watching from the window. “Your blood is nice and red!” I get another high five. Pietro, one of the doctors leaving the room, says, “Will you let us read what you're writing afterwards?” Apparently the staff are amused at watching me work at the Mac while I’m under the helmet. A psychoanalyst can be fun, too, can’t he?

In addition to music, upon feeling better I also read a great deal, catching up on things. The best company was Disturbance by Philippe Lançon, one of the eleven survivors, amid twelve victims, of the terrorist attack on the offices of Charlie Hebdo. It’s the account of his time in the hospital, nine months and fifteen operations. A place he never wanted to leave. A sort of protective cocoon. I understand him well. I never want to leave his book.

I watch an interview with Angelo Marzano, a dermatologist and one of the first patients in Milan. He, too, was a patient at the Sacco. He admits the fear he felt. He says that now he can understand his patients better because he has been a patient himself. Holy words, a mantra for me.

***

The last steps are marked by a real walk—two, in fact.

The first one happens in the ward. The doctor, Marta, calls me out of the room, takes me into the hall, where I haven’t been in twelve days. She makes me put on a mask, measures my oxygen levels and tells me, “Now walk to the end of the hall and turn back, and we’ll see how you do after an effort.” I feel the same sensations, physical and emotional, as you would feel during an important exam at the university. Trying to keep my emotions at bay, I cover the twenty or so meters. On the wall at the end of the hall is a big poster with a rainbow and that phrase “Everything will be alright” that has annoyed so many people. In that moment it seems marvelous to me, as if it were speaking to me personally. I reach it feeling very emotional. I turn around and head for my personal judge. The oxygen level is unchanged. “Do it again, but faster!” I think I’ve already gotten an A+ and imagine that this is the question that will give me my cum laude. Now I walk quickly, smiling. The oxygen is still stable. I’ll be discharged tomorrow.

I write my third and last message to my patients: “Recovery.”

Dear all, with great, immense joy I can tell you I have recovered!

This is the message that, from the moment I became ill, I’ve wanted and imagined being able to send you as soon as possible.

And I can’t deny that it has been one of my strongest motivations for successful healing.

As you can imagine I am extremely happy and I am delighted to share the news with you.

The office will obviously remain closed until the government issues a new decree, but I am available for sessions by Skype, FaceTime, Zoom, or any other means you want to use. Even if it’s just to say hello after this abrupt break.

I ask, then, that you let me know individually what your plans are and the possibility of rescheduling the timing of our meetings, so that we can respond to your and my new needs and availabilities.

For now I greet you all collectively, awaiting the opportunity to do so one on one.

A hug.

The morning passes between preparations and waiting, greetings and farewells.

During my final sampling of arterial blood, I ask Federica, the young specialist: “Dottoressa, without any pretense at science, can you give me the percentage of responsibility for my cure between your competence, the therapy, and . . . dumb luck?” 30-30-30 she says without thinking. I think she underestimated the third component.

We say goodbye. I want to hug, I tell her, but I know we can’t.

“But we can clasp two hands. That, we can,” she says. We do it with the appropriate pleasure and intensity.

“I don’t know how to thank you.”

“It’s we who should thank you.”

If we didn’t have masks on, we’d probably discover that we’re both teary-eyed.

I say a warm goodbye to Alberto. I’m sorry he’s staying there, and so is he. He’s worried about who will come next.

My son arrives. He has to wait for me on the ground floor.

Now for the second walk.

I take my briefcase and tote bag, moving along the corridor in the opposite direction.

My things are heavy. I wonder if it’s too much of an effort. We’ve entered into a new phase: temporary, the state of fear for what happens afterwards.

I get into the car on the rear seat, among the gloves and masks. I don’t even know what I feel. But there’s a photo of me in the car, looking like a winner.

Roberto leaving the hospital

Joy. Certainly. I’d rather have done without it.

On March 23, I was discharged. Cured. Like 7,432 other Italians and 6,075 residents of Lombardy since the start of this epidemic. I am safe. I’ve saved myself, unlike the 3,776 people who have died in our region.

All of them numbers that will only be increasing in the coming days.

____________________________________________________________

ABOUT THE AUTHOR AND TRANSLATOR

Pietro Roberto Goisis and Ingrid Rowland

Pietro Roberto Goisis is a Milan-based psychiatrist, psychotherapist, psychoanalyst SPI and IPA. He is a survivor of the coronavirus.

Ingrid Rowland is a professor at the University of Notre Dame with a joint appointment in the Department of History and School of Architecture who serves as a faculty fellow at the Nanovic Institute for European Studies. She is a regular contributor to the New York Review of Books and lives in Rome.

ABOUT THE PHOTOGRAPHER

Davide Pizzigoni, capturing his reflection, in the heart of deserted Milan

Davide Pizzigoni is an artist and photographer based in Milan, Italy. He has had personal exhibitions in Milan, Rome, New York, Tokyo, and Osaka. Davide’s artworks can be found in private collections throughout the United States, Argentina, Japan, France, Austria, Italy, and Germany. He graciously provided many of the artistic photos featured in this article, particularly those of “deserted Milan.”

Credits:

Photos by Davide Pizzigoni, Milan-based photographer; Marco Vasini for La Repubblica Parma; Google Maps; Google Street View; Jim Reardan; CDC