Gian Battista Danzi
Pietra Ligure, Italy
Aevo rarissima nostro Simplicitas
–Ovid, Ars amatoria I, 241-242
Some five years ago, I had the privilege of treating M.A., a visionary and restless soul who used to dabble in writing, and who had been admitted to my Cardiology Division because of an acute coronary syndrome. I was particularly struck by my meeting with her and it still haunts me. She had a rebellious spirit, and her complex life had been marked by admissions to psychiatric hospitals where she underwent electroshock therapy with devastating results.
The circumstances of our meeting proved to be difficult. She categorically rejected my attempts to propose an appropriate diagnostic and therapeutic course. My greatest difficulty was that it was virtually impossible to make contact with her inner self, and I could not penetrate the defensive armour of this apparently simple but resolute and shrewd woman. I remember that our first meeting took place in a smoke-filled hospital room as she refused to comply with even the smallest request made by me or the nursing staff. Her provocative and challenging attitude was reflected in her generally dishevelled appearance and the careless way in which she dressed, as well as by her deep and raucous voice. Fortunately, bed rest and pharmacological therapy led to the complete remission of her symptoms within a few days. During one of my morning rounds, after I had given up any hope of establishing a relationship with her, she unexpectedly gave me a sheet of paper with a poem on it saying simply: “This is for you!”
The poem read:
Heart, you stop every day without knowing why.
The cure is very simple:
Look at the small things and the happiness of the world.
A doctor cannot experience death, but we, the sick, invoke it but do not want to tell the doctor.
When the heart speaks in our place, we will die and this is our great secret.
I have read these words many times in an attempt to interpret their meaning. These few lines represent the only chink in the thick armour defending a unique and limpid voice that suffering had tempered but not broken, and gave me my only glimpse of what lay behind. She is no longer alive, but I still retain what I learned from our meeting: only death has the power to end suffering, whereas the infernal solitude and neglect that the she had lived through can only be overcome by looking at the small things and the happiness of the world.
GIAN BATTISTA DANZI, MD works in the Division of Cardiology at the Ospedale Santa Corona, Pietra Ligure, Italy