Federico Pezzo graduated in Italian Studies from Alma Mater Studiorum – University of Bologna with a thesis in Literary theory on the American writer Cormac McCarthy. He is mainly interested in modernism and postmodernism in literature.

In the short story Lo strumento della voce umana (published in the collection Per le antiche scale in 1972), the psychiatrist Anselmo, protagonist and alter ego of the author Mario Tobino, is confronted with “il Meschi”, a man unable to communicate with the outside world through words, but incredibly gifted at playing the saxophone. Faced with this prodigious case, Anselmo cannot help but agonize over the elderly patient’s fate and he rails against the “cursed madness” that consumes man as termites consume wood.

It is safe to guess that the author experienced similar situations many times firsthand during his long years of service in the Maggiano psychiatric hospital near Lucca. More than anyone else in Italy, Tobino was able to intertwine his poetics with his profession as a doctor, ensuring that these two seemingly opposite vocations of his nurtured each other fruitfully.In his long career Mario Tobino was the author of numerous novels, short stories and poems (as well as a play). 

His production is characterized by acute attention to the psychological dynamics of the characters and their interpersonal relationships, and by the constant presence of the theme of illness, both physical and mental. The illness, while described with the exactitude that is to be expected from a writer-medic, is not told as a mere clinical fact, but is also and above all presented from a social and emotional point of view. Illness, for Tobino, is not just a source of discomfort for the patient, but an event that strongly influences the lives and relationships of everyone involved.  

Le libere donne di Magliano

In 1953 Tobino published Le libere donne di Magliano (the writer somewhat disguises the name of the locality where he worked as a psychiatrist for many years: Maggiano). The novel is autobiographical and it is written in the form of a diary, so the main perspective is that of a doctor; but the attention given also to the point of view of the patients and of those we would nowadays call caregivers (i.e. family members or those who provide medical help at home) is interesting. The women of the title are in fact mainly patients of the institute, but also nuns, nurses, and even workers and peasants from the province of Lucca. 

Particularly important is the character of Lella, a woman described with masterly elegance in the fragility of her illness and in the ups and downs of its course. Tobino enters in an empathetic relationship with this woman establishing a bond of strenuous pain-sharing. Lella seems to be continually improving only to regress again: “e da alcuni giorni la Lella non è più al reparto medici, è “dentro”, tra le matte, ora di nuovo anche lei completamente trattata da matta [and since a few days Lella is no longer in the medical ward, she is “inside,” among the crazy, now again also completely treated as crazy]”. And Tobino stands by her side in the ups and downs of her illness, sharing  everything that is in his power to share. And all this is recounted in a diaristic form that shows us with immediacy both the doctor’s thoughts and actions and the lives of the characters who live in and around the hospital.

Per le Antiche Scale

Let us return to the aforementioned collection of short stories Per le antiche scale. The common thread that ties these stories together is Dr. Anselmo, who always appears as the protagonist. This time the autobiography is not fully explicated, but it is nevertheless evident that through the figure of Anselmo, Tobino stages himself. In each tale Anselmo is always faced with mental illness, but this is shown from a different perspective each time, and it is touching how delicately the author is able to describe the uniqueness of each patient’s pain. The most interesting tales of all are those in which the line between sanity and psychosis is not at all clear – as in the case of the harmless Idelfonso, guilty only of loving wine a little too much. “Ognuno ha le sue spine. La meditazione, la difficoltà di Idelfonso erano semplicemente sul bianco o sul rosso [Everyone has their own prickles. The meditation, the difficulty of Idelfonso were simply on the white or red wine]”.

And, for that matter, all throughout the collection (as well as in Le libere donne di Magliano) insanity, rather than binding itself double-handedly to the individual asylum guests, seems rather to hover over the whole structure like a gigantic, disturbing presence. Throughout Mario Tobino’s production, one can sense that tendency – which was beginning to spread in the Zeitgeist of the second half of the twentieth century – to see mental distress more as a social fact than as an illness to be treated in the traditional way (Michel Foucault, for example, has written extensively on this subject, from his 1961 doctoral dissertation  Folie et déraison. Histoire de la folie à l’âge classique onward).

That is why, even more than material support, Tobino and his literary alter egos seem to offer patients simply to share thier suffering. This is an effective approach for both mental and physical illness; in this regard, a paradigmatic example from the work of another great contemporary author, this time from the United States, Cormac McCarthy, comes to mind. 

The Road 

The two protagonists of his postapocalyptic novel The Road (2006) – a father and a son whose names are not given – at some point near the end of their journey have to deal with an unknown disease that affects the boy. Initially the father seems helpless, his son is vomiting and delirious with fever, and he is unable to cure him in any way: in a world totally devastated by a catastrophe of biblical proportions, any illness is likely to be fatal, since there are no doctors to contact, and even just finding uncontaminated food and water seems to be a feat with no obvious outcome.

During his illness, the boy for most of the time lies unconscious, and in the few waking moments he seems unable to form sentences of any meaning except for his constant pleas to his father, “don’t go away.” And the father does not go away, “[not] even for just a little while”. And he shares with him everything that is in his power to share. In the end, the boy survives, but what matters, what sticks with the reader, is McCarthy’s ability to describe both illness and the power of empathy and pain-sharing, in a way that is on the surface cold but actually delicate and at the same time tremendously powerful. 

Two key models

Whether physical or mental, the literary description of illness – as well as of cure and recovery – is an incredibly complex exercise, but for that very reason, when it succeeds, it is also an indicator of extraordinary skill. Illness, with all its nuances and complexities, is not just a sum of symptoms and diagnoses: each individual patient brings with him or her a unique and personal experience that shapes his or her perception of the course of treatment. Tobino and McCarthy masterfully addressed this theme, as we have just seen, and their narratives remain a model for those who want to tell the story of illness in all its forms.

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