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Early Registration for SY 2021-2022 extended until may 30, 2021
Distribution and retrieval of modules is every Friday
Schedule of Third Grading Examination will be held on May 3-7, 2021
Submission of Grades for the Third Quarter will be on May 17 – 21, 2021
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Letter from a COVID -19 Survivor

Pietro Roberto Goisis

Letter from a COVID -19 Survivor

Pietro Roberto Goisis

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

Thank you for inviting me to share the experience I lived early in the pandemic before and during my illness with Covid-19.

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. He asked me 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, a woman, 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.

SARS-CoV-2

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.