Diary

Ian Thomson

At ten past three the phone rang. ‘Pronto,’ I said, and the voice answered: ‘I am Signor Calvino.’ It was the novelist Italo Calvino; I was due to interview him later that afternoon. We had scarcely agreed on the place when something hard hit me on the back of the head. The room spun; there was a glare of light. Calvino assumed it was a bad connection.

I sat for a while on the marble steps outside the flat, my vision blurred and a taste of copper in my mouth. I remember moments of lucidity when I was aware of a burning pain in my head and blood running down my face.

Had Gilly not come home early that evening I might have died. At about six o’clock she opened the door to our flat on Via Salaria. Bloody handprints covered the walls where I had tried to steady myself. A pungent smell filled the air. Down the hall in the bathroom she found two damp bath-towels stained with blood. I was in the kitchen, sprawled face-down on the floor. Blood had congealed in a pool round my head. In a panic Gilly tried to sit me up but my movements were unco-ordinated and my speech garbled. I seemed to be ‘speaking backwards’, Gilly later told the police.

It was an age before the ambulance arrived. A cold rain was falling and the buildings were wreathed in fog. Paramedics manoeuvred me down the stairs but they had difficulty fitting the stretcher into the back of the ambulance: one of the doors had jammed. As they struggled in the pouring rain, Signor Capaldi, the caretaker, appeared and, pointing at me, exclaimed: ‘He’s overdosed! That’s why he’s gone all yellow.’ His face above me flashed a spectral white and blue from the ambulance beacon and I wondered why he insisted on accompanying us to the hospital. It seemed odd at the time and it still does. Perhaps he wanted to help Gilly? As we set off through the night he tried to console her. ‘He’s a good person really.’

I was taken to the nearby Policlinico Hospital, but they didn’t have the equipment needed to make a firm diagnosis. At the Nuova Clinica Latina, a prototype PET scanner took cross-sectional images of my brain that revealed a fracture in the lower left rear (parieto-occipital) region of my skull. The X-rays didn’t show any bone splinters round the edge of the fracture, indicating that whatever hit me might have been ball-shaped. A large stone, say, concealed inside a sock. But who would have hit me? The clinic couldn’t perform the operation I needed and by the time the ambulance reached San Giovanni Hospital on Via dell’ Amba Aradam I was a neurosurgical emergency. Surgeons were called from their beds and I was operated on in the early hours of the morning. A group of white-coated orderlies rushed me down the corridor. ‘Stai ferma!’ they shouted to Gilly. ‘Stay where you are!’ The caretaker had by then returned to 115 Via Salaria; Calvino had waited for me at our agreed rendezvous, then gone home.

The operation on my acute epidural haematoma lasted two hours. The prognosis was coma if not death. Gilly was told to remove her shoes so that her pacing didn’t disturb the other patients. I was left with a cranial cavity the size of a tangerine where the haematoma had been evacuated.

The next morning I regained consciousness outside a latrine on the sixth floor of the hospital. ‘I’m afraid you’ve had an emergency brain operation.’ A blurred but familiar face came into focus as Gilly. I asked her: ‘What have I done?’ Then I was out again. When I came round the following day I saw a sign at the end of the corridor that read TRAUMATOLOGIA CRANICA. I was in a bed in the corridor (there was no space on the ward).

A group of nuns swished past, each bearing a carafe of white wine. So I was in paradise. Or perhaps a Fellini movie. (The carafes turned out to contain urine samples.) San Giovanni Hospital was next to the basilica of the same name. Nuns, as well as priests and social workers, acted as paramedics because there was a shortage of trained nurses. I cried in pain as a catheter was disconnected: ‘Madonna!’ Why had I sworn in Italian?

For two weeks I lay in the neurosurgery ward. My head hurt like hell and my right arm had large blue-black bruises on it where the Sisters of Mercy injected painkillers. In the public ward with me were survivors of motorcycle crashes and victims of brain tumours and assault. A young Tunisian called Mustah had been attacked with a hammer; a great scar like a railway track ran across his right temple. In his post-traumatic delirium he believed his mother and sister had been replaced by duplicates. ‘Ho paura di nessuno!’ he would yell at the nuns in broken Italian. ‘I’m not afraid of anyone!’

Each day I was visited by my neurosurgeon, the quaintly named Professor Milza (milza means ‘spleen’), and a group of trainee doctors in white smocks. Examining the chart at the foot of my bed, Milza would ask me: ‘And how is our Englishman today?’ Questions designed to gauge my mental alertness met with little success. In English I was asked: ‘Do you know why you’re here?’

I was in two minds about that. ‘I fell – or else I was hit.’

‘Interesting. Now look at the clock on the wall over there. Can you tell me what time it is?’

‘Three o’clock?’

‘It’s six o’clock. Can you touch my nose for me with your left hand?’

‘I’ll give it a go.’

With every incorrect answer I gave to my times tables, the doctors cast each other nervous glances. They moved on to the days of the week, this time in Italian. Here I had few difficulties: my spoken Italian had become unaccountably fluent. ‘Very impressive,’ Professor Milza said, raising an eyebrow. ‘It’s hardly the Berlitz method, but a blow to the head can work wonders.’

It seems that the brain may remap itself in peculiar ways, altering the neural circuitry laid down in the womb. Sometimes a slight error is made in the remapping. The sensation Nelson had that his non-existent fingers were digging into his non-existent palm led him to believe in the afterlife. If an arm can survive an amputation, he thought, then an entire person can survive annihilation of the physical body. Nelson’s neural connections were trying to make sense of the pain of the injury, but the wiring had gone wrong.

After I’d spent a week in the ward, the air conditioning broke down and a nun suggested that I sleep on the roof during the day as the ward was so stuffy. A makeshift bed was set up on the terrace overlooking San Giovanni, with its statues of Christ and John the Baptist. A frozen winter light hung over the church and wisps of mist blew off the statues. I lay on the bed wrapped in my raincoat and tried to sleep. The rooftop had a high wire-mesh fence round it to prevent patients from jumping off. (In November last year, the Italian film director Mario Monicelli leaped to his death from the fifth floor of the hospital.) One day Gilly came to the roof with an extraordinary story: a group of patients had been seen running in their pyjamas towards the Egyptian obelisk in the middle of Piazza San Giovanni. It was like a scene from One Flew over the Cuckoo’s Nest; a handful even hopped onto a bus.

A couple of days later, the ward sister told me that I was ‘clinically recovered’. Gilly came to collect me as I still couldn’t walk without help. I climbed uncertainly into the taxi and off we drove to Via Salaria.

A week into my convalescence, wonderfully, it snowed – the first snowfall in Rome for ten years. It was still snowing when I found wedged behind a cupboard a cranial X-ray of the previous occupant of the flat. He had had a fractured skull. He too was an Englishman; he too had sustained a haematoma.

All this happened in 1983. Last autumn, I began to experience severe headaches. Household painkillers made no difference. My GP referred me to the National Hospital for Neurology and Neurosurgery in London. My head was glued with electrodes as rolls of chart paper registered my firing brain cells. The readings were normal: in medical terms I appeared to be ‘neurologically intact’.

I decided that it was time to go back to Rome and make some inquiries. What had happened, really? Before attempting to trace my surgeon, I returned to the scene of the injury.

Via Salaria is a wide airy street of 19th-century tenement blocks hard by Termini Station. Once, long ago, it must have had a certain elegance; now it is lined with tacky bars and boutiques. At all hours the railway terminus is crowded with touts, hustlers, migrants, and poor people with nowhere to go. Had my assailant come from there, or had I just fainted and hit my head? It was a Sunday and Via Salaria was almost empty. On the brass plate outside Number 115 to my surprise was a bell marked capaldi. I pushed the bell, and heard it ring far away inside. Eventually a wary-sounding voice answered the intercom. I explained my business. ‘Yes,’ said the voice, ‘this is Nina Capaldi.’

I walked past the porter’s lodge to a large inner courtyard with green-shuttered windows and washing hung up to dry. Nina was waiting for me by one of the two ornamental ponds. Short and solidly built, somewhere in her mid-sixties, she had blue eyes in a wide pale face. Her hair was dyed a chemical dark blonde. ‘Nothing much has changed since you left,’ she said to me with a half-smile. Solicitously she held the door wide open, and I went in past her to a dark lobby with an old-fashioned lift cage. The lift made me think of Gilly, a strikingly English figure in her floral-print jackets and pearls. We had gone for walks along the Tiber and drunk Campari in Piazza Navona.

A smell of frying hung on the stairs. We took the lift to Flat 18, four flights up. Signora Capaldi unlocked the door and I followed her in to a dim-lit hallway. It was as though I had never left: the same smell of old carpet dust and cigarette smoke, the same raspberry-red mat in the hall, the same mustard walls. I went into the sitting-room. (The current owner was away for the weekend.) On the table there was an empty but unwashed ashtray. The phone was still high up on the wall by the front door. I saw my 23-year-old self talking to Italo Calvino. I was wearing navy blue wool trousers and a white shirt.

‘Yes. I think an interview will be all right,’ Calvino was saying. ‘What is the best time for you?’

‘Around five o’clock?’

‘Good. We can meet at the Caffè Giolitti. Do you know it?’

‘I think so. Near the Pantheon?’

‘Yes, near the Pantheon. And what is your name again?’

I was about to tell him when our line got crossed by a pair of quarrelsome lovers. ‘I believe that we have some confusion with other people,’ Calvino said. The telephone entanglement seemed appropriate: crossed lines permeate Calvino’s fiction.

Two decades on, there was something mournful about the flat. The kitchen looked different. Rooms usually appear larger in a dim light, but the kitchen seemed to have got smaller since I was last here. The dark blue majolica tiles had not changed. Signora Capaldi was on her guard; she claimed to have no memory at all of the injury. ‘Are you saying an intruder came in and hit you?’ she asked.

‘That’s what the police thought – I mean they didn’t rule out the possibility of an intruder. What about you?’

‘You might have slipped,’ she answered with a shrug. ‘You might have fainted. You might have imagined it all! There are too many things that might have happened.’ Was the front door unlocked? ‘People don’t leave their front doors unlocked,’ she said. ‘Especially not in districts like this near the station.’ Was it someone in the flats? She wouldn’t be drawn. ‘Look, I was here at the time of your … incidente. I had a position in this building. But I’m telling you: I saw nothing, I heard nothing.’

I nodded but didn’t reply. In the hall by the phone I had noticed a low, marble-topped table with sharp-looking edges. Had I banged my head against that? That lunchtime I had shared half a bottle of white wine with Gilly, and had a grappa. At least half of all traumatic brain injuries involve alcohol. I don’t even know what Gilly really thought had happened. I don’t see her any more. I know she makes couture hats, but that’s all I know. Memories of Rome began to turn over in my mind. Gilly with a bagful of peaches. Gilly on her motorino.

I asked the caretaker about the other Englishman who’d lived in the flat and whose X-ray I’d found. ‘You know he had an accident here?’

‘Did he?’ she said. ‘I never heard that. Is that why you’ve come back?’ The Englishman had come to Italy to research the ancient salt routes of Rome, of which Via Salaria is one. He had died 15 years ago in England, I thought, but now Signora Capaldi was telling me he had ‘disappeared’ in Rome. What did that mean?

‘Nobody could find a trace of him. Like I said, he disappeared.’

‘Are you serious?’

‘I’m not asking you to believe me. You can think what you like.’

‘You knew him well?’

‘Well enough. You look like him,’ she added. ‘The two of you – like brothers!’

As I was leaving the building with Signora Capaldi we saw her husband, Gianni, standing in the hallway of their flat cradling a baby. ‘Our granddaughter,’ Nina said, gesturing to the baby with a quick smile. Signor Capaldi shook his head without speaking when I asked him what he remembered about the injury. ‘But you were in the ambulance with me,’ I protested.

‘Ambulance?’ he gave a pantomime shrug. ‘What ambulance?’ That seemed implausible. How could he and his wife not remember? The flat had looked like a murder scene.

Later that night in my hotel the phone rang. To my amazement it was the surgeon: I had left a message for him at San Giovanni Hospital. His office was on the third floor of a faceless building off the Via Appia Nuova. I rang the bell and waited. Presently a bald, smiling face appeared. ‘Ah, Signor Thomson,’ he said with enthusiasm and held out a hand. Milza was a man of old-fashioned courtesies. He said he had retired from San Giovanni Hospital eight years ago. I showed him a copy of the surgical report he had written in January 1984. Removing his glasses, he began to examine the handwritten document, running a fingertip over the pages. Glancing up, he said: ‘The severity of your injury was such that it ruptured the traverse sinus vein at the base of your skull.’ The vein receives blood from all areas of the brain and its rupture can cause an insidiously slow build-up of blood within the brain cavity. In lucid intervals the subject may act as if nothing potentially fatal has occurred. ‘But all the while the blood is building up,’ Milza said. In March 2009, the actress Natasha Richardson died of a seemingly mild head injury after a fall in Canada while skiing. Although she appeared unhurt at first, she developed a haematoma; there was a delay and she was dead on arrival at the hospital.

‘If the bone in your skull was broken at the back,’ Milza continued, ‘we might assume that you were struck from behind … Or else you slipped.’

‘What’s more likely, do you think?’

‘It’s an understandable question but one which I’m afraid I’m unable to answer.’ I had bled from my left ear and that, he told me, was typical of certain skull fractures caused by a blow. ‘Let’s assume for argument’s sake that you were hit. There ought to have been a weapon. But did the police find one? Did they detain anyone?’ No one was detained, I said, and no weapon was found.

‘Then the results of your investigation may prove anything but hopeful,’ he said flatly.

Milza had seen all kinds of neurological disorders in his day. One of his patients had spoken in a ‘different accent’ following surgery. The areas of her brain that control speech, tongue placement and intonation were damaged, and her voice sounded ‘Chinese’ as a result. Another patient had been afflicted by alien-hand syndrome. One of his hands appeared to act independently. ‘His left hand would close a drawer as soon as the right hand had opened it, or undo buttons that had just been done up.’ Before my operation I made advances to a nurse in the lift at the Policlinico Hospital. A quarter of a century on, I can remember Gilly’s embarrassment. Disinhibited sexual behaviour is a common consequence of brain trauma.

I had had a ‘very close brush with mortality,’ Milza said, ‘a quarter of an inch from death.’ More than 40 per cent of acute epidural haematoma cases die. Smiling, he showed me to the door. ‘It’s been so nice meeting you – it’s not often I get a chance to talk about the things that really matter.’ He took my hand and, holding it between both his, shook it warmly. Returning to my hotel I thought of the other patients with me in neurology. Luigi was a huge man with a bald, Mussolini-like head. Every day three female relatives would visit him from Naples, all of them dressed in black. In what was almost a parody of the Adoration they would prostrate themselves before Professor Milza and even offer him food. But one day screens went up round Luigi’s bed.

As a parting shot I rang the police commissariat on Via Salaria to ask who had been in charge of my case 25 years ago. I was told the name of the detective-sergeant and for good measure his nickname: Robocop. Robocop had been an ‘honest cop’ but had died two years ago, at the age of 64. In retirement.

‘Look, I don’t want to waste your time,’ I said, ‘but were the police absolutely certain it wasn’t foul play?’

‘Foul play? Pretty certain.’

‘So there were no misgivings?’

‘Misgivings? I’ll be frank, Signor Thomson. I’ve looked at the records. The case was closed owing to lack of evidence. No evidence was found of any foul play. And that is the sum of the information I have for you.’

I went back to 115 Via Salaria for the last time. A late afternoon light was shining on the building and the windows glowed like small fires. I thought I could see the caretaker and his wife at one of them, looking out over the street. Two identical injuries had occurred in the same place; that surely was suspicious. The conjecture had one serious flaw, however: perhaps the other X-ray had actually belonged to me.