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Dottoré! is a weekly column by Mariateresa Fichele, a psychiatrist and writer based in Naples, Italy. Fichele works in a public health facility in the bustling southern city of three million famously teeming with humor and heartache — not to mention unspeakably delicious food. Indeed, Naples has long been the setting for art, cinema and literature, including the celebrated series of novels by the pseudonymous author Elena Ferrante.

Fichele’s work, which she initially shared on Facebook in a mix of Italian and Neapolitan dialect, has the urgency of a professional notebook and the timelessness of city folk tales. Whether listening to patients or talking with neighbors, soaking up her crazy city or aching for her troubled country, hers is a certain truth in a particular place of the world we all now share.

A note on the name of the series

Dottoré! [doh-toh-RAY] comes from the shortened Neapolitan form of the Italian word dottoressa, or female doctor, with both patients and acquaintances often addressing Fichele as dottoré.

Worldcrunch publishes her writings each week in English (with an occasional sprinkling of napulitano), with the help of our own trusted Neapolitan-born translator and journalist Irene Caselli. Illustrations by another talented napulitana, Giulia d’Anna Lupo.

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Dottoré!
Mariateresa Fichele

A Sound Mind In A Sanitized Body?

Trying to put the "health" in "mental health" ...

Now with COVID, everyone thinks they’re experts in antibodies — even my patients.

“Dottoré, I've been taking drugs for 20 years because you say I'm sick, but couldn’t it be that maybe I'm cured, that now I have the antibodies, and you don't know?

"Gennà, unfortunately your disease is not caused by a virus, so you can't develop antibodies to fight it."

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Dottoré!
Mariateresa Fichele

Mightier Than The Sword

"What am I supposed to do with this, Dottoré?"

I have a patient who’s in great distress because of a physical peculiarity of his.

"Gennaro, did you know that in Ancient Greece, heroes, kings and all important men were said to have a small penis? Greeks associated small penises with moderation, one of the indispensable qualities of manhood — and therefore of a warrior. In contrast, a large penis symbolized the inability to manage impulses and act with intelligence and decisiveness. Actually, elderly men were often depicted as having large penises."

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Dottoré!
Mariateresa Fichele

Far From The Tree

"Mamma, do you know that when I grow up I want to be a surgeon?"

"And wouldn't you like my job instead?"

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Dottoré!
Mariateresa Fichele

Photographic Memory

Flipping through the pages of an old photo album with my nonna, I asked her, "Grandma, why were you all in black and white when you were young?"

She replied, "The war broke out. One morning we woke up, and all the colors were gone."

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Dottoré!
Mariateresa Fichele

The Wrong Meaning Of "Homotransphobia"

Hatred cannot be cured.

The term “homotransphobia” is not in any diagnostic manual of psychiatry. Phobias, like all pathologies, create suffering for those who are affected — and can be cured. Instead, the only ones who suffer from the effects of homotransphobia are its targets.

Those who are "afflicted" with this condition are people for whom prejudice and ignorance prevail; and when they act on the basis of this ignorance, they are criminals, not sick people.

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Dottoré!
Mariateresa Fichele

A Patient's Old Habits, A Doctor’s Call For Justice

Fifteen years ago, Francesco kept busy by scamming people. He was a regular visitor to the beaches of Terracina, south of Rome, where he was caught several times selling counterfeit Ray-Ban sunglasses. Then came the drugs, which fed a serious substance-induced psychosis and eventually he tested positive for HIV.

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Dottoré!
Mariateresa Fichele

Don't Anger The Patron Saints Of Calcio

From St. Paul to St. Diego...

"Dottoré, I know you’re going to say I’m superstitious and strange, you always give rational answers ... but I have to ask you a question: Is it true that ever since our stadium was renamed after Maradona, Napoli doesn't win at home anymore?"

"So?"

"Could it be that Saint Paul, to whom the stadium was initially dedicated, got offended and is making us lose now?"

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Dottoré!
Mariateresa Fichele

The Real Estate Of Psychological Disorders

To each mental illness, its castle.

The bipolar patient builds castles in the air, and when depression arrives, no longer needs them and destroys them.

Instead, the psychotic has the castle built for him, and locks himself inside.

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Dottoré!
Mariateresa Fichele

A Cave Of One's Own

"Who am I to be horrified by poverty while I have no means to offer relief, no alternative to show these people?"

Picture a cave, complete with a vault and yellowed walls. Inside, a single room with a small table, a double bed and a bunk bed. And there, imagine three brothers living together.

"Excuse me," I said, "but where is the bathroom?"

"Outside, Dottoré.”

"And the three of you live here?”

"Of course. This is our house. Mom and Dad raised six children here."

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Dottoré!
Mariateresa Fichele

From Nigeria To Ukraine To Naples, Childhood Words We Can't Forget

The scenes of the welcoming of Ukrainian refugees in Italy have been deeply moving.

I was particularly struck by the choral embrace in a Naples elementary school classroom of a beautiful child, happy but also embarrassed because he did not speak Italian.

It brought me back to a story that Chiara, a young patient of mind born in Naples to Nigerian parents, once told me:

"On the first day of school, the mothers of the other children looked at me strangely. One of them said to her son, ‘If she's in your class, make sure you sit far away and don't bring any illnesses home, because these must be people who just got off the boats.’

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Dottoré!
Mariateresa Fichele

Something To Be Afraid Of

One day a patient, after listing all his phobias, asked me:

"Dottoré, be honest, who's worse off than me?"

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Dottoré!
Mariateresa Fichele

Bygone Tips: My Not So Great Depression

“Dottoré, the reason why I am depressed is simple. But to explain it, I need an answer first. How much did you use to pay for a coffee?"

"Over the last few years, it was 80 cents, then 90 cents, and now one euro.”

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