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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

Delusions Of Grandfather

"And where is your grandson?" — "Who knows. He must be old by now."

“Dottorè, do you know that I am a grandpa?”

When Gennaro told me this, at first I thought he was being delusional. But then I looked into his eyes: They were lucid — not because of the drugs his psychiatric treatment required, but from some strong emotion, something real that had at last lit up in his gaze.

Gennaro had to have a grandchild somewhere, and therefore also a child.

Yet, he had spent his life in a psychiatric hospital until 1994, and when he left the hospital, there was no trace of his previous life.

"And where is your grandson?"

"Who knows. He must be old by now. Maybe he's a grandfather himself. I've only seen him once: My son brought him to meet me outside the Leonardo Bianchi psychiatric hospital, when it was still open. He was ashamed to bring the baby there, it was the first and last time he came to see me.

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Dottoré!
Mariateresa Fichele

Sowing The Seeds Of Paranoia

"They must be dumping garbage — good, it makes for good fertilizer!"

"Dottoré, I know a lot of flags, and let me tell you why. I grew up in the province of Caserta, and — like everybody in those days — my parents owned a piece of land, and they would take me with them to farm it.

I remember there were other kids in the fields around us. But then, slowly, we were the only ones left because everybody was selling the land, making a lot of money off of it too.

Papà wouldn't listen to reason and he kept the land. But in the meantime, instead of farmers, trucks began to arrive. Many many trucks, unloading thousands of barrels and burying them into the ground.

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Dottoré!
Mariateresa Fichele

Of Rats And Men

Our Naples-based psychiatrist remembers a 2019 conversation with a patient on the geopolitics of pest control.

"Carmela, how long did you have to fight rats entering your house?"

"Eh, Dottoré, for years!"

"And how did end up solving it?"

"I adopted three cats that were in my street!"

"And then what happened?"

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Dottoré!
Mariateresa Fichele

The Political Revelation Of A Windshield Cleaning

Charity may begin at home, but for our Naples-based psychiatrist, it also begins behind the wheel.

Every time we stop at a traffic light, the same scene takes place between my husband and me.

It goes something like this: Someone approaches our car to clean the windshield, I tell my husband to turn on the windshield wipers, he gets outraged and tells me I’m a horrible person.

But then, if we've instead decided to give them something in exchange for their service, my husband somehow never has any change on him. I always manage to find some, and feel obligated to give the person whatever I've found.

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Dottoré!
Mariateresa Fichele

Vending Machine Blues: The Rising Cost Of A Healthy Break

"Dottoré, do you have 1.50 euro by any chance?"

Until recently, if you entered a Mental Health Center, you might be approached by a patient who asks you for a cigarette or a euro to buy a coffee.

But since they installed vending machines, things have changed, and the requests have become more specific.

The other day, a patient approached me and asked, "Dottoré, do you have 1.50 euro by any chance?"

"Pasquale, don't you think that's a bit much? What's the money for?"

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Dottoré!
Mariateresa Fichele

Social Media Envy Is More Than Just Your Imagination

Our Naples psychiatrist's view on unrealistic social media standards, feeling inadequate, and the price of happiness.

Some of my female patients are struggling with the way life is exposed on social media. It is becoming extremely problematic not only in relation to the beauty standards exhibited online, but also the family models that are exposed.

Some women — who struggle with their role as working women and mothers or housewives — have difficulty in understanding that behind a bright young entrepreneur who constantly shows herself on social media as a loving mother and wife, immersed in an opulent and perfect reality, there is a hidden world of waiters, nannies, makeup artists, hairdressers, drivers, airplane pilots and photographers, who certainly do not appear in videos and Instagram stories.

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Dottoré!
Mariateresa Fichele

A Confession At The Holy Church Of Therapy

"Who do you think I am," our Naples psychiatrist asks her patient, "a priest?"

As soon as I arrive at work, I get a call from a patient who says he urgently needs to talk to me:

"Ciro, what’s the matter? What happened?"

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Dottoré!
Mariateresa Fichele

Remembering Papà, And The Ultimate Driver's Test

A psychiatrist unpacks her relationship with driving, and her dad.

I remember vividly the night I came home with my newly obtained driver's license. I was 18 years old.

My mother congratulated me. Papà, on the other hand, took the document from my hands and said: "You will only get this back when you pass the most important test. Mine."

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Dottoré!
Mariateresa Fichele

Miscarriage And Motherhood, When Pregnancy Is A Battlefield

"There’s still a pulse," they told me, surprisingly.

They call it 'recurrent abortion.' Your test shows up positive but then you end up losing the pregnancy in the first few weeks. I've lost count of how many times this happened to me.

I do remember the last time, though. I was eight weeks pregnant. I got up one morning and found myself in the usual pool of blood. I was so used to it that I didn't say anything to anyone. I called a cab and asked the driver to take me to the ER.

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Dottoré!
Mariateresa Fichele

A Very Neapolitan Hatred For Summer

Volcanic outburst about heatwaves and impossibility to cool off.

Such awful heat that you can’t even be naked, mosquitoes that eat you alive, sweat that sticks to your skin, the kids that want to go to the beach and the money you spend sending them there, the craziness that grows inside your head and not even a cool shower can help you cool it off …

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Dottoré!
Mariateresa Fichele

Naples Wasn't Built In A Day

"Do you realize that this changes everything for me?"

Locals have always known that the Sanità neighborhood in Naples was a place full of traces from a distant past. But since news has spread that visitors must now pay 25 euros to access the Hypogeum of Cristallini street, located under an ancient noble palace, residents are feeling a new sense of confidence.

Anna, for example, lives not far from the archaeological site.

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Dottoré!
Mariateresa Fichele

The Walls Of A Loving Home

Ciro was waiting for me at the hospital entrance. He had been told the psychiatrist was coming.

"Dottoré, please let me come up with you, I need to see him and tell him I love him."

Two days earlier, he had found his father lying in a pool of blood. He did not understand why his father had done it, he just couldn’t wrap his head around it.

Because his father, Antonio, was a decent person. A hard worker.

Then the pandemic hit. His job as a street seller did not earn him enough to feed four children. So he had to turn to loan sharks.

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