The doctor and the cognition of pain

What is the right distance from evil, from one's own and others' suffering? Each person must find it for themselves, through constant adjustments. It coincides with a delicate balance, which allows for empathy, but only until the pain of others turns us to stone, like Medusa's gaze. Giorgia Protti (Turin, 1988), an internist in an emergency room for many years, finds the equivalent of Perseus' shield in her vibrant and sharply precise writing: The Right Distance from Evil (Einaudi).

The first hundred pages are worthy of anthology. The emergency room becomes a theater where the eternal human comedy is played out in the most extreme and transparent way. The protagonist visits hundreds of cases day and night: head injuries, renal colic, cardiac failure... (the hypochondriac reader will identify with it to a greater or lesser extent). What is striking is the meticulous description of the phenomenology of human behavior , worthy of French moralists. Take dignity, a concept that spills over from the ancient world into modernity, and which Christianity sought to demolish. A patient with a broken femur cries and screams like a child, while another, gripped by colic, displays an unusual understatement and allows himself sarcastic quips between one pang and another. Should we admire this? Dignity is always ultimately "disintegrated by pain."

The book oscillates between memoir and reportage on the emergency room of a large hospital: those who work there hate residential care homes, which inexhaustibly dispense diseases, but are in turn viewed with suspicion by those working in other hospital departments, to whom they refer the most problematic patients. Then there are the "high school class" dynamics between doctors and nurses, the admission that diagnoses are often mistaken, the fatal uncertainty of the profession ("abdominal pain is the doctor's grave" no matter how many organs the belly contains), the obnoxious posture of the chief physicians, etc.

There are three categories of patients: the "lazy" (they have nothing special, prefer the early morning, and are exasperating), the truly sick, and those who have nowhere to go (the homeless, the poor, etc.). A visionary and Faustian narrative unfolds within the field investigation , in which none other than the devil appears to the doctor, part hippie in a Rolling Stones T-shirt, part illegal parking attendant. Lucifer does his job well. On the one hand, he takes advantage of a moment of weakness in the doctor, dumped by her partner ("Aren't you tired of this miserable life yet?"), on the other—by asking her to help him take the soul of a desperate alcoholic—he reveals his "logical" attitude. Even if there is no true happy ending, we are saved only by experiencing pain again, breaking the "cocoon of darkness" that encases the soul, and learning the art of maintaining the right distance between paralyzing empathy and frozen indifference. Perhaps Doctor Chekhov was right: the only cure is a patient, attentive gaze.

The book – The Right Distance from Evil by Giorgia Protti (Einaudi, 256 pages, €19.50)