Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

An American doctor in Rome

Susan Levenstein, MD
Physician
September 21, 2019
98 Shares
Share
Tweet
Share


An excerpt from Dottoressa: An American Doctor in Rome.

When I migrated from the banks of the East River to the Tiber shores the path was strewn with bureaucratic boulders, land-mines, and pitfalls. I offer the tale of my odyssey as an object lesson to would-be fellow cosmopolites in that art of abandoning all hope the Italians like to call pazienza.

The idea was to try working in Rome for a year and see how it went. This sensible American plan collapsed under the weight of Italian bureaucracy.

Luckily I didn’t investigate every angle before starting off; if I had known the true lay of the land I might not have kept going after that Italian medical license like a donkey after his carrot. I’d have taken a job in some clinic in the Bronx, where I’d be seeing four patients an hour to this day. Instead, I made those steps you can’t retrace: gave up my three-bedroom apartment on the Upper West Side with views of the Empire State Building and the Tri- borough Bridge, and sold my Dodge Challenger convertible to a pinky-ringed Turkish importer-exporter who planned to strip it down to the skeleton of an Oriental low-rider.

Months beforehand I started focusing my Manhattanite efficiency on getting registered in Italy, my Italian husband leading me by the hand through the wilderness of Old World red tape. The first step was “getting my documents together,” an Italian ritual repeated before every encounter with officialdom. Sticking to a list kindly provided by the Italian Consulate, I collected my birth certificate, passport, high school diploma, college diploma, college transcript, medical school diploma, medical school transcript, certificates of internship and residency, National Board Examination certificates, American Board of Internal Medicine test results, and specialization diploma. Then I got them transfigured into Italian by the one person in New York authorized by the Italian Consulate to crown his translation with an imprimatur. We judiciously gave him a set of our own translations as crib notes, tailored by my husband to match the Rome medical school curriculum.

I wrote a cover letter from Andrea’s dictation. It had to be in my own hand, on a folded sheet of double-sized pale yellow ruled Italian paper embossed with a State seal, and had to be addressed “To the Magnificent Rector of the University of Rome.” You have to live in Italy a while to appreciate the theatrical elegance of making every fiddler a Maestro and every teacher a Professoressa; even the most corrupt member of the Italian parliament is by definition Honorable, and every client of a parking lot is by default, for lack of any higher title, a Doctor (“Back up, Dotto’, turn the wheel hard to the left, Dotto’”).

There came the proud day in June when I got to deposit the stack of documents in front of a smiling consular official in red nail polish and Armani. After expressing puzzlement that an American doctor would want to move to her country (“You medical people have it so good here”), she Xeroxed my certificates, transcripts, and diplomas, made squiggles on the back to certify the Xeroxes were “authentic copies,” gave me back the originals, and assured me that she’d get things processed zip zip in Italy so that by the time I left for Rome three months later I’d have my Italian license and be ready to get a job. Don’t call me, I’ll call you.

When we were about to fly in September and I still hadn’t heard from her, I went to check. Found the Xeroxes piled up on Signora X’s desk right where I’d left them, and the Signora gone for a month’s vacation. Slightly put out, I snatched up the stack to hand-carry over (re-inventing a common expatriate method for avoiding challenges to the efficiency of the Italian mails), prepared to do battle with the system on its own territory.

Glossary: pazienza

Patience squared. An essential Italian virtue, often invoked as a gentle reprimand for a foreigner’s loss of cool. When the grocery is out of milk, or an unannounced bus strike cancels your next patient’s appointment, the word to say (with palms upturned) is pazienza. It extends beyond the prosaic “keep waiting” to the philosophical: you have just experienced yet another reminder that the universe is fickle and, if not haphazard, certainly not designed with your benefit in mind.

In Rome, the person in charge of equipollenza, or training equivalency, was located at the Foreign Ministry. I got into that mass of marble by depositing my passport at the front desk, and was escorted through dimly-lit halls wearing a temporary ID badge on my lapel and clutching my little pile of documents. The diminutive official took a glance at my grimy Xeroxes and harrumphed a little laugh through his moustache. The colleague at the New York Consulate had unfortunately gotten several things wrong, he said.

First a procedural error: the “authenticating” squiggles on the back of the copies were meaningless. They didn’t even vouch for the accuracy of the photocopying, much less prove the validity of the originals. All the documents would have to be sent back and scattered around the USA for proper authentication, by local Italian consulates. For example, the Italian Consul in Boston had to testify that Harvard was a degree-granting university.

Second, the Consular list had omitted a crucial document, the Certificate of Existence in Life. No, the mere observation of me stamping my foot and tearing my hair was not, for the Italian government, sufficient proof that I existed. Yes, a nonexistent person was unlikely to be asking for an Italian medical license, but rules were rules. The Consulate’s final error was a bit of misinformation, bred, perhaps, of tenderheartedness. All these documents couldn’t possibly get me an Italian license. They would merely get me a toehold in the University where they might, at best, be alchemized into an Italian medical degree, but an actual license would be another and rather more difficult question.

This was my first lesson in Italian bureaucracy. The Consular official in New York clearly hadn’t had the faintest idea what she was doing and no intention of trying to find out, but she had found me too simpatica to disappoint—a sentiment not strong enough to keep her from abandoning my application to gather dust.

Susan Levenstein is an internal medicine physician and author of Dottoressa: An American Doctor in Rome.

Image credit: Shutterstock.com

Prev

Should the government regulate hearing aids as consumer electronic products?

September 21, 2019 Kevin 2
…
Next

A mercy killer in the ER

September 22, 2019 Kevin 0
…

Tagged as: Primary Care

Post navigation

< Previous Post
Should the government regulate hearing aids as consumer electronic products?
Next Post >
A mercy killer in the ER

More by Susan Levenstein, MD

  • An update on COVID’s long tail

    Susan Levenstein, MD
  • COVID-19 vaccines: the state of the art

    Susan Levenstein, MD
  • A summary of state of the art COVID treatment

    Susan Levenstein, MD

Related Posts

  • Asylum seekers: a snapshot from an American physician’s lens

    Madeline Cohen and Gauri G. Agarwal, MD
  • An American physician in Sweden. Here’s what he thought about its health care.

    Richard Young, MD
  • American physicians deserve timely payment

    Peter Ubel, MD
  • Osler and the doctor-patient relationship

    Leonard Wang
  • Finding a new doctor is like dating

    R. Lynn Barnett
  • Doctor, how are you, really?

    Deborah Courtney

More in Physician

  • The hidden gems of health care: Unlocking the potential of narrative medicine

    Dr. Najat Fadlallah
  • The dark side of immortality: What if we could live forever?

    Ketan Desai, MD, PhD
  • It’s time for C-suite to contract directly with physicians for part-time work

    Aaron Morgenstein, MD & Corinne Sundar Rao, MD
  • From rural communities to underserved populations: How telemedicine is bridging health care gaps

    Harvey Castro, MD, MBA
  • From solidarity to co-liberation: Understanding the journey towards ending oppression

    Maiysha Clairborne, MD
  • Finding peace through surrender: a personal exploration

    Dympna Weil, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Why it’s time to question medical traditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden gems of health care: Unlocking the potential of narrative medicine

      Dr. Najat Fadlallah | Physician
    • The realities of immigrant health care served hot from America’s melting pot

      Stella Cho | Policy
    • The dark side of immortality: What if we could live forever?

      Ketan Desai, MD, PhD | Physician
    • Lazarus: the dead man brought back to life

      William Lynes, MD | Conditions
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Doc Moms, Mind the Gap -- $3M Earning Difference by Sex
  • Clinical Note Writing App Powered by GPT-4 Set to Debut This Year
  • Helping Patients Get Fit -- One Walk at a Time
  • TB Cases Rebound to Near Pre-Pandemic Levels, CDC Data Show
  • Marginalized Groups May Benefit More From Decreasing Air Pollution

Meeting Coverage

  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Why it’s time to question medical traditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden gems of health care: Unlocking the potential of narrative medicine

      Dr. Najat Fadlallah | Physician
    • The realities of immigrant health care served hot from America’s melting pot

      Stella Cho | Policy
    • The dark side of immortality: What if we could live forever?

      Ketan Desai, MD, PhD | Physician
    • Lazarus: the dead man brought back to life

      William Lynes, MD | Conditions
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

An American doctor in Rome
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...