Nuts To Starbucks

Brigida, you’re like a cup of coffee, bitter on top but sugar underneath. I’m going to stir and stir to get your sweetness from the bottom of the cup into my mouth.

- Neapolitan song

When I was a kid there were three foods I hated: Coca-Cola, peanut butter, and coffee. Now there are only two, because coffee, like flattery and sports cars, is one of those things Italians do better than anyone else.

Everybody agrees the very best brew is the intense nectar made in the bars of Naples, where coffee is a cult as well as a metaphor. Nobody really knows why. Some think the secret’s the choice of beans, others the roast, others the water. More mystically-minded locals believe it lies in the ritual – “Here coffee isn’t loved because it’s good, it’s good because it’s loved.”

Neapolitans make the best coffee at home too, with an ordinary stove-top machine, because of their attention to detail. Here’s some of their tricks: break in any new Moka pot with a plain-water dry run, never contaminate its inner surfaces with soap, fill with water just so, choose the best beans (Illy will do), heap your grounds into a perfectly calibrated mound, resist the urge to tamp it down, set your flame to barely cover the base, leave the cover left open for aeration, drop a little bonnet over the central post to prevent spray, turn off the heat just in the nick of time, give it a quick stir in the pot before pouring, and never ever reheat. Try, but you’ll never quite make the grade.

Italians traditionally end every meal with an espresso and seem always to be wandering off to the corner bar to knock one back. But when it comes to total coffee consumption northern Europeans win hands down – Finns average 21 pounds of dry beans per capita per year, Italians just seven and a half.

A hard-core Italian coffee lover drinks his espresso straight up, no milk no sugar, like a Bourbon lover who disdains water and ice. I say he advisedly, because women are expected rightly or wrongly to prefer theirs served up in gentler form. My colleague Vincenzo likes his coffee lungo, with extra water, but in a bar the long one will inevitably be set down in front of me rather than him. When my husband and I order one plain and one macchiato I always get served Alvin’s, the one with a touch of milk.

Italian espresso is so dense with flavor that people think it must also be loaded with caffeine. Wrong – it actually packs less of a punch than any other form of java, because steam rapidly forced across the ground beans doesn’t extract as much caffeine than water dripping through or soaking or God forbid percolating. For decades coffee was framed for bringing on all kinds of diseases, based on the puritanical conviction that anything pleasant must be bad for you. True, coffee won’t help if your nerves are already on edge (Hag is the brand name for decaf), and it’s hell on heartburn. But I am pleased to be able to report that medical researchers have not only let coffee off the hook from causing heart attacks, but even speculate it might help ward off – hold your hat – blindness, Parkinson's disease, type 2 diabetes, liver disease, atrial fibrillation, heart attacks, stroke, and cancer.

P.S.: If there are Italians in sight, don’t end your meal with a cappuccino. If you insist and the waiter looks at you funny, try telling him it’s for medical reasons.

P.P.S.: How come at Berkeley’s Market Hall they fuss around for ten minutes to produce a mediocre cappuccino when any barista in Rome can produce a great one in 30 seconds flat?

P.P.P.S.: If you ask for a latte in Italy what you’ll get is a plain glass of milk.

In The Beginning: New York To Rome By Way Of Africa

November 1978, eleven at night, five weeks after my then-husband and I had left New York for good, just inside Tanzania. The two soldiers who stopped our truck were so drunk they barely managed to keep their bayonets pointing in our direction. Andrea and I, about to close our six-week African parenthesis before settling in Italy, obediently climbed down to be escorted at riflepoint to the tent of an equally sloshed camp commander, who dressed us down and ordered the protesting driver to haul us back to Kenya. An abrupt closing of the Tanzanian border, due to fighting near Uganda, had dashed our dreams of watching lions stalk wildebeest at Ngorongoro Crater and smelling the cloves in Zanzibar. Public busses between the two countries had been halted, railway lines had never existed, Andrea’s awkward stab at bribing a ship’s captain had fizzled, and our final attempt to cross the border, by hitchhiking, had now met the same fate. The trucker fumed all the way back across 10 miles of no-man’s-land and dumped us at the Kenyan border station.

There were two benches outside, narrow, wooden, and painful, where we got snatches of sleep until a workingman’s bus stopped at dawn, en route to Mombasa, and picked us up. In my dreams that night I said farewell to my American life. That dusty nowhere in Africa seemed to straddle not just the edge between two countries but a watershed between my old world and my new one. Perhaps it was facing those bayonets as a couple that hammered it home: I really had thrown in my lot with my Italian husband and with the unknown. When our plane took off from Nairobi a week later, I was ready to leave all certainties behind and begin a joyful adventure in chaos.

Chaos aplenty awaited us, joy zero. The Rome we touched down in was bewilderingly dark, depressed, menacing, with none of the raucous street life that had seduced me as a tourist a few years back. Just months earlier former Italian Prime Minister Aldo Moro had been kidnapped by the leftist terrorists of the Red Brigades. When he was murdered and his body dumped two blocks from his Christian Democratic party’s headquarters, it made headlines around the world.

The oil crisis was at its peak, forcing restaurants to close at 9 pm when in normal times people would have just been sitting down to eat. Trigger-happy cops manned the intersections, and the few pedestrians scurried like rats from doorway to doorway. My personal gloom deepened when I learned my Italian medical license wasn’t there waiting for me, as a nice but ignorant lady in the New York Consulate had promised.

Fortunately everything came right in the end. Yes, the license took a year and a half to come through, but by 1981 Rome had regained its bustle and I had launched a medical practice that would with time become the envy of my American colleagues. I’ve gotten to play the old-fashioned country doc for decades, treating three and four generations in the same family, while enjoying a clientele – one-third American, one-third Italian, one-third miscellany – that’s included Kenyan diplomats, English nannies, Burmese nuns, Italian auto mechanics, and Nobel laureate poet Joseph Brodsky. I have the world’s best medical secretary. I practice blissfully free from the diagnostic coding and insurance company pre-authorizations and electronic medical record regulations that torture physicians in the US, and I can choose for myself which medical guidelines to follow and which to ignore. OK, I haven’t had the peace of mind that comes from top-notch hospital backup, or accumulated a fat investment portfolio like my colleagues back home, but between the professional plusses and the glorious Italian lifestyle I wouldn’t exchange my Roman career for any other.

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A slightly modified version of this post is being published simultaneously in The American In Italia as the first entry in my new column, Bedside Manners.

Abortion, Birth Rates, The New York Times

As the Italians say, it’s been raining on wet ground. Following my recent blog entry on contraception in Italy I received several emails from readers asking whether the rock-bottom Italian birth rate might be the result of a sky-high abortion rate. By amazing coincidence, two days later the New York Times published an article about abortions in Italy and how hard it can be to get one. So the subject matter of this post is overdetermined – I get to write a wonky post about abortions in Italy at the same time as firing off a Letter to the Editor.

Amazingly, the Italian Parliament legalized first-trimester abortion in public hospitals back in 1978, making it available on demand and free of charge on the National Health Service. Three years later a nominally Catholic electorate roundly scotched a Church-promoted national referendum that tried to re-criminalize it. The Church retreated licking its wounds but eventually hit on an excellent means of sabotage: conscientious objection. The law’s option for gynecologists to refuse to participate was originally intended to remain buried in the fine print but by now 70% of all Italian gynecologists are registered as conscientious objectors. So waiting lists, despite shrinking due to the increasing use of pills rather than surgery, are still scandalously long. One out of three women seeking a legal abortion is given an appointment more than two weeks away, which drives many (20%, it’s estimated) to get one illegally instead.

As the Times article points out, it’s obvious that conscientious objection and Catholicism are related. But the Church uses stronger weapons than mere moral persuasion in its promotion. I explain in the letter I submitted (in vain) to The Times:

To The Editor,

In her otherwise excellent article, “Abortion in Italy, a Right Wronged,” Ilaria Maria Sala omits one crucial element in why so many Italian gynecologists register as conscientious objectors. In addition to the genuine religious convictions of some, and the fear of others that performing abortions would tarnish their reputation, there are more practical threats to their livelihoods. Abortions are performed only in public hospitals, by gynecologists employed by the National Health Service. Many public system gynecologists, however, want also to be able to treat their own patients, after hours, within a large network of private hospitals which in Italy are mostly owned and/or run by the Catholic Church. Any physician who performs abortions – supposedly, any physician who even just counsels patients about them – is barred from operating, delivering babies, or hospitalizing patients in any Church-run institution. Thus a gynecologist who wants to be able to work privately in Italy is virtually obliged to declare him- or herself a conscientious objector to abortion.

So to get back to our original question, do abortions have a big influence on Italian birth rates? Nope. Italy has one of the lowest abortion rates in western Europe. In proportion to the number of babies born alive Swedish women have 40% more abortions than Italians, French women 35%, English and Spanish about 18%. And only one in five abortions performed on Italian women is a repeat procedure.

Since legalization there have been fewer and fewer abortions in Italy, especially among citizens – non-Italians, many of them immigrants from developing countries, now account for one in three.

The bottom line is that the Church has indeed succeeded in mounting barriers to abortion, especially in southern Italy, but those barriers can be overcome. And women here don’t have to run the gauntlet of demonstrators you find screaming abuse outside the entrances to abortion clinics in the USA. And no one has ever shot an Italian abortionist.