Christ Stopped at Eboli is Carlo Levi’s memoir of his forced exile to rural southern Italy. He was a writer, painter and political activist from Turin, and because of his anti-fascist activities he was sent to the village of Gagliano in 1935 as a political prisoner. Stranded far from civilisation, and given the freedom only of the village limits, Levi turned his attention to his immediate surroundings. In this book, he writes beautifully and poetically about the inhabitants of the village, their way of life, and the lens through which they saw the world.
Unbeknownst to me, a major theme of the book turned out to be the provision of healthcare. Levi originally studied medicine at the University of Turin, but hadn’t worked as a doctor for several years at the time of his exile. He was initially reluctant to practise medicine in the village due to a lack of confidence in his skills, but he inadvertently made a better job of it than the dessicated old village physicians who had lived there for years. The peasants flocked to Levi because he was able to make a genuine human connection with them, even though he was an outsider, and it is this aspect of the book that I wanted to reflect on.
“Christ stopped short of here, at Eboli”
Christ never came this far, nor did time, nor the individual soul, nor hope, nor the relation of cause to effect, nor reason nor history…the seasons pass today over the toil of the peasants, just as they did three thousand years before Christ: no message, human or divine, has reached this stubborn poverty.
Upon moving to the village of Gagliano (called Aliano in real life), Levi encountered a land which was truly a world apart from his native northern Italy. The “Christ” of the title stands for religion, rationality and Western civilization itself. Society ran on the fumes of a medieval feudal system, and the peasants had to contend with abject poverty, squalor and disease. In one gut-wrenching passage, Levi’s sister describes the inhabitants of Matera, the main town in the region, the majority of whom lived in pre-historic cave-dwellings cut into the slope of a ravine:
The women, when they saw me look in the doors, asked me to come in, and in the dark, smelly caves where they lived I saw children lying on the floor under torn blankets, with their teeth chattering from fever. Others, reduced to skin and bones by dysentery, could hardly drag themselves about. I saw children with waxen faces who seemed to me to have something worse than malaria, perhaps some tropical disease such as kala azar, or black fever. The thin women, with dirty, undernourished babies hanging at their flaccid breasts, spoke to me mildly and with despair. I felt, under the blinding sun, as if I were in a city stricken by the plague.
Despite, or probably because of, these dire living conditions, the peasants had an intense feeling of connectedness – to nature and to every other individual person. They saw themselves as one small aspect of Nature in all its sorrowful terror, having lived beholden to the sun and the rain, the mosquito and the wolf for time immemorial. Since their neighbours all lived the same precarious life, with no chance of improvement or self-actualisation, they all felt each others’s suffering vividly and literally lived through it. This produced a profound bond of passive fraternity, or, in Levi’s words, sympathy in the original sense of the word.
Throughout the book it is clear that Levi was keenly sensitive to the villagers’ suffering, even though he was shielded from sharing in it by his status as a political prisoner and a doctor – this elevated him into the middle classes no matter how sheepish he appeared about it. Fearing for his own safety, he never openly railed against the exploiting “middle-class village tyrants,” but his sympathy for the peasants is apparent in the depth of his observations of their hardships. Rather than objectifying their suffering voyeuristically, he writes of the young children in the village with a lightness which could only be used to describe a equal human beings:
These boys, who had made the rounds at Christmas with their cupi-cupi and who ran through the streets like a bevy of birds ready to take flight, had no leader such as Capitano at Grassano. They were lively, wide-awake, and sad.
Levi relates how his compassion won him the peasants’ trust on his very first day in the village. Soon after his arrival, the family of a sick man found out he was a doctor, and pleaded with him to attend their relative. When Levi came, nothing he did availed, and as the man died and the onlookers began to wail in mourning, he quietly took his leave. But the next morning there were a dozen women waiting outside his window, imploring him to see their children and supplicating him:
Their faith and hope in me were absolute and I could only wonder at them. The sick man of the preceding day had died and I had been powerlesss to help him, yet the women claimed to see that I was not a fifth-rate doctor like the others but a good Christian who could help their children. Perhaps I owed their esteem to the natural prestige of a stranger whose faraway origin makes him a sort of god, or else to their perception that, in spite of the hopelessness of his case, I had really tried to do something for the dying man and that I had looked at him first with real interest and later with genuine sorrow.
It seems to me that compassion has to be understood as a feeling between two equal human beings if it is to be received and felt as genuine by the one who is sufferering. If patients feel objectified or patronised, then they won’t appreciate any quantity of superficial sympathy sent in their direction. This is why often a doctor expressing “interest and sorrow,” is not enough by itself: we must go further to show a high regard and respect for our patients. This appears to be what Carlo Levi did in the village of Gagliano, and it helps explain his success in building relationships with his patients in the face of so many challenges.
“Medicine, too, derives its power from magic”
The peasants of Gagliano had a deep mistrust of rationality, since they lived in a world which was so completely at the mercy of nature. In any case, they hadn’t felt a single benefit of said rationality, whether it was through science, technology or the policies of the State. Instead everything around them was bound up in natural magic, an all-pervading force which influenced the action of every living creature and inanimate object. This magic also made religion quite redundant, since everything was “actually, not merely symbolically, divine.” Having found this out, Levi reasoned that any public figure in the region had to understand and appease the force of this deep natural magic if they were going to smooth out the troughs of life for the peasantry.
He soon discovered that health was no exception to this rule. Magic underpinned the peasants’ understanding of how sickness could take hold of the body and how it could be driven away:
The peasants called jaundice male dell’ arco or rainbow sickness, because it makes a man change his colour to that which is strongest in the spectrum of the sun, namely yellow. And how does a man catch jaundice? The rainbow walks across the sky with its feet on the ground. If the rainbow’s feet step on clothes hung out to dry, whoever puts them on will take on the colours of the rainbow, with which they have been impregnated and fall ill.
…
The cure for jaundice was to carry the sick man at dawn to a hilltop outside the village. A knife with a black handle was applied to his forehead, first vertically, then horizontally, making a sort of cross. The knife was then applied with slightly different gestures, but still in the sign of the cross, to every joint of the body. This operation was repeated three times over, without skipping a single joint, for three consecutive mornings. Then the rainbow faded away, one colour at a time, and the sick man’s skin was white again.
What I find striking in the descriptions above is how earnest they are: Levi doesn’t adopt an ironic or disbelieving stance. He chooses to describe factually and precisely, neither passing judgement nor providing evidence one way or the other. This feels consistent with his practical approach to magic in all his interactions with the peasants: it’s not something to be argued against nor apologised for, it just is what it is.
Therefore, when he sees the peasants using amulets and incantations to ward off disease, or undertaking elaborate rituals to cure particular conditions, he doesn’t denounce or dissuade them, as they expect a young doctor like him to do. He reasons that since these amulets and incantations are essentially harmless, he would do better to respect them and treat them as an ally. Making an enemy of them in the name of reason and science would be counterproductive, as we can interpret from the bitter recollections of Dr Milillo, an older physician who did nothing to hide his contempt for the peasants and their beliefs:
He [said he] had lived in the place for more than forty years, looking after them all and showing them every kindness, only to be repaid by their saying he was senile and incompetent. Whereas he was anything but senile. It was sad to see the peasants’ ingratitude. And their superstitions. And their stubbornness. And so on, and so on.
Levi understood that although as a physician he was afforded middle class status, as an person he was still connected to the network of village society. Therefore he was bound by the same ‘rules’ of natural magic as his patients, and to be successful in his medical practice he had not only to abide by them, but demonstrate some affinity for this sorcery or magnetism to his patients. Without that, he would not have gained their trust in him or the treatments he prescribed.
I don’t believe this was collusion or charlatanism, but more a healthy sort of pragmatism. Patients come to us with all sorts of prior beliefs about their health, their illnesses, and potential treatments. It does well to remember that we and they are part of the same society, and sometimes the unfamiliar beliefs we encounter are not necessarily outside the accepted spectrum of views in the wider community. Most of the time it helps to work together in the patient’s world: when that’s not possible, the solution is often to understand the lens through which our patient looks out on it.
That means we have to be curious about our patients: who they are when they’re not being patients, what are their hopes and fears, who are the other people around them? When patients come to see their doctor, they offer up little windows into their lives, and it is our privilege and obligation to look inside and exercise that curiosity, since above all our patients want to be known as human beings. We need to give them that acknowledgement because it is at the heart of a fruitful relationship between patient and doctor.
Looking in through the window
When Carlo Levi was exiled to this remote corner of southern Italy, I don’t imagine he expected to find it such a foreign place to him, and he certainly wouldn’t have been prepared for pressing his medical skills into action. The publication of Christ Stopped at Eboli created a national scandal in Italy which led to concerted efforts to improve living conditions in the Basilicata region after World War II. For me, the most admirable thing that comes through in this beautifully written book is how earnestly Levi makes connections with the people around him, and how sincerely he sees the humanity of his patients.
Picture credits:
- Image from Matera Welcome – Tourist office of the Municipality of Matera, under Creative Commons BY SA 4.0. https://www.materawelcome.it/en/perche-matera/i-sassi/ ↩︎
- Image from Wikimedia Commons, under Creative Commons BY SA 3.0. upload.wikimedia.org/wikipedia/commons/9/96/Lucania_61_di_Carlo_Levi_5.JPG ↩︎
- Image from Matera Welcome – Tourist office of the Municipality of Matera, under Creative Commons BY SA 4.0. https://www.materawelcome.it/en/luogo/casa-grotta-di-vico-solitario/ ↩︎