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Tobino courageous writer and psychiatrist

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It seems right and proper to recall the figure of Mario Tobino, courageous writer and psychiatrist. Courageous because it was the only voice out of the chorus, applauding the subjects who criticized and opposed to the theories basagliane.

I would bring my article published last year.

Mario Tobino Writer and Psychiatrist brave

If in life we \u200b\u200bwere given by lot, as children, or at most as teenagers, they can throw for a moment, look into our future and see ourselves as adults, at some point in our future existence, if only for a small but significant stage of our states on the stage of life, of our existential comedy, then perhaps many of us give up living, perhaps many of us withdraw from representation, but some of us, me including, for whom childhood and adolescence was not exciting at all, they might have lived and endured a little more gently and sympathetically the weight of the awkward age and suffered, in spite of what the clichés read on happy innocence of childhood and the carefree joy of childhood.

If during a task in class before the paper version of the incomprehensible latin, or greek, or a question to the board, under the gaze of unflappable and inscrutable Professor of Mathematics and abstruse in front of a formula, from which you would have to get a result, clear and evident to all, except for me , I had almost miraculously, the insight that all this would end one day, maybe the shock, terror, the dramatic sense of loneliness, feelings of inadequacy and failure unbridgeable, the despair of what is considered without end, it would was certainly not abolished, but somehow endured a little better.

If, during the long years of university studies of medicine, if before the exams difficult and required a long and painful preparation, if for two years when I left school for a severe depression and have never thought that I could graduate, if for two years when I was a traffic policeman in Rome, having declined to be doctor, I had insight that everything would be over and he would happily resolved, I would certainly lived in a less desperate those years.

If, when, in the early seventies, medical students are a beginner, and having already decided he wanted to be a psychiatrist, looking for a reference point, a model to follow, an ideal to be taken such as in an atmosphere of total loss, when I had my readings as an argument that had the folly and as the protagonist, a psychiatrist and author, if in those years of searching for an identity, so I had to project, even for a moment, in the distant future, by means of a sci-fi car precisely in time and a distant 19 January 2009 and I had seen, only on the stage of the beautiful Municipal Theatre of Lucca, in front of an audience of more than eight hundred people filled the auditorium and the stage of the theater, up the gallery, to commemorate the figure, the character of a citizen of the Opera, Mario Tobino, psychiatrist and writer, I never thought in my eyes, and I thought of a tragic error of fantasy, a tragic misunderstanding, to a cruel joke.

What, me? Named to commemorate Mario Tobino? The psychiatrist and writer who, since I had discovered through his most famous works, "The liberal women Magliano" and "To the ancient stairs" without his knowledge, had elected him and assumed the role of mentor and teacher, figure of reference, role model and inspiration which ideally and emotionally, for example to follow?

Finally, then, I had found a true and real figure whose inspiration and reference, even if unattainable, though known only through his books, his novels, his poems, his stories and some interviews and photography I had made the newspapers. Times of the Internet were still desperately distant and it was impossible to document, as now, through the "network" which did not exist.

Tobino Mario was born in Viareggio in 1910 but lived most of his life in Lucca, or rather in May, a town close to the city and home of the asylum he himself directed, Lucca, who rewarded him for His love and His loyalty by conferring honorary citizenship in 1987, died in 1991 in Agrigento, the birthplace of Luigi Pirandello, where he had gone to receive the award at the Playwright called Palermo.

The same wanted to commemorate the city of Lucca, a year after his death, your memory while raising Sanitarium, within this, on the wall of the Medici family, where Mario Tobino had always lived, even after retirement, dealing with two "little rooms "used as a dwelling, a plaque engraved with the best, most honorable, the most moving tribute that never The you could spend a phrase from his masterpiece, his first book that I had the pleasure and honor to read, "The liberal women Magliano": " My life is here in the Asylum of Lucca. Here starts my feelings. Here I am sincere manifesto. Here I see sunrises and sunsets and the time goes to my attention. Inside a room of the Asylum Study men and love them. Look here: glory and death. From here on holiday. Here, so far I have returned. And my desire is to make every grain of this area a quiet, tidy, universal talk. "

few, simple, tidy, singular words that enlighten us in a moment, with lucid precision and touching emotion, soul, simplicity, intellectual clarity, the feeling of Mario Tobino, which took in His life only a single purpose: the care and love for your sick, what should be the only or the supreme and the main goal of every doctor.

And that single, ultimate goal, Mario Tobino continues to pursue it even now, even after His physical death, but not moral, through his books, his writings, all together, dealing with them for Asylum and sick of war in Libya, of partisan struggle, love, Dante Alighieri, of fascism, of autobiographical memories.

And the soul of Mario Tobino was, in my opinion, but not only in my opinion, quell'ormai distance, but close in memory and emotion, January 19, 2009, in the Theater of Lucca, near us, near His fellow next to me, close to your city, but especially close to his patients, whether they are with him present among us, that we talked about Him and Them.

Tobino Mario, the writer was certainly enough for this slide his bibliography, even before becoming a doctor and then a psychiatrist.

Psychiatrist and full as it was certainly attest to the forty years spent in a mental hospital in the management of the asylum, living in the asylum itself, folding there, inside, the days of your life, your existence.

But why "courageous", as the title that I wanted to give this paper?

To answer this question, legitimate and necessary to this question, we must take a step back and examining the life of Tobino that intersects, is part of the life and history of psychiatry, particularly Italian.

Tobino graduates, in fact, in Medicine, in Bologna in 1936, after fulfilling his military service in Alpine. Discharged specializes in Neurology and Psychiatry and began working in the psychiatric hospital of Ancona. At the outbreak of World War II is recalled and posted on the Libyan front, where he remained until 1942, when wounded and disabled, is returned.

By the way the experience of a medical officer in Libya led to two beautiful books, "The desert of Libya "in 1952 and" lost love "in 1979.

returned to Italy, start working as a psychiatrist in Asylum Maggiano, where it will remain forever.

Here I captures the September 8, 1943 and participates actively in the resistance against fascism in Tuscany.

From this experience, born in 1962, a book, unique of its kind that I propose as a historical reading in schools: "The Clandestine." In Tobino it describes, with great acumen, but also extraordinary objectivity and intellectual honesty, the climate of civil war that saw Italians oppose other Italians, often within the same families.

intellectual honesty and objectivity all the more evident and appreciated, if one considers that Tobin. His private, took a clear position and clear, active and unmistakable.

After the War continue to occupy Also in May of his patients and its literature.

I forgive this accuracy is chronological in the life of Mario Tobino, maybe boring but necessary, to answer the question and understand the meaning of "brave."

Mario Tobino had, in fact, the lot, I can not tell the fortune of live, to participate, to be a witness of the three key historical periods that characterize Psychiatry and Italian in particular.

The years of the degree of specialization and the long war, are those in which Psychiatry is, unless the contributions made by psychoanalysis, but in a specific matter and not purely scientific, essentially that of the previous century, a psychiatrist mental hospital, where psychiatrists, real Cinderellas of Medicine, in the absence of valid and effective therapeutic tools, which was reserved the task of diagnosing mental illness and describe their characteristics and their evolution and, alas, only keep people with these serious diseases, in suitable environments, mental hospitals, where one could take care of them, especially avoiding that nocessero to themselves or others. Nothing more was given to, knowledge of the time.

only truly therapeutic tool, it was so notorious Electroshock, invented by Cerletti and Bini in Rome and that, far from being the instrument of torture that would have us believe, and despite the many prejudices of ignorance, continues to save lives and be a valuable therapeutic tool in specific situations, when and where it can still be used, for example in Anglo-Saxon countries and in civilized Europe, except in Italy, of course, where the injury is king.

This dramatic situation of immobility and impotence therapy against mental illness, was stopped, ended, almost miraculously in 1952, when it was discovered, by chance, the first psychotropic drug, chlorpromazine , active on delusions, hallucinations, the state of severe agitation in schizophrenia and other mental illness as serious and hitherto totally incurable.

The annus mirabilis 1952, is the watershed, the red line on the border between a psychiatrist and only institutional care and a psychiatrist for therapeutic purposes, for the first time in its history, has, like the other branches of medicine, drugs, effective medicines designed to treat mental illness so far left behind, abandoned to their natural evolution.

At this point the road was open el'armamentario therapeutic psychiatrists became rich soon, other medications are similar to the first and with the same therapeutic indication, which was given the name of neuroleptics.

Shortly after the fate of other mentally ill, suffering equally in soul and body would change, with the synthesis of drugs to treat and cure another disease as serious and a cause of acute and severe pain: depression.

not rhetoric to say that the antidepressants to depressed patients returned the smile, returning to life and also to psychiatrists, for the first time they had in hand a valid and effective instrument for treating and curing the depressed patients they turned for help, against first of them nothing could, if not the human closeness and understanding. Finally

were synthesized in the 60s, benzodiazepines, substances with an activity specifically anxiolytic and muscle relaxant.

The therapeutic use of psychotropic drugs, radically altered the work of psychiatrists, which was not resolved and no more than summing up, only in the diagnosis and description of the symptoms of diseases, but also, and finally in the care of them.

But more than that and more, the advent of psychotropic drugs and only one, radically altered the external appearance and internal condition of nursing homes, asylums, only the first areas of custody of the unfortunate patients, who once entered into they rarely came out, and now finally and for the first time "hospitals" in the modern sense of the word, places where diseases are treated, at best, and also healed from which you enter, but it comes out.

The advent of psychotropic drugs and only those, I repeat without controversial ideas, but with strength and conviction, allowed the birth of a new logic, a new philosophy towards mental illness, and then in the care of this, but in practice care of sick people, for the first time were no longer, as I said before, just because nocessero kept to themselves and to others, but also treated and sometimes cured.

disappeared the very serious crisis shaking the sick more serious, destructive and self-destructive, impressive for those who attended, contained drugs, and not by "means of containment" certainly not happy and pleasing to the eye, but the only possible remedy for avoid the worst damage, are resolved crisis and delusions melancholic major depression in endogenous melted the delusions of schizophrenic patients and loosen the hallucinations of these began to disappear the gruesome conditions of "troubled department," "violent ward", the rooms with padded walls and many other iconographic images, which are unfortunately still far from disappearing in the collective imagination, more inclined to identify psychiatrists as sadistic torturers of unsuspecting victims, rather than doctors like everyone else, moved by the same intent and animated by the same desire to be helpful, but dedicatisi, by their choice and vocation, the treatment of diseases hitherto incurable and unfortunately looking and often shocking and disturbing events.

Some patients could be discharged and delivered to the families, others, who in earlier times would have needed a shelter, could now be treated at home and, in parallel to the changing of the disease and treatment options in respect of this, began to change the logical treatment and care towards the patients themselves and so the internal organization of psychiatric hospitals, asylums alias, which certainly would have had their natural and logical, peaceful evolution, as was the case in all other countries, if in Italy, and only it, had not been developed and established a real "mental revolution" that has nothing to envy to the best-known "French Revolution," at least for the "Terror" and the innocent victims who did it, in respect of the domain and the prevalence of irrational and destructive emotional impulses, the more sinister fanaticism and self rational control, but that should always prevail when you make important choices and big consequences.

was born in the late '60s, in the context of non-native and imported '68, the so-called movement of "anti-psychiatry," a political ideology and as such is certainly not scientific, that starting from the absurd assumption that mental illness does not exist, but is the product of the bias and cruelty of the capitalist society, that "crazy" are the victims of the company responsible for inventing mental hospitals to imprison dissidents and exclude, and consequently leads inevitably to the claim and the desire to close the asylums and to "liberate the lunatics" and prisoners locked up in them.

goes without saying that psychiatrists are considered to be torturers torturers, servants of power, their diagnosis, a label equivalent to a psychiatric hospital convicted of infamous instrument of exclusion from society of dissidents capitalist, was in charge of their ailments.

This absurd argument, however, would be less absurd if it were sustained and nourished by a political soaked, destructuring and revolutionary ideologies, but not, as it has been, to a psychiatrist Mark Levy MD, a psychiatrist who by definition should have known and studied mental illness in its essence and its existence, a psychiatrist who was in daily contact with mentally ill patients in psychiatric hospitals who directed, Gorizia and Trieste, the city became the capital of revolutionary anti-psychiatry .

psychiatrist Mark Levy MD became the champion, champion of the anti-psychiatry, but with this abjured his being a doctor and psychiatrist, becoming a politician assault carrier and a supporter of a fanatical ideology and devoid of any scientific sustainability, but that, like any fanatic, found a large group of followers and supporters.

Unfortunately, when Medicine, loses the target language and the science that is congenial and takes the political language, immediately ceases to be science and changes in ideology, religion, faith, nouns respectable in itself, but well and far away from what is universally called scientific objectivity.

And as always, unfortunately, happens in nature when it embarked on a downhill road, the speed increases with the progress, like thesis wicked, but that correspond to the feelings and emotions of the moment and the spirit of the time, to move forward , often even beyond the initial intentions of those who have incurred the first to live its own life and sweep away with explosive power and destructive, irrational, those who oppose them with vision sensing the danger and destructive power. History teaches us, but men do not learn.

And 'what happened in the '70s with the anti-psychiatry movement, which led by Mark Levy MD, transformed by a psychiatrist in the tribune of the people, with a wide following in the spirit of consensus and the time when the watchword was "forbidden to forbid", led to the promulgation, in great haste and without anything to worry about the consequences of a Law, the Law 180 or better known as Law Basaglia, which sanctioned, in other words, the permanent closure of psychiatric hospitals and discharge of patients hospitalized in them.

I will always remember the title of a foreign newspaper that commented on the decision: "Italy has finally cured mental illness, that mental hospitals have become useless, are closed"

In reality, mental illness was by no means cured, but it continued to exist as it exists to this day. Simply, and with a stroke of a pen, they used to hospitals, where it was kept and where the patients were admitted, putting them out, abandoning them to themselves, their families, to their fate.

psychiatric hospitals were replaced by ... nothing, or almost nothing.

In an interview transcribed and documented Basaglia says: "... I was asked:" The lunatics come out of mental hospitals, but those who take them in charge? "I said," Look, she is a woman , belongs Women's liberation movement, when the woman who is released is that the take-over? ".

These words sum up beautifully the spirit and the mood of the moment, doing justice to the absurdity of the thought of utopia and a psychiatrist, who soaked in ideology rather than knowledge and belief, perhaps acting still in good faith, having lost his way but the correct clinical reasoning, and perhaps not only clinical.

not equal good faith, show and demonstrate to his colleagues and followers, while realizing the absurdity and danger of fanaticism that followed him and humor him prone and submissive, drawing from personal earnings.

showed good faith not just as politicians, that cling and become promoters of a false conception of revolutionary and libertarian, saw in it an opportunity for a very substantial economic advantage, freeing tout-court with a heavy expense and demanding that the maintenance psychiatric hospitals, raised in a moment of care to patients difficult and demanding, that falling back completely on the families, creating quite a few dramas.

The only ones who were happy and satisfied, in addition to promoters, were the owners of private care facilities and often contracted with the public health.

After thirty years after the promulgation of the law and de jure by the closure of public psychiatric hospitals, they are by no means disappeared, but "left the door they came back from the window," as they say, have simply changed its name and appearance.

have proliferated, in fact, excessively private facilities and convention, which under various names and conditions of mental rehabilitation facilities, institutions for disabled people, etc.. are veritable mini-mental hospitals, where patients are "voluntary" psychiatric patients, unable to fend for themselves, or that families can not afford.

These structures, private, receive from the Public Health contractor, a reasonable fee for treatment provided after a "control" of services actually provided.

While not wishing in any way call into question the honesty and clarity of these individuals, I wonder if it was logical and intelligent remove existing structures and functioning, to break up, secretly and subtly, the care of these patients so difficult and problematic in many ministrutture, poorly controlled, and against a vastly superior spending without any regard for the very serious hardships and personal tragedies which were displayed in the first patients and families themselves.

Tobino Mario, I have said before, he had the chance, but not the luck of being the protagonist and witness of these three periods of Italian psychiatry, that prefarmacologica, the pharmacological and therapeutic and that unfortunately the anti-psychiatry and the closure of asylums .

Your participation and testimony is clear and there is admirably in the three books in the "trilogy" of books in which he profusely and gave us your experience and your existence of a psychiatrist: "The free women Magliano "1953," To the old scale "with whom he won the 1971 Campiello Prize and "The Last Days of Magliano" in 1982.

same dates of publication, as well as course content, make us reason to like the three books are the witness and the memory of the three eras of Psychiatry Mario Tobino through which he lived and worked, he led his own existence, which had as a single, primary purpose, to be close, close to its patients, as "father, brother, grandfather ... stay continuously with the sick, visit them as friends, learn their language, identify with them, love them, even their creatures Human , but also close to the side of madness, mystery and character, faithful companion of his life, "madness is here, angel perched on my shoulder to sing his arias, the madness, one of the most profound, beautiful, mysterious events Human .

In the first of three, "The liberal women Magliano", Tobin, following an order, not chronological but one dictated by the thread of memories and emotions, personal charm, tells us, he describes to us to live by in the life of the Asylum and its female protagonists, whose stories very human and painful intersect and intertwine, in the form of narrative fragments, memories that come back and reappeared in the author's mind.

Ten years Tobino after himself said, about his book: " I wrote this book to show that the lunatics are creatures worthy of love, my goal was getting the sick to be treated better, better fed, better dressed, they had more concern for their spiritual life, for their freedom. Sottilizzai not about words, whether it was better to call the mental institution or mental hospital, I used the words faster, I wrote crazy, just like everyone else calls them, instead of the insane. I ran to my purpose, I tried to draw the attention of health on those who had been affected by madness. "

The book begins with these words: "Today is arrived from Florence, a sick, crazy, young, fresh, tall, with the stamp of physical health. ... Is suffering from schizophrenia, the mental illness that breaks down the human person, making it meaningless and purposeless ".

tone and content different is the second, "To the old scale" in which, by the mouth of a nurse, Anselmo, draw, and outlines the life of the asylum in that delicate and difficult stage of transition, three two conceptions of Psychiatry and thus also the places of care where it is practiced, namely the transition between a psychiatrist and still aimed at medical care and if possible to cure the disease, even mental, is a psychiatrist who, abandoning his medical and scientific sources, it is, and is cloaked in social roles and sociological, ideological, perhaps not compete and that they distort the essence of science, as a branch and specialty of medicine.

In the first part of the book, Anselmo talks about the image and the existence of Dr. Bonaccorsi, a key figure and leader of life in the Asylum Magliano, who had begun his work as a mission and he knew the folly directly some family matters.

is not difficult to read, see, in Dr. Bonaccorsi, Mario Tobino same.

Then, always tells Anselmo, Bonaccorsi dies and mental changes due to new ideas about mental illness, suggesting that the mental illness itself, is no longer considered serious and deserving of specific and particular care, but rather as a consequence of social problems , injustice and violence of the company of this over the weak. It 'clear that the death of Dr. Bonaccorsi's death represents a conception of psychiatry as a scientific and medical and replacing this with an increasingly Psychiatry Sociology.

Anselm, in his story illustrates the transition between these two different concepts, and regrets the "new direction" taken by the psychiatrist.

This regret Anselmo lies the prologue, the anticipation of the third and final book in the trilogy, "The Last Days of Magliano," certainly the most sad and desperate among the books of Tobias.

E 'in 1982, the tragedy of Act 180 and the closure of mental hospitals has already been consumed and Mario tells Tobino your despair, your pain, your sorrow, your despair at seeing his patients , your crazy left to themselves, " these children without the cradle .... Many patients, in fact, they are worried, anxious. Stop me in the paths, ask me: "We send way is not it? "... I did not want to write about crazy, but how can I? ... I also give the reactionary servant of power, but I must say the my. And 'my duty.. "

Tobino Mario And, true to himself, makes it his duty to the end, to the end and, on the other hand, could not do otherwise, as it has always been faithful to the ideals of Giuseppe Mazzini , which Duty had a beginning and an Act.

Tobino Mario does his duty, taking a clear position and precise, clear and unambiguous, single and lonely, and it is here that shows the meaning of "courageous," in explicit, clear, clear, courageous opposition to the current ideology, the folly of the closing of mental hospitals, with the absurdity of a law that closed mental hospitals, without replacing them with alternative structures, that existed only on paper but were never implemented, leaving patients left to fend for themselves and their destiny. "I provoked pain should know what was the price, the number of deaths due to that law. He died by the thousands. Found themselves free and those who loved and was sad death, he embraced death. Are left free to approach death and in her sink.

seems that these deaths are not true. The important thing is that it killed the asylum. Humans do not count. Is hanged, or remain in life, no one should be of interest. The innovators socialpsichiatrici list in front of the dead stretching, rest assured, saputi, they say: - It 's the price you pay - ".

Mario Tobino "courageous" because only.

In a long article published in the newspaper "The Nation ", the most popular in Tuscany, "Leave them alone, is their home" , he denounced the folly of the reform, unable to ensure the patient "continues to charity is nothing that you never lose patience, never angry, never put off till later and be aware that we ever grateful to anyone, at best, maybe the flash of an eye" .

only because nobody had the courage to take a stand next to him, nobody had the courage to express their opinion, no one else had the courage to oppose the new direction being dominant.

only replied, " the head of the innovators," as he called Tobino, Mark Levy MD, well standing on the chariot of triumph, in the columns of "Paese Sera ": "Tobin speaks continues to charity and human, but which have real meaning of these expressions? None. The political discourse is ... we want to destroy the institution that is the same power ... Psychiatry is the science that serves the power to control the marginalized person ... relies on a writer's pen cecoviana analysis of an environment that is In fact, the dominant ideology. "

I wanted to restore in full the words of Tobin and Basaglia, because the player could be held personally accountable for style, content and human diversity of the two.

But the drama Tobin, in "The Last Days of Magliano," is not only the collective drama of his patients no longer home, but also a personal drama, sharp and painful.

Once again the story personal, intimate, Tobin, intersects and binds to one of your patients.

The Last Days of Magliano, are the "last", not only for themselves but for him, now seventy years old and reached the limits of his profession. Must retire. "I had to leave Magliano, the asylum ... I could have come back as a thief, escape. Magliano no longer part of me, not I him. "

great people here, deep humanity of Tobino Mario, who in his modesty, it is not credited, but gave it to Joan, the woman he loved in life, confessing " that for you, for Giovanna I could hold out for forty years not to be the psychiatrist who usually makes a visit and runs away, but instead I live with a crazy, live together, get up in the morning and see the window, be the night to sleep and hear their opinions ".

I realize only now, but he had only spoken to Mario Tobino writer-psychiatrist, having missed his other works not subject to psychiatric ... but space is running out and patience has a limit of players.

Maybe they will be subject of another article.

Domenico Mazzullo