Chiesa Di San Salvatore in Mustolio, Lucca

Lucca is known as the city of 100 churches. The bigger ones are opened frequently and welcome visitors most days. And the rest seem to be opened at random days and times. When we see one of the smaller churches with an open door, we take the opportunity to step in and see what’s inside.

Yesterday, the door of Chiesa Di San Salvatore in Mustolio was opened and we popped inside. It is a smaller church made from simpler materials (brick instead of marble, two colors on the windows, etc.). I came home and read more about the church THEN had an opportunity to visit again today. I always find it more meaningful when I understand the history and context of what I am seeing.

It’s relatively easy to find dates of constructions and renovations, but I like to get a better sense of the story of the churches that I visit. The Wanderer’s Guide to Lucca by Brian R. Lindquist describes a period of colorful history of the church and its interactions with two larger churches in town: San Michele and San Frediano:

“During the early 1100s San Salvatore was a source of conflict between the churches of San Frediano and San Michele. At that time the canons of San Frediano were becoming a powerful group. They built a magnificent new church and began acquiring widespread property, in the process alienating not only the officers of other churches but at times the Bishop and even the Pope. At the same time San Salvatore was available and had acquired sufficient wealth to be worth a takeover. It was located between San Frediano and San Michele, but closer to the latter and, therefore, the Canons of San Michele saw themselves as the rightful proprietors. In the traditional method of negotiating such disputes, street fights broke out between the two claimants. Stones were thrown, holy services disrupted. The dispute went on for years. In 1140, his patience at an end, the Pope issued a bull granting the church to the monastery of San Frediano. Popes come and go, but grudges live on. The dispute drew the censure of successive popes, until it was finally settled in favor of San Frediano, which had established firm ties at the Vatican; the prior of San Frediano would soon after be appointed a Cardinal.” (Bold is my emphasis)

So, the next time that there is a disagreement in your church, be thankful that there aren’t street fights, thrown stones, and disrupted church services to resolve the differences!

Today the church is the under the care of the Confraternita di Misicordia (Fraternity of Mercy) that provides ambulance service (free of charge!) and other services to the Lucca community. The church has an active congregation and the only non-peaceful interruptions are the ambulance sirens.

The Lintels

The most treasured pieces of artwork of the church today are outside. Above two of the doors are lintels, carved horizontal supports of stone across the top of a doors. These are considered “narrative lintels” as they each tell a story, both related to St. Nicholas. Most of these narrative lintels have been removed and placed in museums. There are only nine remaining on churches in western Tuscany and this church has two of them! These lintels are more than 800 years old and are still in good shape.

The lintel on the right front door tells a story in three episodes:

  1. A pagan king sat at a table with his queen and others. He is being served a drink by a young man whom he had captured and enslaved. St. Nicholas appears and grabs the young man by his hair.
  2. St. Nicholas delivers the young man to his mother and there is a lot of celebrating.
  3. Similar to the first episode, but this time the young man’s father is at the head of the table.

The second lintel is considered to be even more valuable, but I couldn’t find it on my first visit. I wandered around the church with Google Street View and found it on the side of the building…  today there is some construction materials in front of it and an ambulance next to it. Oh boy…  The carving on this lintel represents “the miracle of the washing” of the newborn St. Nicholas who stands up in the tub where two women are washing him.

Two crucifixes

There are two wooden crucifixes in the church from the 1300s. Both of have been restored and repaired several times.

We have probably visited a dozen churches in Lucca – some large and grand and others much simpler. Each one is filled with beautiful artwork that was created to be placed in this (or another) church. Beside admiring the artwork, architecture, and contemplating their history, I take a few minutes to pray for those that serve and attend church there. I am thankful that I have the time to stop and explore them as we wander the city. And that I can share all of this with you.

My experiences with the Italian Health System

When Jim and I started seriously considering moving to Italy, we investigated the Italian health system. It is as different from America’s as you can get…  The Italian constitution states that “The Republic safeguards health as a fundamental right of the individual and as a collective interest, and guarantees free medical care to the indigent.” And we learned that Italy has a highly rated medical system – second in the world, according to Wikipedia! I want to use this blog post to share my personal experiences with the medical system, including my recent Total Knee Replacement surgery. No pretty pictures in this blog post…

Year 1 (and 2!) – Private Medical Insurance

We applied for Elective Residence Visas to allow us to move to Italy. One of the many requirements was to show that we had Private Medical Insurance because the Italian Government recognizes that there are many actions that must be taken before new immigrants are eligible to become part of the Italian health system. During a pre-move visit, we signed up for a plan that covered major and unplanned medical expenses – similar to what we would call catastrophic coverage in the USA. The coverage values seemed low to us (€30000 each) but our lawyer said that it seemed adequate to him. The annual cost was €1614 for both of us. We expected not to use the insurance, but unexpectedly Jim needed hernia surgery. I wrote about this experience in one of my earlier blog posts. We had to pay all costs at the hospital but the insurance reimbursed us for all of it! Because of COVID, we still weren’t able to sign up for the Italian medical system as our insurance was getting ready to expire. We renewed the policy and used it one other time, with the same results – all costs covered with no deductibles. During this period, we paid the full cost for our prescription medicines, but they cost us less than half of the co-pays that we had in America with our health insurance.

Participation in the Italian Health System

Once we became official residents, we were able to sign up for the Italian Health System and received our coveted Tessera Sanitara cards. We had read many places that this insurance is “free” but also read that there were costs involved. It turns out that the Constitution and the laws state that it is “free” but with the kind of visa that we have, we were required to make a voluntary contribution for the insurance. LOL! The first of many bits of confusion regarding the Italian Health System. We pay €2788 per year for this “public” insurance.  We selected a primary doctor that speaks some English and has an office close by.

Working with our primary doctor

I don’t actually visit our primary doctor frequently. After my initial visit and a review of my medical histories, he provided prescriptions for my regular medications and encouraged me to use WhatsApp to send further requests to him. So, whenever I need a prescription for medicine, a referral for a special visit, or a medical test, I simply send him a message with WhatsApp. He writes the prescription and leaves it at the pharmacy in his building and I pick it up that day or sometimes the next. Very easy and efficient but a bit impersonal! Many prescriptions cost nothing, some have a co-pay up to €20.

When it is time for a visit to our primary doctor, I send him a message via WhatsApp and he tells us when to come. Usually that day or the next. When you enter the waiting room for several doctors, you simply ask the group of people waiting “L’ultimo per Dottore Morotti” or “Who is the last person waiting for Doctor Morotti?” Someone should acknowledge that they are the last and you sit down and wait your turn; you need to remember who was last, so that you can enter the doctor’s office after that person finishes. When the next person enters the waiting room with the same question, you acknowledge that you were last and they now know where they fall in line. When the doctor is ready for the next patient, he simply appears at the door and says “Chi è il prossimo?” or “Who is next?” This sounds like a wonderful and informal approach, but seldom works as smoothly as it should. They typically are confused by my pronunciation and there are often disagreements about who is actually last or next. This approach is so characteristic of the Italian culture… I giggle to myself every time I watch it in action.

Once it is your turn and you are in the doctor’s office, you share your questions, requests, concerns, problems. There is no nurse, no unnecessary blood pressure readings or weigh-ins and frankly I can’t remember him actually examining me.  He fills out needed forms and prescriptions and hands them to you.  At the end of any visit to a doctor, they give you a one-page summary of the results. You wait while they type and print it or simply hand write it. The doctor may keep some records for their patients but the expectation is that you maintain your own records. There is no charge to see your primary doctor. Once I needed to pay to have a specific form completed and I had to pay €50 for the administrative costs. He took out his credit card machine and I gave him a credit card… no billing department needed! A specialist visit typically requires a payment of around €30.

Working with a private orthopedic doctor

When my knee started hurting in November 2020, we still weren’t covered by the Italian Health System so I went to a private doctor. Once we were covered, I continued to see the same doctor as I had a lot of confidence in him. His office is run a little closer to an American doctor’s office. He has a receptionist who checks you in, accepts the payment, and schedules appointments. This doctor speaks some English and his receptionist speaks English very well.  During an early visit he reviewed my Xrays and MRIs and said that my right knee was in terrible shape. I would need a total knee replacement within a year or two. I was definitely in pain but had no idea that my knee was so bad. Jim had struggled for years with his knees and visited the same doctor. The doctor said that mine was much worse and I would “get to go first”. My initial visit was €130 and included a cortisone shot.

The cortisone shot helped a lot and I was back to walking the streets and wall of Lucca pain free. About six months later the pain started to return and we were getting ready for Derek and Dani’s visit to Italy. I had plans for lots of fun activities and did not want to be in pain for their visit! I returned to the doctor and got a second cortisone shot (only €50 this time) and was pain free again. The doctor indicated that I should plan to have knee surgery in 2022. But the bad news was that the cortisone shot lasted only about a week… After an exchange of emails, we targeted February 2022 for the surgery. I was in pain during their visit and skipped a few of the activities, but it didn’t stop me from enjoying my time with them.

Surgery – private or public insurance?

We had planned to use our private medical insurance because the doctor is a private doctor. But then we learned that we could not renew the same private medical insurance policy because we were now residents; that kind of policy is only for non-residents. So, we asked our insurance company for a similar policy for residents. Bad news, cost was higher and all pre-existing conditions were excluded. I had heard horror stories about people waiting many months for knee operations using the public insurance and was in too much pain for that. I visited my primary doctor to ask how long it would take to get a public orthopedic doctor and get the surgery scheduled. I explained my situation and he confirmed that my orthopedic doctor was the best in Lucca and said that he would certainly accept my Tessera Sanitara (i.e., the public insurance) for my surgery. Another moment of confusion – could my private doctor use the public insurance for the surgery??? I contacted my doctor and waited anxiously for the response. Of course, they would accept the Tessera Sanitara. Certainly no one would be expected to pay the full cost of the surgery! Confused but happy!!!!

Time for surgery – Total Knee Replacement

I won’t provide the full story of the surgery and recovery. If you are familiar with this surgery, you’ll know that it is particularly painful and a difficult recovery. Instead, I’ll provide a list of some of the similarities and differences between an Italian and American hospital visit:

Different – my hospital is a 9-minute walk from my apartment… if I could walk that far. It likely took Jim 12 minutes to drive there…

Similar – pre surgical tests and meeting with the anesthesiologist scheduled a few days before surgery

Different – bring your own crutches, pajamas (no gowns provided!) and all toiletries

Similar – bland food. Even the pasta.

Probably similar – no visitors because of COVID

Different – minimal pain meds. I received intravenous acetaminophen (Tylenol) several times a day. When the pain got bad, I insisted on a stronger pain medicine and received “something like” morphine. Two times.

Similar – high quality staff (doctors, nurses, aides, therapists, etc.).

Different – 6 nights in the hospital versus 0-2 in America

Different – cost for doctors, surgery, hospital, Xrays, physical therapy in hospital, etc. was €0.

Recovery – Total Knee Replacement

From the moment I heard the word “surgery” I started worrying about all of the steps in our apartment. We live on the 3rd, 4th, and 5th floors (with the ground floor designated as zero). There are two different sets of stone steps before reaching the elevator then once you reach our apartment, we have four more sets of stairs. Some have just a few steps… one has 12 steps. There are two ground-floor Airbnb apartments in our palazzo complex that are owned by our neighbors. We rented one of them for my first two weeks home from the hospital. The apartment was perfect for those initial weeks, including a front door that opened directly onto a paved road for my first walks. Most of the streets in Lucca have cobblestones, so a paved street seemed like a luxury.

Given that my knee would hardly bend, it was not easy to get into our Mini Cooper. My doctor referred me to Marco, a physical therapist who comes to your house. He comes 3 days a week and I do need to cover the cost of these sessions. We have had several friends visit us and provide meals. A month or two ago we met a woman who recently moved to Lucca. It turns out that she was a nurse in America and worked at a hospital in Reston, Virginia that we visited more than we would have liked. Joanne visited us nearly daily, giving me my blood thinner injections, changing the bandages, and answering my stupid questions.

I have now moved back to my apartment. Marco walked me to my apartment from the rented Airbnb. He gave me instructions on how to tackle each set of stairs. My days are now filled with PT exercises, time using an automated knee bender, and walks around town. I’m also trying to pick up my daily chores. The weather yesterday was unseasonably warm so after our walk, we stopped for a Spritz at PuntoZero, a café across the street from our apartment. Allesio surprised us with a candle in our Aperitivo snack.

I have months to go before I am fully recovered but I feel very blessed by the good medical care that I have received and the many family members and friends that have supported me through texts, phone calls, visits and meals. And most of all the help provided by Jim all day and all night.

Our first visitors from America!

At the end of September 2021, Derek, our son, and Dani, his girlfriend, came to visit. It’s been 18 months since we’ve seen Derek or any family member, so you can imagine that we were quite thrilled to see them. We had a wonderful time with them and visited some new sites and some familiar ones.

Pickup in Rome. Derek and Dani flew into Rome and were set to arrive early in the morning. So Jim and I drove down the day before and stopped at Tarquinia, an hour north of Rome on the coast. The city is known for their Etruscan tombs and Etruscan Museum. I’ve seen a lot of Etruscan stuff, but I was surprised at the beauty and quantity of these tombs! In this necropolis there are 22 different underground tombs that you can look into with beautiful painted walls. Each tomb has a modern building covering the tomb with steps going down. Lighting was not good (to protect the paintings), so I’ve included one from the town’s museum, which was moved for accessibility and protection. I’ve also included a picture of a decoration from one of their temples. Keep in mind that these are from the 4-6th centuries BC!

The next morning Derek and Dani arrived on time. After more than a few hugs we were off to Sorrento where we planned to spend 5 nights.

Sorrento, Amalfi Coast, and Capri. None of us had ever been to this region so we were excited to explore the cities, the views, and the sites. While approaching Sorrento Jim stopped for a view of the city… the view was a great first impression, the traffic not so much!

We headed to Capri Island the next day… joining a boat trip from Sorrento, went around Capri, a short swim break and then a stop at one of the marinas. We visited the town of Capri, filled with shops selling beautiful (and overpriced!) souvenirs. Jim and I enjoyed wandering through the small streets while Derek and Dani headed to another marina to check out some of the boats. The wait to see the famous Blue Grotto was over an hour, so everyone on our boat agreed to skip it. Instead the captain stopped at two of the lesser known, but equally beautiful grottos, and Derek, Dani and many of the others jumped into the water to check them out.

The next day we headed to Pompeii where we spent hours wandering through the city. “Pompeii is a vast archaeological site in southern Italy’s Campania region, near the coast of the Bay of Naples. Once a thriving and sophisticated Roman city, Pompeii was buried under meters of ash and pumice after the catastrophic eruption of Mount Vesuvius in 79 A.D. The preserved site features excavated ruins of streets and houses that visitors can freely explore.” (from Google) I was struck by the size of the city and how well preserved everything is. There were so many details here and there that really gave you a sense for life in an early Roman city. I definitely want to spend more time here.

And the next day we had another boat trip planned – leaving from Sorrento and going along the Amalfi Coast. My knee was too sore at this point, so Jim and I opted to stay in Sorrento while Derek and Dani headed back to the boat. They had a great time, seeing several small towns and popping into the water at a few swimming spots. Each evening of our trip, we had dinner at one of the restaurants that featured local delicacies and a good wine list.

Chianti. We had planned for one more day in the Sorrento area, but we were all ready to move along. So we headed towards home, stopping for a night in Castellini in Chianti. This small town holds special meaning for Jim and me. In 2016 we stayed here and used it as a base to explore this part of Tuscany. One evening after dinner as we wandered through the town, we paused to look at the available real estate in one of the realtor’s window. That was the evening that we realized that living in Italy would be affordable for us and planted the seed to “retire in Italy someday”. At the time, we expected that to be a decade or so away, but why wait???

We were in Chianti, so naturally we visited a winery and some of the nearby towns.

Next stop, Lucca! Derek and Dani were likely tired of hearing us talk about what a wonderful city Lucca is to live in and they now had an opportunity to check it out. They stayed in Lucca for a week… we spent quite a bit of time in town, but also used it as a base for day trips. I’ve included some photos of our time with them, but they also visited a nearby cave in the mountains, took a cooking class, and visited the Irish Pub (in Lucca???) multiple times. You’ll need to ask them if Lucca lived up to the hype from Jim and me…

Derek and Dani then left Lucca and wandered around Europe for another two weeks, visiting Prague, a small German town, a few places in Switzerland, Chamonix, and Milan.

It was wonderful to spend time with Derek, to really get to know Dani, and to show them some of the aspects of Italy that we enjoy so much. We are looking forward to future visits from our family and friends!

“Val d’Orcia”, the Southern Tuscan Countryside

A month or so ago Jim told me that him and Pasquale would be heading to Montalcino for “Benvenuto Brunello” on 21 November and asked if I’d like to go with them. Pasquale owns a local restaurant and is a wine sommelier. Jim and Pasquale love to talk about wine, shop for wine, and drink wine. At this event they would be tasting the recent releases of Brunello di Montalcino, considered to be amongst the best wine of Italy. Nope… no interest in a 2.5-hour drive there, tasting a bunch of wine, then a 2.5-hour drive back all in the same day.

Two days before the big event, Jim asked again. He suggested that it would be helpful to have a “designated driver” but I protested – they don’t actually drink the wine; they taste it then spit it out. (Hence my lack of interest in attending.) But then Jim said that they would still be absorbing some of the alcohol into their system and they planned to taste a lot of wine. So, I agreed to go. And I started planning some places where I could drive to see some of the beautiful scenery of southern Tuscany known as “Val d’Orcia”.

At 5:45am Pasquale came to our house, I got into the backseat and tried to make a bed in the back of a Mini Cooper. 2.5 hours later I woke up as we were close to Montalcino and was excited to see fog (oh, cool pictures!). Then realized that there was A LOT of fog. Perhaps I would get some cool pictures later in the morning?

We had breakfast and coffee, they headed to their wine tasting which started at 9am (another reason for my lack of interest in attending) and I took off for a leisurely morning of driving around the countryside to look for beautiful scenery. I stopped about 3 minutes later and took my first pictures – with the edge of Montalcino on a hill top and layers of fog. Perhaps it was going to be a good day after all!

Montalcino with layers of fog

And a few minutes later, I took a picture of showing all of Montalcino with some wispy fog.

Montalcino, famous hilltop Tuscan town

In the meantime, Jim and Pasquale stopped for another coffee and had the opportunity to enjoy the foggy valley.

My first destination was Cappella della Madonna di Vitaleta, a small chapel in the countryside. This is one of the locations that photographers love and I was inspired from pictures like this and this and this. Although it was longish walk to get there (which sounded painful with my bad right knee), one of the pages showed a great spot where a photographer with a long lens could get great views. Not happening with this fog, so I prepared myself for the 15-minute walk and was “welcomed” by a gate that made it clear that you were to walk and not drive to the peaceful chapel.

Within a few minutes I found myself on a dirt “road” with plowed fields on both sides covered in fog. And no people anywhere to be seen. It was a little eerie…

And then I finally reached my destination, but it did not look like the pristine “inspiration” photos that I saw. We are talking major constructions!

So, I spent some time, played with some different compositions, and came up with a few nice pictures of the chapel with a foggy, dreamy feeling. On the way back, I did see two different couples who were likely envisioning the perfect Instagram shot. I just gave them an update on how much further and let them discover the construction on their own.

Cappella della Madonna di Vitaleta (rear)
Cappella della Madonna di Vitaleta (front)

I then proceeded to drive around the countryside stopping often to take pictures of the beautiful landscape. There were so many beautiful scenes… it really was so lovely to just take them all in. Here are a few more shots that I took – click for full size.

I planned to head to the Abbey of Sant’Antimo. Jim and I had seen it twice before, even attending one of the services where the monks chant throughout the mass. But this morning I had made too many stops, so I needed to head back to Montalcino to meet Jim and Pasquale. Here are a few pictures from those prior trips.

Abbey of Sant’Antimo in 2014, another foggy day
Abbey of Sant’Antimo in 2015, on a sunny day

I headed back to Montalcino and found Jim and Pasquale. They had tasting 60 wines! We started the long drive home and they chatted about this wine and that wine. Until they fell quiet and rested. The day was a success – they enjoyed many of their old favorites, each discovered a few new ones, and noted those that they did not like.

We look forward to more visits to Montalcino, hopefully for a longer stay next time!

Dinner in a vineyard!

Ilene and Gary were invited to a dinner in a vineyard and asked if would like to come along. Of course! The winery is located outside San Miniato, a small town about an hour from Lucca, so we decided to spend the night there so that we could enjoy the dinner without the concerns of a longish drive home. The town is long, narrow, and perched on a hill. We enjoyed lunch then wandered through the town. I usually research towns before heading there, but I focused mostly on the winery, so was pleasantly surprised to find a beautiful seminary, cathedral, and tower. And the views of the Tuscan landscape!

The seminary was started in 1650 and continually expanded until 1713. The exterior has beautiful fresco, including 30 sets of religious “mottos” (not quite scripture quotes). I was particularly pleased to find a sign that had the translations of these mottos in four languages, including English. I can imagine that the students spent time outside memorizing each and contemplating the meaning of them.

The Cathedral of Santa Maria Assunta e San Genesio required quite a climb, but was well worth it. The exterior is quite plain but the interior art, architecture, and marble are beautiful – and the ceiling is gorgeous! While inside the Cathedral, we realized that the walls were fake marble (or should I say “Faux Finish”) but while reading about the Cathedral I learned that the columns are also fake. I also read “On the 22 July 1944, an artillery shell from the United States military went through the church via the rose window on the southern side of the transept, and exploded in the right aisle, killing 55 people. The cathedral was full of citizens who had been gathered in the churchyard by the Germans.” So sad! Next time, I’ll remember to research the towns properly BEFORE heading there…

The Cathedral was quite a climb, so I skipped the next climb up to the Rocca di Federico II. Jim took my camera with him and took some beautiful pictures of the tower and the countryside. This tower served as a lookout to watch those moving between Florence and Pisa. During World War II German soldiers detonated charges inside and it was destroyed. It was rebuilt in 1958.

Time for the dinner that we had traveled here for! The vineyard is called Pietro Beconcini Agricola. They grow several types of traditional Tuscan grapes but also Tempranillo, a Spanish grape. After owning the property for about 7 years, the owner still couldn’t identify some of the grapes on his property. A DNA analysis showed that it was Tempranillo. The thinking is that a pilgrim from Spain left some seeds on the property as they traveled the nearby via Francigena path. Because the grapes were growing nicely on his property, he decided to plant additional Tempranillo vines. They now sell three wines made from Tempranillo – Fresco Di Nero (an Early Harvest wine), IXE (their mid-priced wine) and Vigna Le Nicchie (their Prephylloxera wine). Jim is always hunting for Prephylloxera wine, so this made him very happy!

The Festa Del Tempranillo was held for three nights, with some of the tables set up within the vineyards. We each received a glass of the three Tempranillo wines and typical Tuscan food, including some some slices of Bistecca alla Fiorentina. The wine, food, live music and beautiful setting made for an exceptional evening.

Special thanks to Jim and Ilene Modica for sharing some of their pictures with me for this blog post. I suggest that you check out Ilene and Gary’s blog at Our Italian Journey. She’ll be posting about our trip to San Miniato and the dinner… and I’m sure that you’d enjoy reading a different version of the same story!