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He arrived promptly at ten o’clock for his appointment and Dr. Coniglio saw him at once. There was something odd in the doctor’s manner, stiff, which worried him and alerted him to the seriousness of the news. He had known Coniglio for years. They were of an age. A graceful man, with athletic shoulders, a clean stiff collar and shirtsleeves invariably rolled. He liked him, the cordiality in his speech, the clarity in his face like sunlight on flagstones. Coniglio had treated his mother at the end of her life, when she was dying in the ruins of Casa Lampedusa, had made the long drive from Capo d’Orlando to Palermo each week. Until the war, he had been the family physician for his cousins, the Piccolos, attending them at Vina, their villa, and it was only in the last five years that the doctor had opened an office in Palermo. He remembered now, seeing the man’s new consulting rooms, how his mother had used to look at Coniglio, the narrow cold assessment in her eyes. She too had thought him a fine gentleman. She too had not wanted to observe himstanding next to her son.

He did not think of himself as shy but a certain shyness took hold in him when he found himself in the company of men such as this, men with a deference for his own station in life, men who had set out and achieved success, men of purpose, men of the world. Their easy manners left him uneasy, their confidence made him falter. He felt himself slow down, grow watchful, hesitant, until he had lost the moment for the quick retort or dry joke that came always to mind. Instead he would blink his lugubrious eyelids, and smile faintly, and meet the other's gaze helpless.

He waited for the doctor to gesture to a chair before he unbuttoned his winter coat and sat. He took off his hat and folded his gloves in its upended crown and rested his walking stick across his knees. He set his leather bag carefully to one side, half unbuckled, the little frosted cakes in their paper wrappers from his breakfast at the Massimo visible, the spine of the book he had brought for later, The Pickwick Papers, shining up at him. He reached at once for the cigarettes in his pocket but caught the doctor’s eye.

No?

Ah, Don Giuseppe—Coniglio smiled, tsking—not all that is pleasurable in life is forbidden. But some things are, or should be. You look tired, my friend.

Giuseppe withdrew his hand and crossed his legs, the bulleted purple upholstery crackling. The other had settled himself at the edge of his desk, one leg hitched up, his hands folded lightly over his thigh, those hands which turned and weighed and cut into the skin of other beings and sought out the secrets in their flesh. Calmly he met the doctor’s gaze.

Well? he said.

It is as I feared. The doctor’s voice was slow now, deliberate. Emphysema. It can be checked perhaps, but not stopped. I am sorry.

Giuseppe smiled faintly. He could not think what to say. The spirometer is not always conclusive, of course. We could examine you again.

Would you advise it?

Coniglio held his eye a moment. I would not, he said at last, gently. Are you here alone? I had hoped the princess would accompany you.

He shook his head, calm.

You should not be alone, the doctor said. He rose and went behind his desk and opened a drawer and unscrewed the lid of a fountain pen. I shall write you out a prescription to help with the pain. But the only true medicine, you understand, is for you to cut out tobacco.

The winter morning was grey and diffuse in the curtains. Giuseppe closed his eyes, opened them.

And will that reverse the effects? he asked.

It is a chronic disease, Don Giuseppe—there is no reversing its effects. It will progress regardless. But it can be managed.You must change the way you have been living. You must exercise regularly. Walk. Eat rather less. Avoid stress and worry as you can.

There is no other treatment?

Well. Let us try this first.

But the disease will kill me? he pressed.

Coniglio regarded him quietly from behind his desk. Anynumber of things could kill you first, he said.

Giuseppe, despite himself, smiled.

I will give you this for the pain, and to help you sleep. The doctor took some minutes to write out the prescription. He then untied a red folder and withdrew two typed pages and perused them and then slipped them back into the folder. We are getting old, Don Giuseppe, he said. That is the substance of it. We may not feel it, but it is so.

Yes. 

Our bodies will not let us forget it.

Indeed.

Coniglio steepled his fingers before him. It was clear he was struggling with what to say next. After a moment, to Giuseppe’s surprise, he began to speak, in a casual way, of his wife. He had a French wife who was known to treat him badly. He said: Jeanette has returned to Marseilles. Her sister is ill. She wishes to be with her family. She has written me to tell me she would like me to join her. Permanently.

Ah.

You and the princess lived apart a long while, did you not?

Yes. In the thirties.

I remember your mother spoke of it. Princess Alessandra was in Latvia?

Giuseppe nodded. He did not like to think what his mother might have said about it.

Coniglio was tapping his fountain pen against his wedding ring, click, click. Otherwise his face was calm, his hair smooth, his coral shirt unwrinkled and immaculate. Yes, he said, yes yours was an arrangement that succeeded. So I tell myself, it is the modern world, Coniglio. Be strong. You have telephones, aeroplanes.

Giuseppe did not enlighten the man. Licy had always gone where she chose to go, as she chose it. She had flet to Sicily only when the Soviets neared her estate in Latvia, burning the great homes as they advanced. He did not deceive himself by imagining she had bowed to his desires. 

Jeanette tells me there is work for a doctor in any city, Coniglio said. Even for a Sicilian doctor, she says. I expect there is some truth in that.

What will you do?

Coniglio looked out the window, smiled vaguely. I will imagine the very worst of fates and settle for a lesser one, he said. But my patients, I would worry for them, Don Giuseppe. It would mean, of course, many farewells.

It is always better to be the one leaving than the one left behind, said Giuseppe.

Yes. And some journeys cannot be delayed.

Giuseppe inclined his head.

Coniglio pinched the bridge of his nose and there was a sudden anguish and bafflement in the gesture. He removed his spectacles, blinked his watery blue eyes. The man’s strong emotion surprised Giuseppe, left him uncomfortable. Do you know, said the doctor, for years now, whenever I am faced with a difficult decision, I think of something your mother said to me. She said, Always take the easier path, Dr. Coniglio. And yet I have never done so. I wonder what is the matter with me.

It was as though a coin flared in the cold sunlight between them.

Your mother was a powerful personality, Coniglio continued. She had strong opinions. I remember she used to talk to me about Mussolini.

She was rather confused, near the end.

She used to complain about his spats. Too many spats, she would say, Coniglio smiled, shook his head. I remember she held my hand one morning and said Mussolini had changed nothing and yet because of him everything had changed. 

She was thinking of her house, Giuseppe said quietly.

A beautiful palazzo, the doctor agreed. The Americans did not need to bomb us as they did.

I did not know you knew it, Doctor.

Coniglio gave him a puzzled look. I visited your mother there. Several times.

It was hardly beautiful then.

Well.

It was a fine house once, before its ruin.

And a fine house after, Don Giuseppe. When I was a child I would pass by it every Sunday morning. My father worked a fish stall in the Vucciria. It was not the fastest route. But then I was not always in such a hurry to join him.

He said this without shame or embarrassment at his low origins and Giuseppe could only nod vaguely. It seemed all at once of supreme insignificance. His mother, he remembered now, had distrusted this doctor by the end, had coughed and grimaced and called him her good doctor Mafioso. He opened his mouth to speak, closed it. Do not gawp like a fish, his mother used to tell him. He got abruptly to his feet.

You must forgive me, he said.

Coniglio half rose from behind his desk. Of course.

I have lost track of the hour.

Certainly. We shall speak again soon, of that I am certain, Don Giuseppe. Remember me to Don Casimiro and Don Lucio, if you will. And of course to the princess.

He suddenly heard in the doctor’s old-fashioned phrasing the syntax of an English novel, as if it were a sentence translated aloud from Meredith or Eliot, and he glanced at the doctor from beneath heavy eyelids. More than most this man had witnessed the tension and soured love directed by his mother towards himself as she ailed, had witnessed her bitterness, the muttered imprecations, the veiled insults. It left him, Giuseppe felt with a quick sharpness, vulnerable and foolish. But then the feeling was gone and he wanted only to absent himself from the small office with its smells of lemon gauze and varnish and camphor, smells that would forever remind him of his own death.

And so Giuseppe Tomasi, last Prince of Lampedusa, put on his hat with care, worked his fingers into his dead father’s kidskin gloves, and took up his walking stick and his worn leather bag. At the door he paused.

How much time do I have, Doctor?

Coniglio’s hands were clasped carefully on the desk before him and as he tilted his head his spectacles filled with light, obscuring his eyes. That will depend on you, he said. Let us pray it is many years yet.

In which case, said Giuseppe, it will not depend on me at all.

The doctor smiled, but there was a sadness in it, and Giuseppe went out, the frosted glass on the streetside door rattling softly as it closed, and he shuffled out into the cold bright air leaning on his cane as if it were still the same morning as before, and he the same man.