Syndrome K, the ‘disease’ that saved lives in occupied Rome

Sarah Freethy uncovers the extraordinary story of Syndrome K, the supposedly deadly disease that saved lives in German-occupied Rome in 1943.

The Fatebenefratelli Hospital sits on an island in the south bend of the Tiber, in the heart of Rome. It looks as if a great ship beached itself between Trastevere and the Jewish Quarter, long ago. Founded in the 16th century, the hospital is a landmark, close to the ancient city walls and the Aventine Hill, where Remus lost the fight to name the city to Romulus, his brother.

I first came across the hospital in one of those happy accidents which make writing historical fiction such a pleasure. I had already chosen this part of Rome as the key location for my second novel. The Aventine is a genteel, tranquil neighbourhood with grand villas and sweeping views across the city. The perfect place for my characters, a family of aristocrats, to live.

Their story starts in 1939, when the threat of war hangs over Europe, with Mussolini’s Fascist Italy acting in tandem with Nazi Germany.

Less than a year later their world was thrown into turmoil when Italy declares war on France and Great Britain.

The family and their staff began to see the city change around them, albeit incrementally. At first, Rome was largely left alone. Allied bombers spared the city’s monuments, for fear of global outcry. They chose to drop their loads on the industrial powerhouses of the north, instead.

There was rationing, of course, and an increase in propaganda and surveillance. Mussolini’s fascist government had already passed laws which stripped its Jewish population of their citizenship and severely restricted their rights. Their iron grip controlled the city as it did the nation, but life went on as normal, more or less.

It wasn’t until 1943 that the Eternal City felt the first real bite of war. On July 19, more than 500 allied bombers struck the city for the first time, hitting the San Lorenzo freight yard and the basilica, and causing an estimated 3,000 deaths.

Reports from the time describe how all the birds of Rome flew up at the violent conflagration. This is a pivotal moment in my novel; a time when the threat of imminent death makes anything seem possible.

On August 14 the Italian government declared Rome to be an Open City, to prevent further damage, though it proved to be a futile hope.

Mussolini was deposed and arrested, by order of the King. British and American troops took the island of Sicily by force, while the retreating German forces fled to the mainland.

On 8 September the Italian government signed an armistice with the allies, then fled the city with the King, in a fleet of limousines, hoping their absence would make the Wehrmacht army stay their hand. Instead, their soldiers marched on Rome, determined to take the capital by force.

For all my characters, these events meant life took a turn took a turn. On September 10, German forces assaulted Rome’s Porta San Paolo, between the modern districts of Testaccio and Ostiense, just south of the Aventine Hill. Despite being heavily outgunned and outnumbered, the Romans put up an incredible fight, turning the city’s ancient gate into a bulwark of resistance.

Italian Grenadiers at Porta San Paolo in Rome, 10 September, 1943

Alongside those armed forces which remained, hundreds of ordinary citizens of Rome took up arms against the invaders. Men, women, even nuns and children, some using weapons liberated from museums. I wrote my characters amongst them.

The battle took place in the streets surrounding the city walls, the looming Pyramid of Cestius and the Protestant Cemetery, which sits behind it – the burial place of poets Keats and Shelley. Somehow the Romans held the line for many hours, sustaining large numbers of casualties, many of which were treated by medics from the nearby Fatebenefratelli Hospital.

Despite these efforts, they were eventually overwhelmed, with 597 Italian men and women killed, and so began the bloody occupation, which the citizens endured for nine long months.

Mussolini was freed from captivity and reinstated as head of a puppet government in the north, while in Rome, SS Lieutenant Colonel Herbert Kappler was installed as head of the Gestapo. Some believed Italy’s ‘civilising forces’ would stay the Nazi’s hand in Rome, but Kappler ignored them. He extorted the city’s Jewish population and forced them to hand over huge amounts of gold, in exchange for promised freedom. It was a lie.

In the early hours of the morning of October 16, the occupying forces began a raid on the Jewish ghetto. As they went house to house, many tried to flee or hide. Some escaped to the nearby Fatebenefratelli Hospital, already established as a haven for persecuted Jews thanks to the efforts of Professor Giovanni Borromeo, a fervent anti-fascist. They were the lucky few.

It’s estimated a thousand men, women and children were rounded up that day and loaded onto trucks bound for trains to Auschwitz. Only 16 of them ever made it back alive.

After watching the raid unfold from his own flat in the ghetto, Dr Vittorio Sacerdoti raced to admit the fugitives as patients, but the Nazis soon became suspicious. In desperation, Dr Adriano Ossicini came up with an ingenious solution: Il Morbo di K or Syndrome K.

This entirely fictitious disease was named in honour of Kappler, the head of the Gestapo, and Kesselring, the Nazi commander of troops in Rome.

The doctors claimed that Syndrome K was so virulent, sufferers must be kept in isolation on a protected ward. They claimed the disease was not only contagious, but highly lethal and instructed the patients to fake violent coughing fits if the soldiers tried to approach.

Vivid descriptions of paralysis and convulsions, leading to an agonising death, finally led the soldiers to flee “like rabbits.” The doctors were then able to communicate with the partisan resistance, who smuggled the refugees out over time, hiding them in safe houses around the city, where many lived until Rome’s liberation.

In 1998 Dr Sacerdoti’s detailed testimony was taken by the Shoah Foundation and, in 2004, Yad Vashem, the World Holocaust Memorial Remembrance Centre, recognised Professor Borromeo as Righteous Among the Nations. In 2016 the hospital was recognized by the Raoul Wallenberg Foundation as one of the ‘Houses of Life’ that sheltered victims of Nazi persecution.

In my novel The Seeker of Lost Paintings, Syndrome K is part of the connective tissue which takes my characters from the sheltered privilege of the Aventine Hill to becoming part of the partisan Resistance — and later fugitives themselves. The simple choice of a location led me to the Battle of San Paolo and the extraordinary bravery shown at the Fatebenefratelli Hospital, both on that day and in October.

As I continue to discover, real history is almost always more extraordinary than a writer’s imagination.