The heart attack took two days. It was a slow-motion realisation that even Alessandro Pavoni's doctor missed. No one saw the signs. Or rather, there were no signs to see. The experience was nothing like what heart attacks on TV might have you expect - no clutching of the chest or gasping for breath. Pavoni was 36 years old, a surfer and yoga devotee, and a hotshot executive chef at the Park Hyatt Sydney. And he was very nearly a dead man.
It was a blood test that the doctor ordered, "just in case", that saved Pavoni's life. There had been a painful lump in his throat that he couldn't quite shake. "You're having a heart attack," the doctor said when the results came through, urging the chef to call an ambulance straight away.
Pavoni at Ormeggio
"They put two stents in and I went back to work," he says. "But I always had this feeling of the stents moving in my arteries. It was weird."
Pavoni was considered "the next big thing" within the Asia-Pacific wing of Park Hyatt and was on track to a significant posting overseas. But his heart attack shook him up - and moving to a more stressful job at a bigger hotel complex in Asia didn't seem like the healthiest idea.
So he quit his job and opened his own restaurant, Ormeggio, on the water at The Spit in Mosman - now the top-ranked Italian restaurant in the country.
There was no confusion when the second heart attack hit. Surfing Long Reef on Sydney's northern beaches nine months later, he was suddenly shattered by the pain stabbing brutally through his chest. Pavoni thought he was going to die.
He stumbled from the shore and, with help from a friend, got to the hospital. His stents had broken, coming loose from his atrophied arteries, and blood was barely flowing through his heart. "I had two hours to live."
What he remembers most strongly is the rising sense of panic in the intensive care unit as his chest began to fill with blood. He woke to find his mother and his wife, Anna, beside him.
Pavoni as a child
It was two months before he was back at work, and a year before he felt like he was functioning again. But though his double bypass had been a success, he was still struggling to feel well. "I couldn't walk for more than 50 metres for several weeks. I had blood clots all over my body, then blood-pressure problems." Something had to change.
Pavoni grew up in Brescia, in Lombardy, in the north of Italy. Good ingredients were abundant - blueberries, raspberries, mountain strawberries, hazelnuts and chestnuts were there for the picking. When his mother wanted salad leaves, she stepped outside to cut chicory or dandelion greens, ready to pile onto plates. And the power of good food to bring people together was clear to him from an early age.
"My grandmother used to cook every Sunday for the whole family, from six o'clock in the morning," says Pavoni. He admired her ability to unite people around a table. "I wanted to have that power to make people sit down and laugh," he says. Nonna's food was good enough to render a crowd silent in admiration.
A young Pavoni with his nonna
He joined the nearby scuola alberghiera Caterina de' Medici, and it was here, as an 18-year-old chef in training, that he experienced mysterious back pain that knocked him out so badly, he couldn't attend school. An initial scan came up clear, but the follow-up three months later revealed a tumour as big as a tennis ball.
"It hit three vertebrae, a big part of T7, T6 and T8," Pavoni recalls, gesturing to the part of his spine between his shoulder blades. He had bone cancer.
"I cried for two months," he says. "I just broke down. I was dead."
The year passed in new definitions of pain: 13 cycles of chemotherapy and complete hair loss. "They put needles in, I'd throw up. It was tough. It was heavy shit," he says. Pavoni recovered - but his body only allowed him a two-year probation before cancer was found in his T7 vertebra. He underwent more drastic surgery: an 18-hour operation where the vertebra was removed and replaced.
"I recovered, then I got on a motorbike and broke all the screws, so they put longer rods from the top to the bottom and it was all good." All good, that is, for three years.
"They said, 'The cancer is back in your lungs'." At 24, Pavoni had a third of his lungs removed. It saved his life, but he wonders today if it was those same operations - those intense procedures so close to his heart - that led to the heart condition that plagued him in later life.
Vitello tonnato at Ormeggio
In November 2016, his ankle and knees blew up with inflammatory pain. As if multiple instances of cancer and a matching set of heart attacks weren't enough, he was diagnosed with seronegative rheumatoid arthritis. The pills prescribed to fight it were devastating to his liver. On a combination of heart medication as well as warfarin for the 32 blood clots in his left calf, Pavoni began to wonder if there was a better - and less drug-intensive - way to stay well.
He thought of Pierre Dell'Orto, a naturopath from his home town. "I really trust this doctor, who has been a friend of my mum's for 40 years now." His mother was a nurse and, when she had an eye problem, Dell'Orto helped her address it - over many years - with dietary changes. So he contacted him. Dell'Orto's advice was straightforward: he recommended he become vegan.
Veganism was a radical idea for Pavoni. He runs four restaurants in Sydney: Ormeggio, famed for its signature veal tartare; Chiosco, which does its gnocchi in a rich wagyu shank ragù with pecorino; Via Alta, where the lamb shoulder is big enough to feed a couple; and Sotto Sopra, where chicken livers adorn the crostini, smoked cheddar bubbles atop eggplant, and even the caramelised radicchio tart is slathered with Gorgonzola fonduta.
Mushrooms being plated at Ormeggio.
He'd grown up eating just about every animal that flapped, flew or fed in the Lombardian alps. He'd foraged for snails and frogs, and his friends fed pigs with chestnuts, fattening them up to produce salami. Whenever his grandmother made her slow-cooked chicken, she'd cook Pavoni a whole hen for himself, and use the broth to make "the best risotto that you can have".
To say Pavoni's family were surprised by his decision to stop eating animals is something of an understatement. "They fucking hated it," he says. His mother had followed a similar diet for 10 years and everyone thought she was crazy. Then his aunt became sick and when her doctor couldn't do anything, she approached Pavoni's mother for help, and the family became more open-minded about Dell'Orto's approach. Now Pavoni has enjoyed the first long-term relief from his inflammation in years.
While his diet is largely plant-based, it's best to think of it as "Italian-vegan". Eggwhite is apparently okay because it's mainly protein and amino acids. Sheep and goat's milk are allowed because they're "very similar to human milk", and aged cheese is permissible because "the enzymes eat all the bad parts of the dairy - they're not there any more".
Even so, Pavoni finds dining out tough, so he mostly avoids it. "But if I want to go to a restaurant that night, fuck the diet." If he goes to Sepia once a year, he says, he wants to eat what chef Martin Benn eats, and there's no way he'd skip the signature dry-aged rib-eye at Firedoor. "I might do four meals like that, six meals a year." These feast days are now a relative rarity, and they're always followed by a day of fasting. He might miss eating a big T-bone on a regular basis, "but I can live without it".
Ormeggio's carrot cake dessert
There's still meat on Pavoni's menus, but at his flagship Ormeggio, for instance, it's not a large component. He still tastes the wagyu beef all'olio and the other non-vegan dishes that pass through his kitchens, but he thinks his diet of starch and vegetables is quite Italian and suits the lighter, more simplified approach to food he now takes at Ormeggio. It also means he's more imaginative in how he achieves rich flavours. The cooking liquor he decocts from roasted red peppers, for instance, gives surprising oomph to roasted rice purée and royal red potato.
As for his own meals, Pavoni is well served by a northern-Italian inclination for pasta and potatoes: gnocchi and spaghetti aglio e olio make him happy. He also tinkers with curries - sweet potato is often the star ingredient of these extravagantly spiced experiments.
And his health has never been better. "I'm taking really good and conscious care of myself - I train, I eat properly," he says. "I need to think about what I'm doing with my body; it has gone through so much. To be honest, I'm often on edge, waiting for the next random health thing to come at me from left-field."
In hospitality, Pavoni says, it's often the norm to push through pain and neglect your well-being. It's a mentality he no longer has any time for, especially as a father. He doesn't want his kids to say their dad's too tired to play, or that he can't. "I want them to grow up excited to come surf with me."