Ignazio Marino set to take the reigns of Rome as end of mayoral race comes in to sight

Mr Marino won 42 per cent in the first mayoral run off (AP)

As a pioneering transplant surgeon, Ignazio Marino has accepted many difficult cases in his career. It’s unlikely, however, that any of them have been as daunting as the task he’s now preparing for – taking the reins of one of the western world’s most celebrated but chaotic capital cities.

Rome is a mess – a very beautiful mess -- but a mess nonetheless. So can the man of medicine find a cure for the Eternal City’s seemingly insurmountable problems with traffic, transport and corruption?

The latest mayoral polls suggest that the 58-year-old surgeon-turned centre-left politician looks set to be handed this difficult challenge. Mr Marino won 42 per cent in the first mayoral run off while his rival, the incumbent mayor Gianni Alemanno, scored just 30 per cent.

The polls open on Sunday and Monday for the deciding vote. But Rome’s main newspaper La Repubblica today declared that it “would take a miracle now to bridge the gap between him and Marino”.

Mr Alemanno is a former neo-fascist boot boy turned modern-centre right politician. But past images of him lobbing petrol bombs at the Soviet embassy remain fresh in the memory for many, as shown by the chants of "fascist" that greeted him during a campaign visit to the city's Garbatella district earlier this week.

Even worse for Mr Alemanno, the fear of violent crime that helped propel him into office five years ago, is now working against him.

The shocking rape and murder in October 2007 of a middle aged, middle class woman, Giovanni Reggiani, at the Tor di Quinto railway station by a Romanian gypsy made the Alemanno law and order ticket irresistible.

But in the last five years the violence hasn’t abated – three people have been gunned down in the capital’s mob turf war since the first electoral ballots on 29 May. And Alemanno as the incumbent mayor might pay the price.

The scandals haven’t been is short supply, either. Exactly why Romans risked dying of hunger when waiting for bus became a bit clearer in late 2010 it emerged that a truly inordinate proportion of employees of the city's woeful public transport system were friends or family members of those in the city council who "ran" the organisation.

Mr Marino has avoided making rash promises regarding Rome’s buses and trains. Even if he were, with the wave of a magic wand, able to instigate modern management and working practices, constructing new roads and metro lines with so many priceless monuments in the way would remain just a dream.

`'I know it's an almost impossible challenge to reorganise a town with the complexity of Rome," Mr Marino said this week. He said that by focusing on practical things such as the roads and the rubbish, improvements would come.

Some critics have questioned his ability to run a major capital city given his lack of political experience -- and a never fully resolved expenses scandal that forced his resignation from Sicily's ISMETT transplant centre in 2002. US newspapers said the trouble involved duplicated expense claims at the clinic, a partner facility of the prestigious University of Pittsburgh Medical Center.

Mr Alemanno said yesterday that “given his (Mr Marino’s) problems managing such a small concern… for him to be criticising us as we run a city with 26,000 employees and 3 million inhabitants is a bit ridiculous."

But the medic-cum-mayoral candidate, who has made a virtue of his non-political past, appealed to electors “disillusioned” by the nepotism on display during the current administration, in a jibe at the transport scandals.

If the current mayor’s problems weren’t bad enough already, up popped a photo this week of a grinning Mr Alemanno posing for the camera with convicted mobster Luciano Casamonica.

Casamonica posted the photo on his Facebook profile, with the title “the mayor and vice mayor of Rome". In all likelihood he’ll have to change that to “ex-mayor” come Tuesday morning.

By then it will probably be Dr Marino’s turn to scrub up and do the best he can with an important but oh-so-difficult patient.