Wow. Add that to my list of international places to visit. How many people speak at least a little English in the cities over there?

You can get by, but you won't enjoy yourself as much as if you spoke the language, same as most places.

Italy is a fantastic place to visit, it has almost as much natural variety as California (mountains, rivers, lakes, estuaries, the arid south), with a quantity of culture, history and man-made things unequaled in the US - or pretty much anywhere else for that matter.