Slice the garlic cloves thickly. Crush the whole tomatoes. In a stock pot, add 2 Tbl olive oil and brown the sausage on all sides. Remove the sausage and partially de-grease the pan. Add the garlic slices and saute them until they are a light golden-brown. Deglaze the pan with wine. Reduce the wine to a tight glaze. Add the tomatoes, tomato paste, nutmeg and sugar. Stir. Add red pepper flakes to taste. Increase the flame to medium. Sprinkle in the Romano cheese. Stir. Bring the contents to a hard boil. Partially cover the pot with a lid. Reduce the flame. Simmer slowly for 1 hour. Periodically, stir the pot and skim whatever scum or grease rise to the surface.
Return the sausage to the pan. Simmer partially covered for 1 - 1 1/2 hours. 10 minutes before the end of the cooking time, add the heavy cream. If desired, remove the garlic cloves. Adjust the seasoning with nutmeg, salt and pepper. Serve the sauce and sausage over pasta (bucatini preferred) with tons of Romano cheese.