The Sarantine Mosaic

by Guy Gavriel Kay

  They controlled the bleeding eventually with lint in the wound. Afterwards, Rustem carefully removed all the packing (following Galinus in this much, at least) and inserted a tube for drainage. That, too, would have hurt. A steady flow of blood-coloured liquid ensued. More than he liked. The man didn’t even move. Eventually it slowed. Rustem looked at the household skewers and pins they’d brought him—all he had for fibulae to close the wound. He decided to leave it open for now. With that much liquid he might need to drain again. He wanted to watch the lungs, the breathing.

  He applied the household’s quickly made poultice (adequately done, with good texture, he noted) and wrapped linens loosely as a first bandage. He wanted a better wound dressing, was inclined to use cinnabar—in modest proportions—for a wound of this sort, knowing it to be poisonous if overemployed. He would try to find proper ingredients somewhere in the morning.

  He needed more drainage tubes as well. The ribs required a firmer support but the wound needed to be reachable and observed during the first few days. Merovius’s famous quartet of danger signs: redness and swelling with heat and pain. Among the first things a physician learned, east or west.

  They moved the charioteer upstairs on the plank of the table. Some bleeding started again when they did so, but that too was to be expected. Rustem mixed a heavier dose of his usual sedative and sat by the man’s bed until he saw him sleep.

  Just before he did so, his eyes already closed, the charioteer murmured softly in a flat, distant voice that nonetheless suggested he was trying to explain something, ‘She was closeted with her family, you see.’

  It was not uncommon for the sedative to cause men to say nonsensical things. Rustem set one of the servants to watch with instructions to summon him immediately if anything at all untoward took place, then he went to bed. Elita was already there—he had told her she should retire to his room. The bed was comfortable, warm with her presence. He fell asleep almost immediately. Physicians needed to know how to do that, among other things.

  THE GIRL WAS NO LONGER with him when he woke in the morning, but the fire was freshly built up and a basin of water lay on the hearth to warm, with linen beside it and his clothing on a rack, also near the flames. Rustem lay still a moment, orienting himself, then made his first gesture with his right arm towards the east, murmuring the name of the Lady.

  There came a knocking. Three times. First significant sound. The sound and the number benign omens for the day. The steward entered to his call. The man seemed anxious and disconcerted. Not surprisingly, given the events of the night before.

  But there was more to it than that, evidently.

  It seemed that Rustem had people attending upon him already. A number of them, and some were distinguished. It had not taken any time at all after the wedding yesterday for word to spread of the arrival in the City of a Bassanid physician and teacher, temporarily residing in a city home of the Master of the Senate. And whereas drunken young Hippodrome partisans might be viciously abusive of all foreigners, those afflicted in body and soul had a differing view of the arcane wisdoms of the east.

  Rustem had not given this possibility any thought at all, but it was hardly an unwelcome development. And might prove useful. Sitting up in bed he stroked his beard, thinking quickly, and instructed the steward— whose manner had visibly gained in deference since last night—to have the patients return after midday. He also told him to advise them frankly that Rustem’s fees were very high and to be prepared for that. Let them all decide he was no more than a greedy Bassanid, simple in his purposes here.

  What he wanted was high-born or wealthy patients. The ones who could pay those fees. The ones who might possibly know things that mattered, and might confide them to a doctor. People did that, everywhere, and he was here for a reason, after all. He asked after his patient, and the steward reported that the wounded man was still asleep. He gave instructions to have someone look in on the fellow at intervals and report—discreetly—when he woke. No one was supposed to know that the man was here. It was still a source of some amusement to Rustem, how utterly overwhelmed the very dour, proper steward had been last night by the arrival of a mere athlete, a person from the games.

  ‘Jad of the blessed Sun!’ he had cried out when the charioteer had been helped across the threshold. His hand had shaped a religious sign, his tone had suggested he was seeing the named deity, not merely invoking him.

  Holy men and charioteers, that is who they honour in Sarantium. An old saying. It appeared to be true. Divertingly.

  After washing and dressing himself and taking a light morning meal downstairs, Rustem had the servants set about rearranging two of the main-floor rooms into examination chambers and fetching certain necessary things. The steward proved to be efficient and composed. They might be spying on him, but Bonosus’s people were well trained, and by the time the sun was high on what had become a mild and beneficent day in early spring, Rustem had rooms and implements sufficient to his needs. He formally entered the two chambers, left foot first on each threshold, invoking Perun and the Lady. He bowed to the four corners, beginning with the east, looked around, and pronounced himself satisfied.

  A little before midday the boy, the Senator’s son who had brought the athlete to them last night, had appeared again, his face tinged a greyish-white with strain. It seemed unlikely he’d had any sleep. Rustem had briskly sent him off to buy linens and certain items for the wound dressing. Tasks were what the boy needed. It was actually necessary to remind himself now that this was the person who’d killed Nishik yesterday morning. Things changed swiftly here, it seemed.

  The lad looked grateful and frightened at the same time. ‘Um, if you please … ? My father won’t know I was the one who … brought him here? Please?’

  That had been said last night, as well. It appeared the boy had been abroad without permission. Well, of course: he had killed someone in the morning. Rustem had nodded then and did so again now. The growing web of secrecy might also be useful, he had decided. People in his debt. The day was beginning well.

  He would want a student or two eventually, for the proper tone and gravity, but they could come later. For now, he had Elita dress herself in a long, dark green tunic and showed her how to present patients to him in the inner chamber while others waited in the second room. He explained that she was to remain with him if the patient was female. Physicians were vulnerable to wild, inflammatory allegations and a second woman was a necessary precaution if there were no students available.

  Just past midday he was informed by the steward that more than twenty people had now gathered—or sent their servants to wait—in the street outside the door. There had already been complaints from the neighbours, the man reported. It was a dignified district.

  Rustem told the steward to make immediate apologies along the street and then take names of those waiting and set a limit of six patients for each day. It was necessary, if he was to achieve any of the other tasks he’d set himself while here. Once he had students they could begin a process of selecting among those who had most need of him. It was a waste of his time, really, to treat routine cataracts. After all, it was Merovius of Trakesia whose methods he used, and they had to know those techniques here in the west.

  Elita, rather appealing in the green tunic and looking somewhat less shy, came hurrying into the room. The fellow upstairs was awake. Rustem went up quickly and entered the room, left foot first.

  The man was sitting up, propped by pillows. He was very pale, but his eyes were clear and his breathing seemed less shallow.

  ‘Doctor. I owe you my thanks. I need to be able to race a chariot in five days,’ he said, without preamble. ‘Or twelve at the outside. Can you do this?’

  ‘Race a chariot? I certainly can’t,’ Rustem said pleasantly. He walked over and examined the patient more carefully. For a man who might have died the night before, he seemed alert. The breathing, on closer attention, wasn’t as good as he’d like. Not surprising.

&n
bsp; The man smiled wryly after a moment. There was a brief silence. ‘You are indirectly telling me to slow down, I suspect.’

  He had had a deep, ripping stab wound that had barely missed reaching a maramata point and ending his life. He had then been kicked in the same ribs the knife had slid between, causing what must have been appalling pain. It was very possible his lung was collapsed, fallen from where it should lodge, against the ribs.

  It was something of a wonder to Rustem that this fellow had actually walked to this house. It was unclear how he’d managed to breathe adequately or stay conscious. Athletes would have high tolerance for discomfort, but even so …

  Rustem picked up the fellow’s left wrist and began counting through the various indicia. ‘Have you urinated this morning?’

  ‘I haven’t left the bed.’

  ‘Nor will you. There is a flask on the table.’

  The man made a face. ‘Surely I can—’

  ‘Surely you can’t, or I withdraw treatment. I understand there are physicians attached to your racing group. I am happy to have someone alert them and have you transferred by litter.’ Some people needed this manner. The signals from the pulse were adequate, though there was more agitation than was good.

  The man named Scortius blinked. ‘You are accustomed to getting your way, aren’t you?’ He tried to shift a little more upright and gasped, surrendering the attempt.

  Rustem shook his head. In his most measured, calming voice now he said, ‘Galinus here in the west taught that there are three elements to any sickness. The disease, the patient, the physician. You are stronger than most men, I believe that. But you are only one of three parts here and this is a grave injury. Your entire left side is … unstable. I can’t bind the ribs properly until I am certain of the stab wound and your breathing. Am I used to having my way? Not in most things. What man is? In treatment a doctor must, however.’ He permitted his tone to soften further. ‘You do know they can have us fined or even executed in Bassania if an accepted patient dies.’ A personal revelation was sometimes effective.

  After a moment the charioteer nodded. He was a smallish, exceptionally handsome man. Rustem had seen the network of scars on his body last night. From his colouring, he was from the south. The same desert spaces Rustem knew. A hard place, making hard men.

  ‘I’d forgotten. You are a long way from your home, aren’t you?’

  Rustem shrugged. ‘Injuries and sickness change little enough.’

  ‘Circumstances do. I do not wish to be difficult, but I can’t afford to go back to the faction compound and face questions just now, and I must race. The Hippodrome is opening in five days, these are … complex times here.’

  ‘They may well be so, but I can swear to you by my deities or yours that there is no doctor alive who would agree to that, or could achieve it.’ He paused. ‘Unless you wish to simply get into a chariot and die on the track from loss of blood, or when your crushed ribs cave inward and stop your breathing? A heroic ending? Is that it?’

  The man shook his head, a little too vigorously. He winced at the movement, and put a hand to his side. He then swore, with great feeling, blaspheming both his deity and the controversial son of the Jaddite god.

  ‘The next week then? Second race day?’

  ‘You will remain in a bed for twenty or thirty days, charioteer, then you will begin very careful walking and other movements. This bed or another, I hardly care. It isn’t only the ribs. You were stabbed, you know.’

  ‘Well, yes, I do know. It hurt.’

  ‘And must heal cleanly, or you may die of the inflammation’s exudation. The dressing must be examined and changed every second day for two weeks, fresh poultices applied and left undisturbed by further bleeding. I have to drain the wound again, in any case—I haven’t even stitched it yet and I will not for several days. You are going to be in extreme discomfort for some time.’

  The fellow was staring at him intently. With certain men it was best to be honest about this. Rustem paused. ‘I am not unaware that the games in your Hippodrome are important, but you will not be part of them until summer and it were best if you made yourself easy with that. Wouldn’t it be the same if you’d had a fall of some kind? Broken your leg?’

  The charioteer closed his eyes. ‘Not quite the same, but yes, I take your point.’ He looked at Rustem again. His eyes really were encouragingly clear. ‘I am being insufficiently grateful. It was the middle of the night and you had no preparation at all. I seem to be alive.’ He grinned wryly. ‘Able to be difficult. You have my thanks. Would you be good enough to have someone bring me writing paper and let the steward send a discreet runner to Senator Bonosus letting him know I am here?’

  A well-spoken man. Not at all like the wrestlers or acrobats or horseback performers Rustem had known as entertainers back home.

  His patient dutifully provided a sample of urine and Rustem determined that the colour was predictably red but not alarmingly so. He mixed another dose of his soporific and the charioteer was quite docile about accepting it. Then he drained the wound again, checking the flow and colour carefully. Nothing unduly alarming yet.

  Men such as this one, who had experienced pain on a regular basis, knew the needs of their own bodies, Rustem thought. He changed the dressing, looking closely at the crusted blood around the wound. It was still bleeding, but not heavily. He allowed himself a small flicker of satisfaction. There was a long way to go, however.

  He went downstairs. There were patients waiting. The six he had allowed. Today it was simply the first six in line; they’d devise a more precise system as soon as they could. The morning’s first omens had proven true, even here among the unbelieving Jaddites. Events were developing in a very benign way.

  That first afternoon he examined a merchant dying of a tumour that was eating at his stomach. Rustem was unable to offer anything at all, not even his usual mixture for this extreme level of pain, since he hadn’t brought that with him and had no connections here with those who mixed physicians’ private remedies. Another task for the next few days. He would make the Senator’s boy be useful. Employ him like the servant he’d killed. It appealed to his sense of irony.

  Looking at the gaunt, wasted figure of the merchant, Rustem spoke the necessary words with regret: ‘With this I will not contend.’ He explained the Bassanid practice in this. The man was calm, unsurprised. Death was seated in his eyes. One grew accustomed to it, and yet one never did. Black Azal was always at work among the living in the world Perun had made. A physician was a minor soldier in their endless war.

  Next, however, came a scented, subtly painted court woman who appeared only to want to see what he looked like. Her servant had held a place in line for her from before sunrise.

  This sort of thing happened often enough, especially when a doctor came to a new place. Bored aristocrats, looking for diversion. She giggled and talked through his examination of her, even with Elita present. Bit her lower lip and looked at him through half-lowered eyelashes when he took her perfumed wrist to obtain the counts there. She chattered about a wedding yesterday—the very one Rustem had attended, as it happened. She hadn’t been there, appeared piqued about that. Seemed even more displeased when he reported that she seemed to have no ailments that required his intervention, or another visit.

  There followed two other women—one evidently wealthy, the other rather a common sort—complaining of barren wombs. This, too, was normal when physicians arrived in a new place. The endless search for someone who could help. He confirmed that the second woman had been able to pay the steward, and with Elita present each time performed his examinations as the Ispahani doctors did (though never those in Bassania, where to see a woman unclothed was forbidden to physicians). Both women were unruffled by this, though Elita flushed red, watching. Settling into routine, Rustem asked his usual questions and came—quickly in each instance—to his conclusions. Neither woman seemed surprised, which was often the case in these matters, though only one of them was
in a position to find solace in what he said.

  Next he saw and diagnosed two cataracts—as expected—and lanced them with his own implements, charging for the examination, the procedure, and a considerable, deliberately inflated sum for the visits he would make to their homes.

  By the middle of the afternoon he had heard a significant amount of gossip and knew much more than he really wanted to know about the Hippodrome season that was starting soon. Blues and Greens, Blues and Greens. Scortius and Crescens. Even the dying man had mentioned the two charioteers. The Sarantines were collectively obsessed, Rustem decided.

  At one point Elita slipped out and returned, reporting quietly that the much-discussed fellow upstairs was asleep again. Rustem diverted himself briefly by imagining the reaction if people knew he was here.

  Everyone had talked, but they offered only trivial information. That would change, Rustem thought. People confided in their doctors. This exercise held great promise. He went so far as to smile at Elita and offer praise for her demeanour. She flushed again, looking down at the floor. When the last patient left, Rustem went out of the treatment rooms, feeling quite pleased.

  Awaiting him was a two-person delegation from the physicians’ guild.

  His mood changed, very quickly.

  Both men were visibly and vocally outraged to find a foreigner having set himself up to practise medicine in Sarantium in a private home without so much as a visit to the guild or a by-your-leave. Given that he was here— ostensibly—to lecture, to learn, to buy manuscripts, share information with western colleagues, this anger was likely to bring consequences.