The Cole Trilogy: The Physician, Shaman, and Matters of Choice

by Noah Gordon

  They began with the maristan, but Karim walked much too fast, a cranky and perfunctory guide who evidently wished to complete an unwelcome task as quickly as possible. But Rob J. was able to learn that the hospital was divided into male and female sections. Men had male nurses, women had female nurses and female porters. Physicians and a patient’s husband were the only men allowed to approach the women.

  There were two rooms devoted to surgery, and a long, low-ceilinged chamber filled with shelves of neatly labeled jars and flasks. “This is the khazanat-ul-sharaf, the ‘treasure house of drugs,’” Karim said. “On Mondays and Thursdays, physicians hold a clinic at the school. After patients are examined and treated, the druggists make up physick prescribed by the physicians. Maristan druggists are accurate to the smallest grain, and honest. Most druggists in the town are whores who will sell a bottle of piss and swear it is rose water.”

  In the school building next door, Karim showed him examining rooms, lecture halls and laboratories, a kitchen and a refectory, and a large bath for use of faculty and students. “There are forty-eight physicians and surgeons, but not all are lecturers. Including yourself, there are twenty-seven students of medicine. Each clerk is apprenticed to a series of different physicians. The apprenticeships vary in length for different individuals, and so does the entire clerkship. You become a candidate for oral examination whenever the bastardly faculty decides you are ready. If you pass, they address you as Hakim. If you fail, you remain a student and must work toward another chance.”

  “How long have you been here?”

  Karim glowered, and Rob knew he had asked the wrong question.

  “Seven years. I’ve taken examinations twice. Last year, I failed the section on philosophy. My second attempt was three weeks ago, when I made a poor thing of questions on jurisprudence. What should I care about the history of logic or the precedents of the law? I’m already a good physician.” He sighed bitterly. “In addition to classes in medicine you must attend lectures in law, theology, and philosophy. You may choose your own classes. It’s best to return often to the same lecturers,” he disclosed grudgingly, “for some of them are merciful during the oral examinations if they’ve become familiar with you.

  “Everyone in the madrassa must attend morning lectures in each discipline. But in the afternoon, law students prepare briefs or attend the courts, would-be theologians hie themselves to mosques, future philosophers read or write, and medical students serve as clerks at the hospital. Physicians visit the hospital in the afternoon and students attach themselves to these men, who permit them to examine patients and propose treatment. The physicians ask endless instructive questions. It’s a splendid opportunity to learn or”—he smiled sourly—“to make yourself a complete arsehole.”

  Rob studied the handsome, unhappy face. Seven years, he thought numbly, and nothing but uncertain prospects ahead. And this man no doubt had entered the study of medicine with far better preparation than his own sketchy background!

  But fears and negative feelings vanished when they entered the library, which was called the House of Wisdom. Rob had never imagined so many books in one place. Some manuscripts were scribed on animalskin vellums, but most were made of the same lighter material on which his calaat had been written. “Persia has a poor parchment,” he observed.

  Karim snorted. “Not parchment at all. It is called paper, an invention of the slanted-eyes to the east, who are very clever infidels. You don’t have paper in Europe?”

  “I’ve never seen it there.”

  “Paper is but old rags beaten and sized with animal glue and then pressed. It is inexpensive, afforded even by students.”

  The House of Wisdom dazzled Rob as no other sight he had ever seen. He walked quietly about the room and touched the books, noting the authors, only a few of them names he knew.

  Hippocrates, Dioscorides, Ardigenes, Rufas of Ephesus, the immortal Galen … Oribasius, Philagrios, Alexander of Tralles, Paul of Aegina …

  “How many books are here?”

  “The madrassa owns almost one hundred thousand books,” Karim said proudly. He smiled at the disbelief in Rob’s eyes. “Most of them were translated into Persian in Baghdad. In the university at Baghdad is a school for translators, where books are transcribed onto paper in all the languages of the Eastern Caliphate. Baghdad has an enormous university with six hundred thousand books in its library, and more than six thousand students and famous teachers. But there is one thing our little madrassa has that they lack.”

  “What is that?” Rob asked, and the senior student led him to a wall in the House of Wisdom entirely devoted to the works of one author.

  “Him,” Karim said.

  That afternoon in the maristan Rob saw the man the Persians called the Chief of Princes. At first glimpse, Ibn Sina was a disappointment. His red physician’s turban was faded and carelessly wound and his durra was shabby and plain. Short and balding, he had a bulbous, veined nose and the beginning of dewlaps beneath his white beard. He looked like any aging Arab until Rob noted his keen brown eyes, sad and observant, stern and curiously alive, and felt at once that Ibn Sina saw things not visible to ordinary men.

  Rob was one of seven students who, with four physicians, trailed behind Ibn Sina as he made his way through the hospital. That day the Chief Physician paused not far from the pallet of a wizened man with skinny limbs.

  “Who is student clerk of this section?”

  “I, Master. Mirdin Askari.”

  So this was Aryeh’s cousin, Rob told himself. He looked with interest at the swarthy young Jew whose long jaw and square white teeth gave him a homely, likable face, like that of an intelligent horse.

  Ibn Sina nodded toward the patient. “Tell us of that one, Askari.”

  “He is Amahl Rahin, a camel driver who came to the hospital three weeks ago with intense pain in the lower back. At first we suspected he had injured his spine while drunk but the pain soon extended into his right testicle and right thigh.”

  “How of the urine?” Ibn Sina asked.

  “Until the third day his urine was clear. Light yellow in color. On the morning of the third day his urine showed blood, and that afternoon he passed six urinary calculi, four like grains of sand and two of them stones the size of small peas. Since then he has had no further pain and his urine is clear, but he will take no food.”

  Ibn Sina frowned. “What have you offered him?”

  The student appeared puzzled. “The usual fare. Pilah of several sorts. Hens’ eggs. Mutton, onions, bread … He will touch nothing. His bowels have ceased to function, his pulse is fainter, and he grows progressively weak.”

  Ibn Sina nodded and looked at them. “What ails him, then?”

  Another of the medical clerks gathered his courage. “I think, Master, that his intestines have become twisted, blocking the passage of food through his body. Sensing this, he will allow no nourishment to enter his mouth.”

  “Thank you, Fadil ibn Parviz,” Ibn Sina said with courtesy. “But in such an injury the patient will eat, only to cast up his food.” He waited. When no other observations were forthcoming, he approached the man on the pallet.

  “Amahl,” he said, “I am Husayn the Physician, son of Abd-Ullah who was son of al-Hasan who was son of Ali who was son of Sina. These are my friends and would be thine. Where are you from?”

  “The village of Shaini, Master,” the man whispered.

  “Ah, a man of Fars! I have spent happy days in Fars. The dates of the oasis in Shaini are large and sweet, is it not so?”

  Tears formed in Amahl’s eyes, and he nodded dumbly.

  “Askari, go now and fetch our friend dates and a bowl of warm milk.”

  In a short time the food was brought, and the physicians and the students watched as the man began to eat the fruit hungrily.

  “Slowly, Amahl. Slowly, my friend,” Ibn Sina warned. “Askari, you shall see to the change in our friend’s diet.”

  “Yes, Master,” the Jew said as th
ey walked away.

  “This must be remembered about the sick people in our care. They come to us but they do not become us, and very often they do not eat what we eat. Lions do not relish hay because they visit the kine.

  “Dwellers in the desert subsist mainly on sour curds and similar preparations of milk. The inhabitants of the Dar-ul-Maraz eat rice and dry foods. The Khorasanis want only soup thickened with flour. The Indians eat peas, pulse, oil, and hot spices. The people of Transoxiania take wine and meat, especially horse flesh. The people of Fars and Arabistan eat mainly dates. The Bedouins are accustomed to meat, camel’s milk, and locusts. The people of Gurgan, the Georgians, the Armenians, and the Europeans are wont to take spirits with meals and to eat the flesh of cows and pigs.”

  Ibn Sina looked flintily at the men gathered about him. “We terrify them, young masters. Ofttimes we cannot save them and sometimes our treatment kills them. Let us not starve them as well.”

  The Chief of Princes walked away from them, his hands behind his back.

  Next morning, in a small amphitheater with rising tiers of stone seats, Rob attended his first lecture at the madrassa. Out of nervousness he was early, and he was seated alone in the fourth row when half a dozen clerks entered together.

  At first they paid him no attention. From their conversation it was evident that one of them, Fadil ibn Parviz, had been notified he would be examined for his fitness to become a physician, and his fellow clerks were reacting with envious gibes.

  “Only one week before your examination, Fadil?” said a short, plump clerk. “You will piss green with fear, I think!”

  “Shut your fat face, Abbas Sefi, you Jew’s nose, you Christian’s prick! You needn’t be afraid of the examination, for you’ll be a clerk even longer than Karim Harun,” Fadil said, and they all laughed.

  “Salaam, what have we here?” Fadil said, noticing Rob for the first time. “What’s your name, Dhimmi?”

  “Jesse ben Benjamin.”

  “Ah, of jail fame! The Jew barber-surgeon of the Shah’s calaat. You’ll find it takes more than a royal decree to make a physician.”

  The hall was filling. Mirdin Askari was picking his way up the stone tiers to a vacant place, and Fadil called to him.

  “Askari! Here’s another Hebrew arrived to be made into a leech. You’ll soon quite outnumber us.”

  Askari looked over at them coolly, disregarding Fadil as he might have ignored a bothersome insect.

  Further comment was cut off by the arrival of the lecturer, a worried-looking teacher of philosophy named Sayyid Sa’di.

  Rob received an inkling of what he had assumed by fighting to become a medical clerk, for Sayyid looked about the room and noted a face that was strange to him.

  “You, Dhimmi, what is your name?”

  “I am Jesse ben Benjamin, master.”

  “Jesse ben Benjamin, tell us how Aristotle described the relationship between the body and the spirit.” Rob shook his head.

  “It is in his work, On the Soul,” the lecturer said impatiently.

  “I don’t know On the Soul. I’ve never read Aristotle.”

  Sayyid Sa’di stared at him with concern. “You must begin to do so at once,” he said.

  Rob understood little that Sayyid Sa’di spoke about in his lecture.

  When the class was over and the amphitheater was emptying, he made his way to Mirdin Askari. “I bring you the best wishes of three men of Masqat, Reb Lonzano ben Ezra, Reb Loeb ben Kohen, and your cousin, Reb Aryeh Askari.”

  “Ah. Was their trip successful?”

  “I believe it was.”

  Mirdin nodded. “Good. You are a Jew from Europe, I hear. Well, Ispahan will seem strange to you, but most of us are from other places.” Their fellow medical clerks, he said, included fourteen Muslims from countries of the Eastern Caliphate, seven Muslims from the Western Caliphate, and five Eastern Jews.

  “I’m only the sixth Jewish clerk, then? I would have thought us more numerous, from what Fadil ibn Pardiz said.”

  “Oh, Fadil! Even one Jewish medical clerk would be too many to please Fadil. He’s an Ispahani. Ispahanis consider Persia the only civilized nation and Islam the only religion. When Muslims exchange insults, they call each other ‘Jew’ or ‘Christian.’ When they’re in a good mood, they consider it the soul of wit to call another Mohammedan ‘Dhimmi.’”

  Rob nodded, remembering that when the Shah had called him “Hebrew” people had laughed. “It makes you angry?”

  “It makes me work my mind and arse hard. So I can smile when I leave the Muslim clerks far behind me in the madrassa.” He looked at Rob curiously. “They say you’re a barber-surgeon. Is it true?”

  “Yes.”

  “I wouldn’t talk about it,” Mirdin said cautiously. “Persian physicians believe barber-surgeons to be …”

  “Less than admirable?”

  “They are not in favor.”

  “I don’t care what’s in favor. I make no apology for what I am.”

  He thought he saw a flicker of approval in Mirdin’s eyes, but if so it was gone in a moment.

  “Nor should you,” Mirdin said. He nodded coolly and made his way out of the amphitheater.

  A lesson in Islamic theology taught by a fat mullah named Abul Bakr was only slightly better than the philosophy class. The Qu’ran was divided into one hundred and fourteen chapters called suras. The suras varied in length from a few lines to several hundred verses, and to Rob’s dismay he learned he could not be graduated from the madrassa until he had memorized the important suras.

  During the next lecture, by a master surgeon named Abu Ubayd al-Juzjani, he was ordered to read Ten Treatises on the Eye by Hunayn. Al-Juzjani was small and swarthy and fearsome, with an unblinking stare and the disposition of a newly awakened bear. The rapid accumulation of assigned scholarly work chilled Rob, but he was interested in al-Juzjani’s lecture about the opacity that covered the eyes of so many people and robbed them of vision. “It is believed such blindness is caused by a pouring-out of corrupt humor into the eye,” al-Juzjani said. “For this reason early Persian physicians called the ailment nazul-i-ab, or ‘descent of water,’ which has been vulgarized into waterfall disease or cataract.”

  The surgeon said most cataracts began as a small spot in the lens that scarcely interfered with vision but gradually spread until the entire lens became milky white, causing blindness.

  Rob watched as al-Juzjani couched the eyes of a dead cat. Soon thereafter, his assistants passed among the clerks and distributed animal corpses so they might try the procedure on dogs and cats and even hens. Rob was given a brindle cur with a fixed stare, a permanent snarl, and no front paws. His hands were unsteady and he had no real idea of what to do. But he took courage from recalling how Merlin had rid Edgar Thorpe of his blindness because he had been taught this operation at this school, perhaps even in this very room.

  Suddenly al-Juzjani was leaning over him and peering at the eye of his dead dog. “Place your needle upon the spot at which you intend to couch and make a mark there,” he said sharply. “Then move the tip of the needle toward the outer angle of the eye, level with and slightly above the pupil. This would make the cataract sink below it. If you are operating on the right eye, you hold the needle in your left hand, and vice versa.”

  Rob followed the instructions, thinking of the men and women who had come behind his barber-surgeon’s screen through the years with opaque eyes, and for whom he had been able to do nothing.

  To hell with Aristotle and the Qu’ran! This was why he had made his way to Persia, he told himself exultantly.

  That afternoon he was among a group of clerks following al-Juzjani through the maristan like acolytes trailing a bishop. Al-Juzjani visited patients and taught and commented and questioned the students as he changed dressings and removed stitches. Rob saw that he was a surgeon of skill and diversity; his patients in the hospital that day were recovering from cataract surgery, a crushed and amputated arm, the excisi
on of buboes, circumcisions, and the closing of a wound in the face of a boy whose cheek had been perforated by a sharp stick.

  When al-Juzjani was through, Rob made the trip through the hospital again, this time behind Hakim Jalal-ul-Din, a bonesetter whose patients were rigged with complex systems of retractors, couplers, ropes, and pulleys that Rob regarded with awe.

  He had waited nervously to be called upon or questioned, but neither physician had acknowledged his existence. When Jalal was done, Rob aided the porters in feeding patients and cleaning up slops.

  He went in search of books when he was finished at the hospital. Copies of the Qu’ran could be found in ample number in the madrassa library, and he discovered On the Soul. But he learned that the single copy of Hunayn’s Ten Treatises on the Eye had been taken by someone else, and half a dozen students had applied before him to study the book.

  The keeper of the House of Wisdom was a kindly man named Yussuful-Gamal, a calligrapher who spent his spare time with quill and ink, making extra copies of books bought from Baghdad. “You have waited too long. Now it will be many weeks before Ten Treatises on the Eye will be available to you,” he said. “When a book is advised by a lecturer you must hurry to me at once or others will get here first.”

  Rob nodded wearily. He carried the two books home, stopping along the way at the Jewish market to buy a lamp and oil from a spare woman with a strong jaw and gray eyes.

  “You’re the European?”

  “Yes.”

  She beamed. “We are neighbors. I am Hinda, wife of Tall Isak, three houses north of you. You must visit.”

  He thanked her and smiled, warmed.

  “For you, the lowest price. My finest price for a Jew who wormed a calaat out of that king!”

  At the inn of Salman the Lesser he stopped for a meal of pilah, but was dismayed when Salman brought two more neighbors to meet the Jew who had won the calaat. They were burly young men, stonecutters by trade—Chofni and Shemuel b’nai Chivi, sons of the widowed Nitka the Midwife, who lived at the end of his street. The brothers patted his back, bade him welcome, tried to buy him wine. “Tell us of the calaat, tell us of Europe!” Chofni cried.