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

by Noah Gordon

  So it happened that on the first Monday of the slushy new year he went to Illingsworth’s Tavern and found himself in the company of a score of medical men. They sat around tables talking and laughing over drink, and when he came in they inspected him with the furtive curiosity a group always directs at a newcomer.

  The first man he recognized was Hunne, who scowled when he saw Rob and muttered something to his companions. But Aubrey Rufus was at another table and motioned for Rob to join him. He introduced the four others at the table, mentioning that Rob was recently arrived in the city and set up in practice on Thames Street.

  Their eyes contained varying amounts of the grim wariness with which Hunne had regarded him.

  “Under whom did you prentice?” asked a man named Brace.

  “I clerked with a physician named Heppmann, in the East Frankish town of Freising.” During the time they had spent in Freising while Tam was ill, Heppmann had been their landlord’s name.

  “Hmmph,” Brace said, doubtless an opinion of foreign-trained physicians. “How long an apprenticeship?”

  “Six years.”

  His questioning was diverted by the arrival of the victuals, overdone roast fowl with baked turnips, and ale that Rob drank sparingly, not wanting to make a fool of himself. After the meal it turned out that Brace was the lecturer of the evening. He spoke on cupping, warning his fellow physicians to heat the cupping glass sufficiently, since it was the warmth in the glass that drew the blood’s ugliness to the surface of the skin, where it might be eliminated by bleeding.

  “You must demonstrate to the patients your confidence that repeated cupping and bleeding will bring cures, so they may share your optimism,” Brace said.

  The talk was ill prepared, and from the conversation Rob knew that by the time he was eleven Barber had taught him more about bleeding and cupping, and when to use them and when not to use them, than most of these physicians knew.

  So the Lyceum was quickly a disappointment.

  They seemed obsessed with fees and income. Rufus even envyingly joshed the chairman, a royal physician named Dryfield, because each year he was furnished with a stipend and robes.

  “It’s possible to heal for a stipend without serving the king,” Rob said.

  Now he gained their attention. “How might this happen?” Dryfield asked.

  “A physician might work for a hospital, a healing center devoted to patients and the understanding of illness.”

  Some looked at him blankly but Dryfield nodded. “An Eastern idea that is spreading. One hears of a hospital newly established in Salerno, and the Hôtel Dieu has long been in Paris. But let me warn you, folk are sent to die in the Hôtel Dieu and then forgotten, and it is a hellish place.”

  “Hospitals needn’t be like the Hôtel Dieu,” Rob said, troubled that he couldn’t tell them of the maristan.

  But Hunne cut in. “Perhaps such a system works well for the greasier races, but English physicians are more independent of spirit and must be free to conduct their own businesses.”

  “Surely medicine is more than a business,” Rob objected mildly.

  “It is less than a business,” Hunne said, “fees being what they are and new shitty-legged come-latelys arriving in London all the time. How do you count it as more than a business?”

  “It is a calling, Master Hunne,” he said, “as men are said to be divinely called to the Church.”

  Brace hooted. But the chairman coughed, having had enough of wrangling. “Who will offer the discourse next month?” he asked.

  There was a silence.

  “Come now, each must do his share,” Dryfield said impatiently.

  It was a mistake to offer at his first meeting, Rob knew. But nobody else said a word and finally he spoke. “I’ll lecture, if it’s your desire.”

  Dryfield’s eyebrows went up. “And on what subject, master?”

  “I’ll speak on the subject of abdominal distemper.”

  “On abdominal distemper? Master … ah, Crowe, was it?”

  “Cole.”

  “Master Cole. Why, a talk on abdominal distemper would be splendid,” the chairman said, and beamed.

  Julia Swane, accused witch, had confessed. The witch’s spot had been found in the soft white flesh of her inner arm, just beneath the left shoulder. Her daughter Glynna testified that Julia had held her down and laughed while she was used sexually by someone she took to be the Fiend. Several of her victims accused her of casting spells. It was while the witch was being tied into the dunking stool before immersion in the icy Thames that she decided to tell all, and now she was cooperating with the evil-rooters of the Church, who were said to be interviewing her at length regarding all manner of subjects relating to witchcraft. Rob tried not to think of her.

  He bought a somewhat fat gray mare and arranged to board her at what had been Egglestan’s stables, now owned by a man named Thorne. She was aging and undistinguished but, he told himself, he wouldn’t be playing ball-and-stick on her. He rode to patients when summoned, and others found their way to his door. It was the season for croup and though he’d have liked Persian medicinals such as tamarind, pomegranate, and powdered fig, he made up potions with what was at hand: purslane steeped in rose water to produce a gargle for angry throat, an infusion of dried violet to treat headache and fever, pine resin mixed with honey to be eaten against phlegm and cough.

  One who came to him said his name was Thomas Hood. He had carroty hair and beard and a discolored nose; he seemed familiar and presently Rob realized the man had been the bystander at the incident between the Jew and the two sailors. Hood complained of thrushlike symptoms but there were no pustules in his mouth, no fever, no redness in the throat, and he was far too lively to be afflicted. In fact, he was a constant source of personal questions. With whom had Rob apprenticed? Did he reside alone? What, no wife, no child? How long had he been in London? Whence had he come?

  A blind man would clearly see this was no patient but a snoop. Rob told him nothing, prescribed a strong purgative he knew Hood wouldn’t take, and ushered him out amid more questions he ignored.

  But the visit bothered him inordinately. Who had sent Hood? For whom was he inquiring? And was it only coincidence that he had observed Rob’s routing of the two sailors?

  On the following day he learned some possible answers when he went to the herb seller’s to buy ingredients for remedies, and again found Aubrey Rufus there on the same errand.

  “Hunne is speaking against you when he can,” Rufus told him. “He says you are too forward. That you have the appearance of a ruffian and blackguard and he doubts you are a physician. He seeks to close membership in the Lyceum to any who haven’t prenticed to English physicians.”

  “What is your advice?”

  “Oh, do nothing,” Rufus said. “It’s apparent he cannot reconcile him self to sharing Thames Street with you. We all know Hunne would rip away his grandfather’s ballocks for a coin. No one will pay him heed.”

  Comforted, Rob returned to the Thames Street house.

  He would overcome their doubts with scholarship, he decided, and fell to work preparing the discourse on abdominal distemper as though he would be giving it in the madrassa. The original Lyceum near ancient Athens was where Aristotle had lectured; he wasn’t Aristotle, but he had been trained by Ibn Sina and would show these London physicians what a medical lecture could be like.

  There was interest, certainly, because every man attending the Lyceum had lost patients who had suffered agony in the lower right portion of the abdomen. But there was also general scorn.

  “A little worm?” drawled a wall-eyed physician named Sargent. “A little pink worm in the belly?”

  “A wormlike appendage, master,” Rob said stiffly. “Attached to the cecum. And suppurating.”

  “Galen’s drawings show no wormlike appendage on the cecum,” Dryfield said. “Celsus, Rhazes, Aristotle, Diascorides—who among these has written of this appendage?”

  “No one. Which d
oes not mean it isn’t there.”

  “Have you dissected a pig, Master Cole?” Hunne asked.

  “Yes.”

  “Well, then you know that a pig’s innards are same as a man’s. Have you ever noted a pink appendage on the cecum of a pig?”

  “It was a small pork sausage, master!” a wit cried, and there was general laughter.

  “Internally, a pig appears to be same as a man,” Rob said patiently, “but there are subtle differences. One of these is the small appendage on the human cecum.” He unrolled the Transparent Man and fixed the illustration to the wall with iron pins. “This is what I am talking about. The appendage is depicted here in the early stages of irritation.”

  “Suppose the abdominal illness is caused precisely in the way you have described,” said a physician with a thick Danish accent. “Do you then suggest a cure?”

  “I know of no cure.”

  There were groans.

  “Then why does it matter a whitebait whether or not we understand the origin of the disease?” Others voiced agreement, forgetting how much they loathed Danes in their unified eagerness to oppose the newcomer.

  “Medicine is like the slow raising of masonry,” Rob said. “We are fortunate, in a lifetime, to be able to lay a single brick. If we can explain the disease, someone yet unborn may devise a cure.”

  More groans.

  They crowded about and studied the Transparent Man.

  “Your drawing, Master Cole?” Dryfield asked, noting the signature.

  “Yes.”

  “It is an excellent work,” the chairman said. “What served as your model?”

  “A man whose belly was torn.”

  “Then you’ve seen only one such appendage,” Hunne said. “And no doubt the omnipotent voice that summoned you to our calling also told you the little pink worm in the bowel is universal?”

  It drew more laughter and Rob allowed himself to be stung. “I believe the appendage on the cecum is universal. I have seen it in more than one person.”

  “In as many as … say, four?”

  “In as many as half a dozen.”

  They were staring at him instead of at the drawing.

  “Half a dozen, Master Cole? How did you come to see inside the bodies of six human folk?” Dryfield said.

  “Some of the bellies were slit in the course of accidents. Others were laid open during fighting. They were not all my patients, and the incidents occurred over a period of time.” It sounded unlikely even to his own ears.

  “Females as well as men?” Dryfield asked.

  “Several were females,” he said reluctantly.

  “Hmmmph,” the chairman said, making it clear he thought Rob a liar.

  “Had the women been dueling, then?” Hunne said silkily, and this time even Rufus laughed. “I call it coincidence indeed that you have been able to look inside so many bodies in this manner,” Hunne said, and seeing the fierce glad light in his eyes, Rob was aware that volunteering to give a lecture at the Lyceum had been a mistake from the start.

  Julia Swane didn’t escape the Thames. On the last day of February more than two thousand people gathered at daybreak to watch and cheer as she was sewn into a sack, along with a cock, a snake, and a rock, and cast into the deep pool at St. Giles.

  Rob didn’t attend the drowning. Instead he went to Bostock’s wharf in search of the thrall whose foot he had removed. But the man wasn’t to be found and a curt overseer would say only that the slave had been taken from London to another place. Rob feared for him, knowing that a slave’s existence depended on his ability to work. At the dock he saw another slave whose back was crisscrossed with whipping sores that seemed to gnaw into his body. Rob went to his house and made up a salve of goat grease, swine grease, oil, frankincense, and copper oxide, then he returned to the wharf and spread it on the thrall’s angry flesh.

  “Here, now. What in the bloody hell is this?”

  An overseer was bearing down on them, and although Rob hadn’t quite finished spreading the salve, the slave fled.

  “This is Master Bostock’s wharf. Does he know you’re here?”

  “It doesn’t matter.”

  The overseer glared but didn’t follow, and Rob was glad to leave Bostock’s wharf without further trouble.

  Paying patients came to him. He cured a pale and weepy woman of the flux by dosing her with boiled cow’s milk. A prosperous shipwright came in with his kirtle soaked in blood from a wrist so deeply cut that his hand seemed partially severed. The man readily admitted he had done it with his own knife, seeking to end his life while despondent with drink.

  He had almost reached the mortal depth, stopping just short of the bone. Rob knew from the cutting he had done in the maristan’s charnel house that the artery in the wrist rested close to the bone; if the man had sliced a hair deeper he would have achieved his drunken desire for death. As it was, he had severed the tough cords that governed movement and control of the thumb and first finger of his hand. When Rob had sewn and dressed the wrist, those fingers were stiff and numb.

  “Will they regain movement and feeling?”

  “It’s up to God. You did a workmanlike job. Should you try again, I think you’ll kill yourself. Therefore, if you desire to live, you must shun strong drink.”

  Rob feared the man would try again. It was the time of year when cathartics were needed because there had been no greens all winter, and he made up a tincture of rhubarb and within a week dispensed it all. He treated a man bitten in the neck by a donkey, lanced a brace of boils, wrapped a sprained wrist, and set a broken finger. One midnight a frightened woman summoned him well down Thames Street—into what he had come to regard as no-man’s land, the area midway between his house and Hunne’s. He would have been fortunate had she summoned Hunne, for her husband was grievously taken. He was a groom at Thorne’s stables who had cut his thumb three days before, and that evening he had gone to bed with pains in his loins. Now his jaws were locked, his spittle became frothy and could scarcely pass through his clenched teeth, and his body assumed the shape of a bent bow as he raised his stomach and supported himself on his heels and the top of his head. Rob never had seen the disease before but recognized it from Ibn Sina’s written description; it was episthotonos, “the backward spasm.” There was no known cure, and the man died before morning.

  The experience at the Lyceum had left the taste of ashes in Rob’s mouth. That Monday he forced himself to attend the March meeting as a spectator who held his tongue, but the damage already was done and he saw that they regarded him as a foolish braggart who had allowed his imagination to rule. Some smiled at him in derision while others regarded him coldly. Aubrey Rufus didn’t invite his company but glanced away when their eyes met, and he sat at a table with strangers who didn’t address him.

  The lecture concerned fractures of the arm, forearm, and ribs, and dislocations of the jaw, shoulder, and elbow. Given by a short, round man named Tyler, it was the poorest kind of lesson, containing so many errors in method and fact that it would have sent Jalal the bonesetter into a rage. Rob sat and kept his silence.

  As soon as the speaker was done, they turned their conversation to the witch’s drowning.

  “Others will be caught, mark my word,” said Sargent, “for witches practice their foul art in groups. In examining folks’ bodies, we must seek to detect and report the devil’s spot.”

  “We must take care to appear above reproach,” Dryfield said thoughtfully, “for many think physicians are close to witchcraft. I’ve heard it said that a physician-witch can cause patients to foam at the mouth and stiffen as though dead.”

  Rob thought uneasily of the stable groom who had been taken by episthotonos, but no one accosted or accused him.

  “How else is a male witch recognized?” Hunne asked.

  “They appear much as any other men,” Dryfield said. “Though some say they cut their pricks like heathens.”

  Rob’s own scrotum tightened with fear. As soon as possibl
e he took his leave and knew he wouldn’t return, for it wasn’t safe to attend a place where life could be forfeit if a colleague should witness him passing water.

  If his experience at the Lyceum had resulted only in disappointment and tarnished reputation, at least he had hope in his work, and rude health, he told himself.

  But the following morning Thomas Hood, the red-haired snoop, appeared at the house on Thames Street with two armed companions.

  “What can I do for you?” Rob asked coldly.

  Hood smiled. “We are all three summoners for the Bishop’s Court.”

  “Yes?” Rob asked, but he already knew.

  It pleased Hood to hawk and spit onto the physician’s clean floor. “We are come to place you in arrest, Robert Jeremy Cole, and bring you to God’s justice,” he said.

  77

  THE GRAY MONK

  “Where are you taking me?” he asked when they were on their way. “Court will be held on the South Porch at St. Paul’s.”

  “What is the charge?”

  Hood shrugged and shook his head.

  When they arrived at St. Paul’s he was ushered into a small room filled with waiting folk. There were guards at the door.

  He had a sense that he had lived through this experience before. In limbo all morning on a hard bench, listening to the gabble of a flock of men in religious habit, he might have been back in the realm of the Imam Qandrasseh, but this time he wasn’t there as physician to the court. He felt he was a sounder man than he had ever been, yet he knew that by churchly reckoning he was as guilty as anyone hailed to judgment that day.

  But he was not a witch.

  He thanked God that Mary and their sons weren’t with him. He wanted to request permission to go to the chapel to pray but knew it wouldn’t be granted, so he silently prayed where he was, asking God to keep him from being sewn into a sack with a cock, a snake, and a stone and cast into the deep.

  He worried about the witnesses they might have summoned: whether they had called the physicians who had heard him tell of poking about within human bodies, or the woman that had watched him treat her husband who had stiffened and foamed at the mouth before dying. Or Hunne, the dirty bastard, who would invent any sort of lie to make him out a witch and be rid of him.