Joanna was feverish and barely conscious. Her right knee kept rising toward her abdomen. It was a struggle to undress her because Mistress Blanche held on to Adelia like a drowning woman to a raft, begging her to save the child. “Use witchcraft,” she kept saying. “I know you can, everybody knows it. You saved those people from the flux, it was you, I saw you. Save her. I don’t care how, but save her.” Eventually, she had to be forcibly restrained by Ulf and taken outside.
Adelia began her examination, barely listening to the O’Donnell telling the others what had happened.
“She was taken ill almost as soon as we got her on board at Saint Gilles,” he was saying. “Doctor Arnulf diagnosed acute indigestion, he’s been treating her with seethed toad, powdered unicorn, cramp rings, various talismans, and I don’t know what else. The good Bishop of Winchester’s been reciting Psalm 91 over her ad infinitum. And her only becoming sicker and sicker.”
He broke off as Adelia abruptly left the room and headed across the bailey to where Blanche sat on a straw bale, her head in her hands, with Ulf awkwardly patting her shoulder.
The lady-in-waiting looked up at Adelia’s approach. “Can you help her? Can you make her well?”
“Has she been constipated?” Adelia asked.
Ulf growled with embarrassment, but it was a measure of Mistress Blanche’s desperation that, after a second’s hesitation, she nodded.
“Nausea? Vomiting?”
Blanche nodded again.
“Hmm.”
Adelia went back to the keep.
The O’Donnell was still talking: “... frantic she was. It’s my opinion, Blanche is the only one of those three women who cares more for Joanna than for herself Lord bless her. When I suggested to them we sail to Salses, where her ladyship here was in situ, the other two set up a caterwauling about what’d the king do to them if he learned they’d delivered his daughter to a witch and a Saracen, what’d Sicily do, what’d dear Doctor Arnulf do. I told them, I said, dear Doctor Arnulf’s doing damn all except kill her quicker....”
On the table, Adelia pressed gently on the lower right quadrant of the girl’s abdomen and then quickly removed her hand. There was a moan. The right knee flexed again.
“So we kidnapped her, Blanche and I. Left the other ladies asleep, had my lads lower the dinghy with Joanna in it, and here we are, and may God save us all from perdition.”
“So brave to dare it.” This was Fabrisse. “’Delia, isn’t he brave?”
Adelia didn’t hear her. The muscles she’d pressed had been rigid.
“And Duke Richard?” Mansur was asking.
“He doesn’t know. He’d already left for Sicily aboard my Nostre Dame. The royalty don’t travel together in case of accidents.” O’Donnell broke off again and looked toward Adelia, who’d left the table and was sitting on a chair, much as Blanche had done, with her head in her hands.
He strode over to her: “She’s dying, isn’t she?”
“I think so.”
“Can you save her?”
Adelia shook her head. “Even if I could have, and that’s very doubtful, I’ve no equipment. It was at Ermengarde’s.”
“Now, then.” He went away calling for Deniz: “What did you do with that damned contraption I brought?”
When he came back, he was carrying a wrought-leather, silver-bound case. “Will this do? I, er ... liberated it from Arnulf’s cabin while the good doctor was sleeping.”
Inside, calfskin pockets held flasks, a well-thumbed urine chart, greasy ointment pots, tweezers, a rusty wound-cauterizing tool, a mallet, presumably for rendering difficult patients unconscious, pliers for pulling teeth, also rusty ...
Adelia threw the instruments on the floor as she delved for the pots and flasks, opening them, sniffing, discarding. The tenth pot held what she’d been looking for—and had dreaded. So did one of the larger flasks. It appeared that, for all his pious protestations. Dr. Arnulf kept anesthetics among his medicaments.
There were no knives—apparently like Arnulf obeyed the papal edict of 1163, which had banned the shedding of blood.
“No knives,” she said, and was ashamed of the relief in her voice.
“For what do you need knives?” the Irishman asked. “I’ve a fine dagger, if that’s of use.”
“Knives?” asked Fabrisse. “If it’s knives you want, Johan’s the man; he travels to Leucate every week. There are some of his fellow Jews there, and he does their slaughtering. He’s a, what’s it called ... a crocket?”
“A shochet?” Adelia raised her head. “He’s a shochet?”
“I believe so. Anyway, he has a fine collection of knives, very sharp, very clean; he’s particular about them.”
“Yes,” Adelia said slowly. “Yes, he would be.”
It was why Jews often stayed healthier than their neighbors, and so were accused of poisoning Christian wells when plague broke out. Adelia’s foster father, Dr. Gershom, a nonpracticing Jew himself put it down to the religion’s command that ritual slaughtering equipment must be be kept honed and clean. It was his contention that the stale, stinking, bloody filth on the knives of Gentile butchers helped to putrefy their meat.
God, dear God, every excuse she had for doing nothing was being taken away from her.
She closed her eyes and went over her diagnosis again. Pain in the abdomen’s lower right quadrant, the flexing knee, rigid muscles. Classic symptoms, her foster father had told her. On the corpse of a child he’d shown her what lay beneath those muscles—the large intestine with a small, wormlike pouch emerging from the bottom of it.
Neither Gershom, nor Gordinus the African, her tutor at the Salerno School, had been able to explain its function. Gordinus had referred to it as “the vermiform addimentum.” Gershom called it “an appendix to the cecum of no damned use whatever except to become diseased.”
And Joanna’s appendix was diseased.
I need air. Adelia got up and went out into the bailey, puffing hard. Dawn was breaking, the clouds had cleared, and, with her dog wheezing behind her, she climbed the steps of the seawall into the light of a freezing, breathless day
To her right the two Roqua sons were filling sacks from the glaring white squares of the Salses salt pans. Beyond them, naked vines stood in neat rows ready, when in season, to produce Salses wine, a substance so rough it could clean armor.
But it was the sea Adelia looked at; blue and gold in the rising sun, tranquil, its touch on the shore like the regular breathing of a child, its only ornament the distant St. Patrick, O’Donnell’s ship, riding quietly at anchor while, on board, its passengers seethed, some with worry for their princess, Dr. Arnulf with resentment, and none of them able to do anything about it unless they swam the couple of miles to the shore.
Adelia would have given anything to change places with them. “Father, help me,” she said, and it wasn’t just God she prayed to but the Jew who had brought her up and had faced what she was facing now.
The responsibility was crushing her. “Father, help me. The only time I’ve used a knife these last months was on a goat—and that was dead.”
A cry came from behind her as Mistress Blanche scurried up the seawall steps, followed by the O’Donnell. “Why are you standing there? Why aren’t you doing something?”
“Because what I have to do may kill her anyway,” Adelia said, her eyes still on the sea.
She took a deep breath and turned to face them. “I cannot magic her well, I wish I could. I am merely a doctor. You see, there is an organ in our bodies ... here.” She pressed her hand against the right side of her stomach. “Sometimes it goes bad....” She wondered if she should go into the subject of suppuration and fecal matter, and decided against it. “I believe it has done so in the princess’s case and must be removed.”
“Removed, how?”
“Well, by making an incision above the affected area and taking the bad piece out.” Dear God, if it were only that simple.
“With scissors? Like cutting
cloth?” Blanche’s knowledge of incisions extended only to dressmaking.
“Yes, except that we use a knife.”
If Blanche’s face had been wild before, it was ghastly now. “You make a hole? In the skin?”
“Yes. It is sewn up afterward....”
“But it will scar her, won’t it?”
“I’m afraid so, yes....” She was going to go on and assure the poor woman that her princess would feel no pain, that there had been preparations of poppy in Dr. Arnulf’s bag ...
This, however, was not the lady-in-waiting’s concern. “You can’t.” She made a rush for the steps as if to go down to Joanna and protect her, but the Irishman stopped her. “Now, now, Blanche. Listen to the nice ladyship.”
Blanche thrashed at him. “Don’t you see? He’ll reject her. Dear Mother of God, he’ll reject her.”
“I don’t understand.” Adelia really didn’t. “The princess is very ill. There is a remote chance that by doing this I can save her life.”
Blanche put her hand over her mouth and began rocking.
The O’Donnell took Adelia’s arm and led her farther along the wall. With the sun on it, his face was lined and the eyes she’d distrusted were infinitely tired. “That poor lady is between Scylla and Charybdis, mistress,” he said, quietly. “On the one hand, she’s desperate for her mistress to live. On the other, if the princess survives this procedure ... Will she?”
“I don’t know.”
He nodded. “If she lives, she’ll be imperfect, d’ye see? Scarred by an unholy operation. Damaged goods, you might say King William could reject her, might even have the right to reject her, I don’t know. And how would our good Henry take that humiliation? A spurned daughter? Wars have started for less.”
Adelia saw. This wasn’t just a sick patient they were discussing, it was a bargain between kings and countries. The girl lying on the table in the keep was of international importance. If she died from the operation, and most likely she might, Adelia herself would be accused of killing her. If Joanna survived—as two of Dr. Gershom’s patients had survived—her surgeon would be equally culpable of—what was it this man had said?—damaging the goods, royal goods. Either way, the political ramifications would engulf not only all of them, but a continent.
From the first, she had known that any operation was a sin against the teachings of the Church, subject to rigorous penalty—all surgery was that; it was an accepted hazard for those who possessed the skill and were compassionate enough to use it to save a patient’s life. That the School of Medicine was known to permit it put it at risk from the Church.
But this, this intervention could not be hidden; Joanna’s body was a present from the King of England to the King of Sicily; when its wrapping was taken off in the bridal bed, its blemish would be discovered, the jewel found imperfect, deliberately spoiled by what was, in the eyes of the Church and, undoubtedly, a royal Christian husband, an act of the grossest impiety
Adelia thought of all this, of the far-reaching consequences, and knew that in the end, it didn’t make any difference.
She looked up at the Irishman. “It doesn’t make any difference,” she said. “It can’t. A doctor’s duty is only to the patient. Joanna is dying. Because there’s just a chance of saving her, I have to take it.”
“What are the chances?”
“Well, it’s been done. My tutor performed the operation once, on an old man, but the patient died; it was too late, the organ had burst and spread poison. My father ... I was assisting when he saved two by it, both children.” It was strange, she thought, how the condition so often affected the very young. “I also assisted when three others died—it’s such a horrible risk.”
“But you know how?”
Tears were making her eyes blink. “O’Donnell, I don’t want to do this, I don’t want to, but I’ve got to. I can’t just let her die.”
“Yes,” he said gently. “It’s the reason I love you.”
He watched her face and gently reached out with his finger to raise her dropped jaw. “Did you not know? Ah, well, it’s no matter.”
No matter? No matter? He had stupefied her. All she could find to say was: “Why?”
It made him smile. “Now, then, if I knew that, we’d have the answer to why the sun comes up and goes down.”
She would have done anything then, anything, to help the pain of this wonderful man to whom she owed everything, anything not to hurt him. But the one thing he wanted of her, she was incapable of giving him.
“I didn’t know,” she whispered. “I’m so sorry. So sorry”
“No need. But it had to be said. Go along now, and get ready”
THE OPERATING TABLE, Gershom said, was an altar on which the surgeon laid his supplication to God and, like all altars, it had to be pristine. Just as he who was to be dubbed a knight the next day took a bath before his night’s vigil in church, so must the supplicant surgeon and his offering be cleansed in the sight of God so that, if the surgeon’s prayers were accepted, God would return that offering to health.
Now Adelia became tigerish. Everybody was put to work. The suffering princess was removed from the keep’s table and laid on a couch while Ulf and the O’Donnell dragged the table itself out into the open air—there’d be more light there—and made to scrub it as it had never been scrubbed before. Johan’s knives gleamed well enough, but they were nevertheless once again put into boiling water, as were the needles and silk thread from the sewing basket that Mistress Blanche, for all her panic, had brought with her from the ship, along with her face powder, rouge, and scents.
Everything, everything must be holy
As Adelia lowered a basket of the wool swabs she would need into the vat’s bubbling water, Mansur touched her arm. “You know you are mad? You should leave the girl be, she is in the hands of Allah.”
“No, she’s in mine. Oh, God, Mansur, I’m so frightened.”
He sighed. “Well, well, they can only hang us once. What did the gladiators say in the arena? ‘We who are about to die ... ’?”
She wasn’t listening to him. “Is Fabrisse scrubbing our clothes?” She must be washed of her sins, of the guilt of Brune’s death, of Ermengarde’s. She had to be pure for this, all things had to be pure.
The Arab nodded. “Scrubbing hard. We shall be in clean robes.” He allowed himself a smile. “But they may be wet.”
It was in the middle of all this that a cry came from the top room of the tower. Fabrisse went up to see about it and returned, grimacing. “Boggart’s waters have broken,” she said. “The baby’s coming.”
“Not now, oh, not now.”
“Now.”
Adelia took in a deep breath. “You’ll have to see to it. Take one of the shochet’s knives. And you ...” She turned on Mistress Blanche, whose worry, so far, had kept her from being of use. “You go and help.”
“But I . . .”
“Help, I said.” Adelia bit her lip and lowered her voice. This was, after all, a brave and loving woman. “Blanche, my dear, you had the courage to bring Joanna to me, now you must leave her in my hands.”
FOR OVER AN HOUR, Ulf and Johan with his collection of grandsons had been squatting in the bailey, well away from the table in its center, like people watching a sacred, terrible rite from a distance—as they were.
Despite a bright sun, it was bitterly cold. Mansur, who leaned over the table, the long fingers of his left hand holding the cut edges of flesh apart, swabbing with his right, shivered in his damp clothes. O’Donnell, standing next to a smaller table, on which implements and flasks lay on a cloth, also shivered—despite the fire in the brazier next to him.
A fresh blanket had been tucked around the head, arms, and legs of Joanna in her laudanum sleep, but the flesh of her bare, white stomach was goose-pimpled, except for the gaping slash down it.
From the top bedroom of the keep, where Boggart’s contractions were coming hard and fast, deep, loud, involuntary huffs from her lungs groaned round t
he bailey like the blasts of a horn.
Adelia was aware of none of it, not noise, not the passing of time, not people, not fear, not even the humanity of the body on which she operated. She was battling with the enemy, a plump, yellowish, glistening, red-veined vermiform tube proving difficult for her tweezers to tease away from the rest of the gut. It hadn’t yet perforated, thank God. But it was taking too long.
At last she had it. Still holding the tweezers in place, she gestured for O’Donnell to pass her a knife, and cut.
“Cauterizing iron. Quick.”
There was a hiss. The body on the table jumped and Mansur, in response to Adelia’s brief look, held the laudanum sponge to Joanna’s nose.
The worm was thrown into a bucket.
Now the sewing up. “Needle.” She was passed the curved steel needle from Blanche’s sewing kit and knotted the sutures.
“Brandy” The wound had alcohol squeezed over it and was covered with lint.
Adelia took a swig of brandy herself and then sat down on the ground, staring into space, still clutching the bottle.
She only looked up as Fabrisse came out of the keep with a lustily bawling baby in her arms.
Joanna was breathing, but the battle for her life would continue and was now mostly in the hands of God. Adelia had done her best; it remained to be seen whether it was good enough.
FOR A WHILE it looked as if the Lord had given and the Lord was taking away. Donnell, as the new baby boy was called, thrived while Joanna went into a delirium and Adelia into panic.
The Irishman rowed out to his anchored ship to tell those aboard that it was still touch-and-go for the princess, but that “Lord Mansur’s ministrations” were doing her good.
He refused their demands to take them ashore and ordered his crew to keep all passengers on board, where water, wine, and food would be rowed out to them.
There was to be no mention of an operation; if Joanna died, it must be assumed that she had succumbed to the illness that had been the reason for her abduction in the first place—some small protection for Mansur and Adelia, who would be blamed by Arnulf and the others for the princess’s death in any case, but might possibly save them from their almost certain execution were it known that death had been caused by the child’s body being cut open.
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