The Book of Maladies Boxset

by D. K. Holmberg

  “An apothecary?” the master physicker asked.

  “He taught me what he knows,” Alec said.

  “Tell me, son of an apothecary, how is it that you were granted entry to the university?”

  “I imagine I was tested the same as others.”

  The master physicker stared at him for a moment before her gaze again drifted around the room. It settled on each of the students before returning to Alec. “Yes. You were. It would be good for all of you to remember that. Many of you studied for months for the testing, and some of you barely passed. Some of you studied much longer, possibly years.” She turned once more and looked at Alec. “And then there are some who have a practical knowledge. They may not have studied at all. In here, you are all students. In here, there is no class system. Do not force one. If you do, you will find that it quickly becomes unnecessary. Here, knowledge and skill is most important.” She tapped a pen on the desk. “Now, if there is nothing else, we will begin.”

  Alec kept his gaze focused on the instructor, not wanting to look around. It seemed an odd way to describe a lack of class structure within the university by essentially calling him out. Had she known that he was the son of an apothecary? She wasn’t one of the master physickers who had tested him, but he suspected that she knew who he was. It felt strangely personal the way she called him out.

  Now they all knew that he was the son of an apothecary and likely someone they could easily dismiss.

  Alec knew something as well.

  He knew that others studied hard to reach the university, some spending months or even years preparing for the testing, and likely through book learning. In this, Alec had an advantage. He had spent most of his life training for this, to the point where medicines and healing and diagnosing were all second-nature to him.

  Even in that, he wondered if the call out had been intentional. Had the master intended for them to know?

  Alec tried to maintain his focus on the lecture. It was difficult to do so. She was going on about some basic physiology, so it was easy for his mind to drift. Everything felt off for him. He was out of his comfort area. It would be much better were he to have a chance to see patients and see if there was anything he could do to help them, anything other than sit in the lecture hall and learn theoretical treatment approaches.

  The master physicker watched him, almost as if knowing his thoughts. She continued her talk, and he continued to listen with barely half a mind focused on her, not nearly as much as what he needed.

  There was one way he could force his focus. It was the same way he had always focused.

  Alec pulled out some paper and began taking notes.

  21

  An Incurable Patient

  Alec stood with other students around the cot, studying the still form of the woman lying there. She no longer writhed as she had been. The master physicker had put a few drops of a tincture into her mouth, administering just enough of the liquid so that she stopped moving. Master Eckerd was an older man, who had made a reputation throughout the university as quite an astute physicker. Alec was eager to see how this man would compare to his father.

  They were in the hospital ward. It was an enormous room with smooth walls, and well-lit by a dozen or more lanterns. There were no decorations along the walls, and the marble floor gleamed, appearing as if it had been recently scrubbed and polished.

  The ward consisted of dozens and dozens of beds, all arranged in rows, and most of the patients here were quite sick. If the physickers were able to help them, they truly did have significant skill. Most of these were people that would have come to his father, and he imagined that his father would have been able to help barely more than half of them.

  The smells of the ward were familiar. Despite the overall sterility to the environment, and the appearance of cleanliness, there was the odor of illness, a mixture of rot and vomit, mixed with another stink that he tried not to think about. Overtop of it was a medicinal aroma, and he tried to pick out the various smells, but couldn’t.

  “What do you see?” Master Eckerd asked.

  Abigail stepped forward. She was petite and had a squashed nose, and Alec had not been able to determine which section of the city she came from. Likely one of the inner sections, especially considering that she wore a hint of makeup, adding enough coloring to her features for him to easily make out the effort she had put into it. So far, the promise of no class within the university had been a lie. Those who were from the inner sections remained together, while those of the merchant class had also remained together. Alec had generally been alone.

  “She was suffering from pain. You applied orphum and—”

  Master Eckerd raised his hand, cutting her off. “Yes. I applied orphum so she would stop moving so that we could do an assessment. I was hoping for something not quite so basic.”

  Someone snickered, and Abigail flushed, the color somehow coming through her makeup.

  Alec continued his study of the woman, his training kicking in. She had ruddy features, but that wasn’t what drew his attention. It was the thinning hair. There were discolorations along her nail beds. Otherwise, he saw no evidence of wasting. Typically, with thinning hair and the changes in the nail beds, along with the cracking he noted along her fingers, there would be a generalized wasting. It made him think of Princess Lyasanna.

  Alec stepped forward and lifted the woman’s hand, checking her pulse as his father had long ago taught him. Her pulse was pounding. Not only were her fingers cracking, but the palms of her hands were, as well. There was a hint of redness there. It was different from the discolorations that he’d seen on her nails.

  “Steady pulse. Cracking skin, but only peripherally. No evidence of malnourishment. Thinning hair could be correlated, but I wonder if perhaps it’s hereditary…”

  Alec cut himself off. He hadn’t intended to step forward and speak, but it was almost involuntary when someone came before him like this. His father had long ago taught him to make assessments and had never faulted him when he was wrong. His father viewed misdiagnosis as an opportunity for him to learn and to improve.

  “What’s your name?” Master Eckerd asked.

  Alec fought the urge to step back and hide among the other students. Now that he had brought attention to himself, he doubted he would be able to hide anyway. All he wanted was to learn, quietly, but he’d drawn attention to himself from the very moment he came to the university.

  “Alec Stross.”

  Master Eckerd studied him. “How long have you been at the university?” His gaze drifted from Alec to the other students standing around the bed. All of them were new admissions to the university.

  “A week.”

  Master Eckerd frowned. “A week? Already you’ve given me a better assessment than many who have been here over a year.” Master Eckerd took the woman’s other arm and held it up. “As you have identified, her pulse is pounding, and it’s strange the way her palms crack. I have seen similar symptoms, but this is more than simply dryness.”

  Alec studied the woman’s hand, which he still held, running his fingers along the surface of her skin. There was more to it than simple extreme dryness. He couldn’t help but feel like the combination of symptoms made no sense. He’d never seen such symptoms presented together before, though he didn’t think he could—or should—tell Master Eckerd that. That would likely come across as arrogant, and make it seem like he had more experience than he did. Besides, Alec didn’t want to draw even more attention to the fact that he was an apothecary by training.

  Alec looked up to Master Eckerd. “I don’t recognize the combination of symptoms.”

  Master Eckerd nodded. “I wouldn’t have expected a student to identify it. This is a particular type of poisoning.”

  With the word poisoning, Alec immediately began to think of the Book of Maladies and the Thelns.

  “It’s typically caused by anrastic berries, but it can also be acquired from snake venom. As you identified, her thinning hair
is likely a hereditary issue.” Master Eckerd surveyed the students. “Often times, it is the assessment that is most important. Once you know what to look for, our library has enough records for you to find answers, even if you don’t know the complete nature of the question.”

  He reached for the binder at the end of the bed, a record of documentation that contained the person’s presenting illness and began to make a few notes. Without looking up, he said, “That is the lesson for today. It’s not identifying the disorder, though I would’ve been impressed had anyone recognized this. It’s more about realizing that you must hone your observation skills, and when you do, you will be able to find the answers to almost anything that you seek. There are a dozen master librarians who can help you in your search.”

  He placed the binder back into the slot at the end of the bed and led them away.

  Alec remained near the woman, frowning.

  As the students departed, Master Eckerd paused and looked back. “Is there something more you would like to add?”

  Alec looked up. “What’s the treatment?”

  The master physicker took a few steps back toward Alec and faced the woman. “Unfortunately, there is little that can be done to cure this woman. Anrastic berries are almost universally fatal. And if she did come in contact with the guilder snake, only the antivenom would save her. Unfortunately, that is not something anyone keeps on hand.”

  The master physicker turned away and led the students.

  Alec remained by the woman, still frowning. He lifted her arm again and began peering along the length of it. Then he went around the bed, doing the same with her other arm. By the time he reached her feet, he had slid the cloth off of her legs.

  “What are you doing?”

  Alec glanced over and realized that Jen, one of the highborn students who had joined the class and remained behind, was watching him. “If it’s snake venom, I imagine there would be a bite mark.”

  “Unless she was poisoned.”

  Alec nodded. “Unless she was poisoned. But if this was an accidental toxic exposure, there has to be something that can be done.”

  “But what does it matter? You heard Master Eckerd. He said there was no treatment for either anrastic berries or the guilder snake venom.”

  “It matters because he said there might not be anything that can be done here, but…”

  “Who would have antivenom?”

  “Maybe not antivenom, but something else.” His father often knew ways around antivenom. It wouldn’t be the first time they had encountered a bite, and it wouldn’t be the first time his father had to concoct an antivenom to combat the toxin of a strange creature. “I can’t leave someone to suffer if there’s anything that could be done.”

  Alec looked over, noting that Master Eckerd and the other students had stopped at another bed. He wondered what lesson the master physicker would present with that patient. Alec should join them, especially since what he had seen from Master Eckerd told him that there was probably much he could learn from the man; his assessment was similar to the way his father made assessments. He didn’t know anything about anrastic berries, but venom from a snake bite was a painful way to die.

  Jen looked over at him. “Come on. You don’t want to be expelled from the university in your first week, do you?”

  Alec sighed. He didn’t, but he also couldn’t leave somebody here who might be suffering. She could be someone’s mother. Someone’s sister. Didn’t she deserve a chance if there was something he could do?

  Before departing, he glanced at her legs and noted two small marks on the inside of her ankle.

  Puncture wounds.

  If there were puncture wounds, then the symptoms were from venom, and not from the berries.

  He glanced over, but Master Eckerd was still busy talking to the class. Alec tore a strip of cloth from her pants and quickly wound it around her upper thigh. If nothing else, it would slow the spread of the poison, though he wasn’t sure how effective it would be given how sick she already was.

  After pulling her gown back down, he hurried off, joining the others in the class. As he listened, only halfway paying attention, he continued to glance over at the woman. How long did she have? How long until they were done with the bedside teaching? How long would it be before he could hurry off to his father’s shop and see if he could find something that might help? If it took much longer, he would be too late.

  When they moved on to yet another patient, Alec knew he had to slip away.

  He stayed toward the back of the students.

  “There are mushrooms in the steam fields,” Master Eckerd was saying. Alec’s ears perked up. This was something new for him. “They grow along the underside of rocks and can cause this type of illness. It doesn’t happen often. Most of the time, people end up with something almost like hallucinations, a vividness to everything they see, but a certain percentage of people will suffer. The telltale sign is found under the tongue.”

  Master Eckerd moved on and began discussing another example of a rash, and Alec thought it amusing, especially considering the nature of the questions that he had been given for entry to the university. He left his gaze drifting to the woman, and both Jen and Abigail watched him. Would either of them say anything when he attempted to disappear?

  He glanced over at the door leading away from the hospital ward. He could sneak off, but he would have to find a way of doing so without raising too many questions. He didn’t know what would happen if he got caught, but he was certain he couldn’t simply wait, either.

  When they moved on to another patient, Alec took the opportunity to sneak away.

  He reached the door and pushed it open, and he hazarded a quick glance back. Not only did Jen watch him, but it appeared as if Master Eckerd did, too.

  His heart sank, but it was too late. Turning back would force him to answer questions, and that would only delay him. What he wanted—and what the woman needed—was for him to hurry away and reach his father’s shop to see if he could find an antidote for her.

  When he returned, he would find out whether he was already expelled from the university.

  22

  Search for Antivenom

  Alec hurried along the street, moving in the shadows out of habit. Since working with Sam, he had gotten used to trying to stay hidden in the darkness, partly because she seemed to practically fear the light, but he also remained in the shadows because of the attack he had nearly suffered. That stayed with him, making him nervous, though he knew in these sections, he didn’t need to be. Dressed in his university jacket, the gray with the sigil that told anyone who would recognize it where he was from and what rank he had—nothing more than the entry-level student—he didn’t need to worry quite as much. He would be able to move freely.

  He passed over bridges that led between the various sections, staying along the canal. As he crossed, he flashed his university sigil as a marker for him to get beyond the guards between each section. The university was a reasonable distance from Arrend, so by the time he reached the apothecary shop, it was late.

  He wasn’t sure if his father would still be up and the shop open or if he would have to force his way in. He had to remember to ask his father for a key. It wasn’t unusual for his father to remain awake late into the evening, but it was getting fairly late.

  Alec saw a lantern burning inside, and when he tried the door, it was unlocked.

  He pulled the door opened carefully, not wanting to awaken his father if he had accidentally fallen asleep. His father had often fallen asleep while working, and Alec had never wanted to disturb him, knowing that he worked himself hard enough that he needed time to recover. He grabbed the bell hanging over the door before it could ring and draw attention. Alec closed the door just as carefully.

  Once inside, Alec heard soft voices talking, and he paused to listen.

  “Why have we come here?” A man’s voice.

  The voice had a deep timbre, but it wasn’t familiar to him.
He moved to the edge of one of the shelves, trying to remain hidden.

  “Because this is where he has been coming,” a woman answered. He was certain her voice was familiar, though he wasn’t sure why.

  “If you revealed yourself, you could simply tell them to continue to study together,” said the man.

  “I’m not sure that I can, especially not now that he’s gone to the university.”

  Alec peeked around the shelf. He realized why he recognized that voice. Marin.

  But why would she be here?

  Had she come to meet with his father? And who was the other person?

  Unless she’d come for the books he’d taken. Alec had given them to his father.

  He couldn’t see the man from where he stood, and tried to move so that he could, but didn’t want Marin to discover that he was there and listening. They had been trying to find answers from her. Sam had been searching for Marin, hoping to learn from her, but couldn’t track her down. Now here she was in his father’s shop.

  “They shouldn’t have managed a pairing. I thought you were preventing her from reaching that,” the man said.

  “Only because it would expose them to danger. It should have been nearly impossible, though I hadn’t expected this.”

  “Yes. I should have remembered him. He left the university years ago.”

  “Is he a Scribe?” Marin asked.

  “I don’t see how that would be possible. If he were a Scribe, he would never have been allowed to leave.”

  Alec remain hidden in a narrow aisle between shelves. From where he was, he thought he could remain unnoticed until they moved to the side of the apothecary shop, but they seemed comfortable waiting at the table, as if expecting his father to come. Where he stood, the shelves contain aromatic leaves, and his mind identified them without intending to. Alec pushed those thoughts away, focusing instead on why Marin was here.