The Book of Maladies Boxset

by D. K. Holmberg

  Why hadn’t she fought that much on Sam’s behalf?

  If she had, what would have been different for her?

  Sam wouldn’t have known Bastan, and she wouldn’t have developed her abilities to sneak around, finding her way into places she really didn’t belong. She never would have gotten to know Marin, though that wouldn’t have been all bad. But, more than anything, she never would have known Tray. Whatever else might have been different, she couldn’t imagine a life without Tray being a part of it.

  She really needed to find him.

  “Why won’t you work with me?” Sam went on, looking at Elaine. She seemed so peaceful as she rested, but did she deserve to be peaceful, did she deserve to have that, when Sam could not?

  “I need to learn how to use my abilities. I deserve to know this.”

  “You are learning.”

  The soft-spoken words startled Sam, and she jumped back a step.

  Elaine didn’t open her eyes, but clearly, she was able to answer and was much more alert than Sam had expected.

  “You abandoned me,” Sam said.

  “I did not abandon you. You were… lost.”

  Lost. Sam didn’t think that she’d been lost. How hard would it have been to find her if Elaine had looked? Marin had known where to find her, which suggested to Sam that Elaine should have been able to discover her as well. Instead, she had seemingly assumed that Sam was dead.

  Maybe she should have stayed dead to Elaine.

  She didn’t really feel that way. She had to admit a certain thrill as she learned the staff with Thoren, and she had to admit an edge of excitement as she realized that her Kaver abilities were not entirely tied to the easar paper. If she didn’t have to rely on the paper, then there had to be other things that she could do, other abilities that she could work, and perhaps she would be able to face the Thelns even without augmentations.

  Yet even Elaine had come at them with an augmentation. The speed she’d used to attack couldn’t have been anything other than an augmentation—could it?

  Unless that was what she had wanted Sam to learn.

  “Did you know they were there?” Sam asked.

  “They entered the city. I lost them.”

  “How did you find them?”

  “Pressure.”

  At first, the comment seemed strange, something that Sam was not meant to understand, but the more she thought about it, the more she thought she understood the pressure that Elaine meant.

  “Their explosions?”

  “Not. Explosion. Their magic.” Elaine still seemed weak, and her words were clearly draining what little energy she had.

  “I don’t understand.”

  “You. Shouldn’t. Untrained.”

  Elaine’s face twisted, and it seemed as if something hurt her, and her breathing quickened.

  “What is it?” Sam asked.

  “Stomach,” Elaine grunted.

  Sam took her hands and squeezed them, trying to find a way to soothe Elaine, but feeling inadequate. There was nothing she could do or say that would help put her at ease. She stroked Elaine’s hair, brushing it away from her face, and realized that sweat had beaded on her forehead.

  She was fighting something awful.

  “Did he hit you?” Sam asked.

  “Staff. Hit.”

  Sam thought back to what she’d seen during the fight. When the Theln had grabbed Elaine’s staff, she’d held on, until he ultimately flung her off and she flew against the wall of the building. But had her own staff hit her in the process? The Theln had reached in, moving so quickly that Sam had a hard time tracking it, but it was possible he had done more than simply throw her against the building.

  The Thelns liked poison, didn’t they?

  The first time Sam had confronted them, she’d been chased by a man who was eager to poison her. The Thelns thought their poison universally fatal to Kavers, but why should that be when Scribes could heal them?

  Unless it had something to do with the Book of Maladies.

  “Do you think you could have been poisoned?”

  “Possible,” Elaine agreed.

  Sam paced around the table, wringing her hands. She needed Alec to get here. He had saved Sam when she’d been poisoned, and she thought if anyone could do something to help reverse the effects of a Theln attack, it was Alec.

  “Need to. University.”

  “You’re too sick to go to the university. I brought you to someone who will help.”

  “Who?”

  “A man who has helped me many times,” Sam said. “A man by the name of Bastan.”

  Elaine moaned. Sam smoothed her hair again, brushing it off her forehead. It didn’t seem like the gesture made much of a difference, but she felt the need to do something for her mother.

  She lost track of time. Elaine had stopped speaking, and Sam didn’t feel comfortable yelling at her anymore about the past. Not now, knowing that her mother might have been poisoned and might be dying before her eyes. She didn’t want her angry words to be the last thing her mother ever heard from her.

  After a while, she heard the door open and looked over to see Alec walk in. Relief swept through her, but it faded when she realized he wasn’t alone.

  The woman she’d seen with him before walked in behind him.

  21

  Surgery

  The hospital was as busy as usual today, and Alec kept his hands clasped behind his back as he looked over the line of students in front of him, peering over the cot. They were with Master Eckerd again, and he made a point of speaking quietly, almost as if he didn’t want to reveal too much to the people near him.

  The patient here was fairly young, certainly younger than many of the patients that were often seen at the university and had dark brown hair that reached her shoulders. Her skin was deeply tanned, and he wondered if she spent significant time working outdoors or if she naturally had a darker complexion. There were many people within the city with darker complexions, though most were lowborns, which fit with their tendency to work outdoors. Most of the highborns had pale skin and preferred to maintain that by remaining inside and keeping covered. It was another way to maintain division between the classes.

  “What do you see about this woman?” Master Eckerd asked.

  Alec couldn’t see anything unusual. Her eyes were closed, and she breathed regularly, but she hadn’t moved in the time they been there. There were many ingestions that could lead to such a coma, and many of the medications used by the university as sedatives would also induce something similar.

  “Has she been administered anything?” The question came from Matthias, who stood across the cot from Alec and shot him an amused glare as he asked the question.

  “An excellent question,” Master Eckerd said. Matthias flashed a satisfied smile at Alec. “But as far as we can tell, she’s not been administered anything.”

  “Nothing from the university?” Alec pressed.

  “There has been no need. She has been motionless since she arrived.”

  Stefan took one of the woman’s hands and raised it to examine her nails, then pulled back her sheet to look up her arms.

  Master Eckerd chuckled. “This is not a self-inflicted injection, either.”

  Stefan shrugged. “I only thought—”

  “You thought that I would have another person who had indulged in solpace juice?”

  Stefan looked down.

  “Master Carl was teaching us about foxglove,” Matthias said.

  Master Eckerd’s gaze narrowed. “He was teaching first-year students about foxglove, was he?”

  No one answered immediately, so Alec nodded.

  “Well then, if you’ve learned about foxglove, see if you think this might be a similar ingestion.”

  Matthias pushed one of the other students—Karen—out of the way. She was short, nearly the same height as Sam, but dressed in much more formal clothing that Sam wouldn’t be caught dead in. She wore a floral-patterned dress that reached
to the ground, and a heavy gold locket hung from her neck.

  “He might want to be careful. He’ll upset his girlfriend,” Beckah whispered.

  Alec’s eyes widened. “She’s his—”

  Beckah shook her head. “Not her. Nanci.”

  Nanci was a taller woman, who dressed nearly as formally as Karen, but didn’t wear the same gold chain, or any other sign of the highborns. Alec had rarely spoken to either of the two women.

  Matthias grabbed the patient’s wrist and checked for a pulse. He moved up to her neck, feeling the artery there, before leaning his head down to her chest to listen.

  Beckah laughed before covering her mouth.

  Master Eckerd arched a brow. “You find this woman’s illness amusing?” he asked.

  Beckah shook her head. “I’m sorry, Master. It’s just that Matthias can clearly see that she’s breathing. And she has a bounding pulse. I can see it in her neck. His exam is more for show.”

  Master Eckerd nodded once. “Wonderful observations.” He tapped Matthias on the shoulder, forcing him to step back. “Yes. You can see her breathing, and her pulse is readily visible. This is not foxglove.”

  “Probably good,” Matthias muttered. “I hear the other patient given foxglove didn’t make it.”

  Master Eckerd frowned again. He looked over at Alec before turning his attention back to the woman. “Yes. Well, can anyone tell me any other observations here? We have decided this is not foxglove. We have decided this is not solpace juice. What else would you question?”

  “Have there been any signs of fever?” Beckah asked.

  “No fever. Any other questions?”

  Everyone fell silent, most simply staring at the woman, waiting for Master Eckerd to explain what had happened. Alec didn’t want to answer. He had suspicions, but after what had happened with Master Eckerd the last time, he didn’t want to speak up and hesitated saying too much, otherwise he ran the risk of getting taunted again. It was bad enough that someone—likely Mathias—had left clippings of leaves at his door.

  “None?”

  Beckah elbowed Alec, and he shot her a look before taking an unintentional step forward.

  “Mr. Stross. What would your assessment be?”

  “He probably thinks some magical spell was placed on her,” Matthias said.

  A few of the people on the other side of the cot—including Karen and Nanci—laughed.

  Alec took a deep breath. “Has she had any injury?”

  “You can see that she hasn’t,” Matthias said.

  Master Eckerd watched Alec. “Assuming no visible injury, why would you ask?”

  Alec took another step forward. He was already committed, and now, it was too late to step back. He slipped his hands under the woman shoulder and tipped her, looking at her back and up to her head. There was no sign of any injury. Had there been, he suspected that Master Eckerd wouldn’t have chosen her as an example.

  His father had once used a similar example.

  “The people who brought her in. Did they mention any previous injury?” Alec said.

  Master Eckerd smiled. “Is that the path you would like to go down?” he asked.

  “I just thought I’d ask,” Alec said.

  Master Eckerd came around the end of the cot and pointed to a spot on the back of her head. “She was seen slipping near the canals after stepping off one of the barges about a week before she was brought to us. There is no visible injury, but her husband claims she hit her head and had been complaining of a headache for the last week.”

  “Wouldn’t you see signs of an injury sooner than this?” Matthias asked.

  “Not if she had internal bleeding. There are some injuries that take time, and bleed slowly, before becoming incapacitating,” Alec said.

  Master Eckerd watched him a moment. “Yes. There are many hemorrhages inside the brain that will lead to swelling. We have tested this with mice and have seen similar effects.”

  “Is that what happened to her?” Beckah asked. She looked up at Alec, a curious expression on her face.

  “Unfortunately, there is little we can do to determine that. Given the history that we were given, it is entirely likely that is the cause of her symptoms.”

  “What can be done?” Stefan asked.

  “There are no medicines that will reverse this,” Master Eckerd said. “At this time, it’s mostly a matter of waiting to see what will happen, but we can also attempt to remove some of the pressure.”

  “Pressure? That means—” Matthias said.

  Master Eckerd nodded. “Yes. That means she will be taken to surgery. Mr. Stross, as you seem to have diagnosed her, I would ask if you would be interested in attending the surgery.”

  Alec made a point of only looking at Master Eckerd. It was uncommon for first-year students to be allowed into the surgical suites. They were reserved for upper-level students and physickers only. For him to be given that opportunity was more than an honor; it was unheard of.

  “I would be happy to,” Alec said.

  “Good. We will take her now. The rest of you will go with Physicker Terrence, and he will review the remaining new patients with you.”

  Terrence walked up to Master Eckerd. He was a junior physicker and looked older than his likely age. He was thin, with a narrow beard, and nodded to Master Eckerd. “Are the students ready for me?”

  “They are.”

  “Good luck,” Beckah said to Alec. “And you better be prepared to tell me all about it later.”

  “I’ll tell you what I can,” Alec said.

  She elbowed him as she moved away from the cot and joined the line of students at the next bed. Alec watched them until Master Eckerd cleared his throat.

  “Are you ready?” Alec nodded. “Good. I will need your help wheeling her out of the hospital and into the surgical area.”

  Alec assisted Master Eckerd as they pushed her down the hall. They took a route he’d not taken before, and the hallway was wide, practically cavernous as they made their way through it. Enormous double doors opened up off the hall, and Eckerd nodded toward them and turned the cot to go through.

  A master physicker—as designated by the jacket she wore—much older than Master Eckerd stood on the other side. She had gray hair pulled into a tight bun and stepped forward to welcome to Master Eckerd. Two junior-level physickers, a man and a woman, stood behind her. Both were older than Alec.

  The other master glanced at Eckerd but said nothing. Eckerd pushed the cot toward the middle of the room then addressed the rest of us. “Today, Master Helen and I are going to try to relieve some swelling in this woman’s head,” Master Eckerd said. “This will require us to remove a piece of her skull bone, which means a steady hand. Physicker Abigail has been chosen to assist. Physicker Jeremy is here to observe.”

  Alec stood at the back, suspecting that as a student, he had little right to be too close to the activity. He preferred to be up close and would prefer to watch what Eckerd did, but was simply thankful that he was allowed in here at all.

  He watched as Master Eckerd and Master Helen prepared for the procedure, and was impressed by the way they moved efficiently, both masters using balsping oil on their hands, a liniment that had a sharp, pungent odor, but was widely known as an effective antiseptic. They used the same oil on the woman’s scalp, scrubbing through her hair. Physicker Jeremy remained nearby and stepped in to remove the liniment container.

  Master Helen procured a scalpel and stood back, waiting for Eckerd to signal her. He nodded, and she leaned forward and made a sharp incision, cutting into the woman’s scalp. She worked quickly and had a steady hand.

  Alec couldn’t help himself, and crept forward, watching as they peeled back a layer of skin, exposing the bone. He’d seen injuries where the bone of the skull was revealed but had never imagined cutting into the scalp to reveal it. His father was skilled with medicines but had never attempted any surgeries. That was the role of the university, and his father had never shown any des
ire to offend them by overstepping his place.

  Master Eckerd took a shiny hammer and a sharp, spike-like instrument off the table next to the cot. Placing the spike against the exposed bone, he gently tapped the hammer against the spike, then moved the spike to a new spot, tapping again. Working quickly, he formed a circle in the skull, and with one final tap, Alec could see the center mass separate from the rest of the skull.

  Alec heard gagging and looked up to see Physicker Abigail looking ashen, her face pale.

  “You can step out if you’re going to be sick, Abigail,” Master Helen said.

  Abigail clenched her jaw and shook her head. “I’ll… I’ll be fine.”

  “If you vomit on our patient, she will get an infection in her head, and there will be no way she’ll survive this.”

  Abigail paled even more before nodding and hurrying from the surgical room.

  “Alec, step into Abigail’s place,” Master Eckerd said.

  Eckerd glanced over at Master Helen who looked at him with an unreadable expression. Alec hurried around the table and stood where Abigail had been. From this vantage, he could see a little better. He saw the way Master Eckerd held the instrument, and the way he made a series of movements that lifted the bone free. From there, the brain matter was visible.

  “What do you—” Master Helen began.

  Blood began seeping from the hole in the woman’s skull.

  Eckerd breathed out. “Ahh. Excellent.”

  “Why excellent?” Alec asked. He knew that he should be quiet, that he was here only as a courtesy, but he couldn’t help himself. It was the same tendency that always seemed to get him in trouble. He couldn’t keep himself silent when he was curious about something.

  “There are times when the blood is deeper. Other times, when we don’t cut in the right place.”

  “How did you know where to cut?” Alec asked.

  Master Helen frowned. “There were slight discolorations of the skin.” She turned her attention to Master Eckerd. “Did you need to bring a chatty student into the surgical suite?”

  Eckerd glanced up and met her gaze. “He has diagnosed both solpace injection as well as her injury.”