I tried to explain the situation to Theogenes and the others one night at the tavern.
“First we had this poor old water vendor,” I said, “with a very nasty enteritic fever, and his only living relative was a daughter in some village right up the Nile. Philon and I went down to the hospital by the church of St. Mark and tried to get the monks to agree to take the man. We met one monk at the gate, and Philon began to explain the situation, and everything seemed to be fine. Then another monk came out of the hospital, recognized Philon, and started shouting at him. He said we’d come to spy on them and were looking for some way to betray them to the authorities, just the way our ancestors betrayed the Christ and handed monks over to the governors to die in the arena, and so on and on. And he said we were idolators, and worshiped ‘the Great Beast in Constantinople, the king of the heretics.’ It took me a moment to understand that he really meant the emperor. I’d never heard anyone speak so recklessly in my life.”
“They always say things like that,” Theogenes said. “So what did your master do?”
“Smiled and said that he’d come to see if they could take another sick old man, and why didn’t they leave ancestors out of it. I was astonished. But eventually the monk calmed down, and they took our patient just as though no one had ever said anything unusual.”
“Was the patient Jewish?” asked Nikias, the pagan.
“Of course not. The Jews look after their own. No, he was a Christian. The problem was just that Philon was Jewish. So once we had the old man installed, Philon said that I should do all the visiting and that next time I could talk to the monks. He thought they’d be less suspicious of a Christian.”
“Lucky you!” Theogenes said, grinning. “Were they? Or are you considered to have been corrupted by Jewish influence?”
“I’m considered corrupt anyway. They don’t like eunuchs much more than they do Jews. We had an old woman with a quartan fever whom we wanted to get into the hospital today, and I had to be almost as persistent as Philon was. Did you know that I am a luxury-loving and venal minister of the imperial idol?” I took a sip of my wine.
“Very luxury-loving you look,” Theogenes observed. “Were you wearing that cloak? Or do you have one without five different stains on it?”
“I was wearing this cloak, stains and all. I did point out to them that it was hardly ‘scarlet and fine linen.’ And I did point out that the pleasures of the flesh are closed to me. And there’s a eunuch in the Gospels, bless him, an excellent man who was converted by the apostle Philip, and his example carried some weight. And I said I was a devout Nicene Christian and a passionate admirer of His Holiness Archbishop Athanasios, and I hinted that I’d come to Alexandria because of that, and implied that I was working night and day to convert my virtuous master to the True Way. And finally the monks became friendly, took my patient, and offered in advance to look after any others I want to send them.”
“You mean you can reason with them?” Theogenes demanded in mock astonishment. “I’ve always thought they were like wild beasts. I’d never go anywhere near one of the hospitals.”
“You don’t have to, do you?” I responded. “Does Adamantios have any poor patients?”
There was a general snort of laughter at the idea of the head of the medical faculty of the Museum of Alexandria treating poor patients.
“He’s taken a few cases out of charity,” Theogenes said, defending his master. “But he puts them in his own household and has his slaves nurse them.”
“It doesn’t make any difference. You don’t need to talk to monks. You would if you had to.”
Theogenes made a face. “I hope I never have to. My great-grandfather was murdered here by men like that. It was the reason my family moved to Antioch.”
“What do you mean by ‘men like that’? There weren’t any monks in your great-grandfather’s time. Christianity wasn’t even legal.”
“By ignorant Egyptian peasants, then.”
“That’s not the same thing at all.”
“They sound like they think it is.”
“It’s a good thing you don’t have to deal with them,” put in another student, Kallisthenes the Sidonian. “You’d be sure to lose your temper, and there’d be a riot.”
Theogenes grinned and laughed, but the Alexandrians who were with us frowned.
“You foreigners don’t know anything about riots,” said Nikias. “The next time there’s a riot the monks will be in the middle of it, and there won’t be anything to laugh at.”
We stopped smiling. “What do you mean by that?” asked Kallisthenes.
“Why do you think those monks are so worried about being betrayed?” Nikias demanded impatiently. “They remember what happened the last few times the archbishop was exiled. Or didn’t you hear about that, up in Sidon? There were floggings, rackings, execution after execution, and it still didn’t stop the rioting. The emperor and some of the court bishops tried to put some foreign bishops on the throne of St. Mark, and the Christians here, particularly the monks, wouldn’t have them. The last time it went on for four months and cut off the grain shipments to Constantinople, so the emperor yielded and let the archbishop come back. But everyone knows that as soon as His Holiness Athanasios dies, the whole thing will start up again. The court sympathizes with the Arian faction, and the Christians here are mostly Nicene. And more than that, the sacred offices don’t want any other bishop to become as powerful as Bishop Athanasios. Naturally the monks are suspicious of Jews and eunuchs; they’re suspicious of anyone they think must be loyal to the emperor and an enemy to them.”
“Is Athanasios likely to die soon?” Kallisthenes asked nervously.
Nikias made a rude noise and poured himself some more wine. “I don’t know. He’s an old man. He doesn’t believe in doctors, or doesn’t trust them. He could die any time. On the other hand, he’s a disciple of Anthony the Hermit, and that old man lived to be over a hundred.”
“How many Christians are there in Alexandria?” asked Theogenes thoughtfully.
“The gods know!” Nikias exclaimed contemptuously. “Half the city are Galileans of some kind, though they’re not all as tidily orthodox Nicenes as His Holiness would like to believe. But it’s not just Alexandrians you have to think about. The archbishop is the metropolitan for the whole diocese, not just the city and not even just this province. And he’s popular everywhere. As a matter of fact, even here in Alexandria you won’t find many people of any religion who’d back the authorities and oppose him. Whatever happens when he dies, the Christians won’t pick another bishop like him.”
“But I thought he was an absolute nobody!” protested Kallisthenes, who was a Neoplatonist of good family. “They say that he even preaches in Coptic sometimes, that he’s not even properly Greek!”
“He’s not,” Nikias admitted. “But he’s Alexandrian. And if I had a dispute at law myself, I’d take it to the episcopal court instead of to the governor. You don’t have to pay a fortune in bribes there, it takes much less time than the provincial court, you won’t be beaten by some guardsman, and the archbishop is incorruptible. And Athanasios and his monks and nuns look after the rabble — there are the hospitals, the charities that give dowries to poor girls and cheap clothes to the poor and food to the beggars. Well, the rabble is grateful. Whenever there’s as much as a rumor that his Holiness is ill, everything around here gets tense. You’ll see. There’s bound to be a riot within the year.”
“What’s the archbishop like?” I asked as everyone digested this notion.
“You’re the Christian!” said Nikias. “Haven’t you been to the cathedral to listen to him?”
I shook my head. “I’m already keeping the Sabbath with my master. I can’t afford another day off every week. I’ve been to the church of St. Mark once or twice when lectures weren’t too early, but that’s it. You’ve never seen him?”
Nikias looked a bit sheepish. “I’ve been to hear him a couple of times,” he admitted. “He knows how t
o speak. I don’t think he wants any more rioting — but he’s old. There’ll be a riot by the spring, I’d be willing to bet on it.”
But there were no riots that autumn, and none that winter. The Alexandrian winter is cold and clammy. The ships stay in harbor, lashed to the docks or pulled up on the beach to keep them safe from the storms. Mists rise off Lake Mareotis and mix with the smoke of the city’s countless braziers: Alexandria lies continually in the dank haze. Our patients came down with fevers, now centering more on the lungs than on the stomach. There were pneumonias, pleurisies, and innumerable colds to keep us busy, plus the usual broken limbs and difficult births. But no riots.
Late in January Philon let me take charge of one of his patients. He had allowed this a few times before, but the others had suffered only mild illnesses or minor injuries. This time the man was gravely ill. He was in fact the old merchant who had paid such a handsome price for my mother’s earrings; his name was Timon, and he was a widower with a son and two daughters. He had a fever and a hard, dry cough, and he’d had them for some time before his son called in Philon.
Philon made the initial examination, and looked fairly grim when he had finished. “You should have called me sooner,” he told the old man.
Old Timon spread his hands helplessly. “I didn’t want to miss work. You know me.”
Philon snorted, gave him some wine with iris root, then took the son out into the entrance hall, where the patient couldn’t hear. “Your father has a pneumonia,” he said. “I don’t like the sound or the look of his chest; the infection is fairly severe already.” He hesitated, looking at the other man sadly, then asked, “Has he complained of pain when he breathes?”
The man nodded, looking nervous and unhappy. “That was why I called you. He kept swearing he’d be better after a couple days’ rest.
Philon sighed and shook his head. “I would guess that he was just afraid of hearing bad news from me. I’m sorry, but I don’t think he’ll live.”
I was shocked and dismayed. I liked old Timon. “You don’t think steam —?” I began, then stopped. The son looked at me eagerly, seeing some hope; Philon looked at me assessingly.
“What were you suggesting?” he asked.
“Steam, hot compresses, hyoscyamus and iris root, and plenty of fluids,” I said. “The way you treated Flavius’ daughter.”
“She was a lot younger. And the disease wasn’t so far advanced,” said Philon. Then he sighed, scratching his beard. “It is the correct course of treatment, though.” He dropped his hand and looked at me again. “Very well. Why don’t you take charge of it then, Chariton? If you and your father don’t mind,” he added, turning to Timon's son.
They didn’t mind. The son was aware that I had more hope for his father than Philon did, and old Timon, when we went back into the sickroom, said he was pleased I was progressing so well at my studies. I was at once thrilled and terrified. I hoped that Philon was mistaken; I swore privately to spare nothing in my efforts to cure the old man.
I started him on the treatment at once, and bought a new casebook so that I could note down Timon’s symptoms and keep a record of the ways I tried to cure him. At first everything seemed to go fairly well. The steam and hot compresses eased much of the pain the old man felt in his chest, and the dry cough became wet and productive. He slept better, though the fever did not go down, and he even took some barley broth and kept it down. His family, who were all very fond of him, followed my instructions eagerly. His two daughters both left their husbands for the duration of his illness, and took turns getting up in the middle of the night to change the hot compresses for his chest and boil more water to soften the air he breathed with steam. I visited every morning before lectures, every afternoon, and in the evening as well, and after three days I thought he might be improving.
Then the fever went up and the cough became harder again; the pain came back, worse than ever. He couldn’t bear for me to tap his chest to check how the infection had spread. “If you could just give me something to let me sleep . . .” Timon asked, almost apologetically. He had to whisper because it hurt too much to breathe deeply. I was afraid to give him opium in case it suppressed the cough, but in the end I did. He slept, but grew weaker, laboring over each shallow breath.
The family didn’t blame me; in fact, they were so sympathetic they made me ashamed, and they listened to all my suggestions as though I were an oracle. They never questioned Philon’s decision to give me the case. I did. I consulted Philon, dragged him back to see Timon, and finally asked him flatly if he thought I was doing something wrong. He shook his head. “I would tell you if I thought what you were doing was wrong,” he said, and apart from that he made no comment on the case.
I ransacked the Museum library, looking for suggestions that might be helpful; I discussed pneumonias with all my fellow students and most of the lecturers as well. I worried desperately whether I should bleed my patient, whether I should give him purgatives, whether I should try surgery or cautery. My instincts, what theories I had, and my experience all suggested that anything dramatic would kill him, but it was almost unbearable to go on with the same old remedies when they plainly weren’t working anymore. In the end I tried bleeding him, from the elbow but only lightly, to see if it produced any improvement. He said that it relieved the pain a little, but it did not help him any that I could see, so I didn’t repeat the experiment. He was very weak by then, and I didn’t think he could afford to lose much blood.
One afternoon, a week after I took the case, Timon called his children together and whispered his blessing to them, and then crossed his hands and prepared himself to die. “You don’t need to trouble yourself anymore, young man,” he told me in a croaking whisper when I arrived that evening with some new exotic herb that an obscure authority had promised was all-powerful.
“Just try this in some honeywater, sir,” I coaxed. “I found an author who swears it is effective in cases like yours.”
The old man looked at me, exhausted but still not angry. “ ‘Man born of woman is of few days, and full of trouble,’ ” he whispered slowly. “No, my friend, I’ve tried enough. No one can put off dying forever.”
I stood there with the herb in my hand, looking at the old man, and then I started to cry. I couldn’t help it. I’d stayed up with him half the previous night, he was my first real patient, I genuinely liked him, and he was going to die. Timon looked mildly surprised. “You did everything you could,” he told me gently. “I’ll try your herb, to please you. May I have something more to ease the pain as well?”
I gave him the herb and some opium, but he couldn’t drink much of it. His children clustered round the bed all night, and I sat against the wall, feeling helpless. He died quietly an hour before dawn, when the city was just waking to another day.
I trudged home through the morning crowds, and arrived to find Philon and his family having breakfast. “He’s dead,” I told them.
Philon gave a groan of sympathy and told me to sit down. I sat, and began to cry again. “You shouldn’t have given me the case,” I told him, sniffing.
Philon shook his head. “No one could have managed it better.”
“Oh, by Artemis the Great! Somebody could have; somebody could have cured him.”
Philon shook his head again. “Timon had an infection through the whole of the left lobe of his lung, and he had the beginnings of pleurisy. I have never seen a patient in that condition survive. I wouldn’t say that it never has happened, but it’s rare, and I think when it happens it’s owing as much to chance as to any method of treatment. I hoped that you might have more luck with him than I would; you were eager to try and full of ideas; and I’d given up already. But no one could have honestly promised to cure him. Medicine has limits. Even the pagans say that Asklepios was punished by the gods when he tried to cure death.” I sniffed, and Philon put his hand on my shoulder. “Go to bed,” he said gently. “You need rest, and we have more patients to see this afternoon.”
Timon’s family did not blame me for the death; they paid me generously for my futile efforts and invited me to the wake, where they introduced me to their friends as “the nice young student of Philon’s who tried so hard to cure Father.” I felt very low for some weeks. However, Philon continued putting me in charge of patients he thought I’d do well with, and between study and work I was too busy to brood over my failure.
The Alexandrian spring came slowly. The swallows never left in the winter, so I didn’t watch for their return. The earth didn’t become green; that happens late in the summer, after the Nile floods. But the air grew steadily warmer, the sky became paler, and the fogs and choking smoke clouds of the winter faded away. The days lengthened; frogs croaked in the marshes by Lake Mareotis; the fig trees and vines in the gardens put out sticky green buds. I began to forget that I had ever been a girl called Charis, that I had ever lived differently from the way I was living now, that I had ever been ignorant of things like the correct dosage of hellebore or the writings of Erasistratos.
One evening in March I took the splints off a child’s arm. I had set the bone myself — it had been a bad fracture, compound of both bones in the lower arm. I had known when I set it that unless I did it perfectly, the child could be crippled for life. I held my breath when I cut the arm free. The little girl moved her wrist as I told her to, held the freed arm beside the other, smiled as I smiled, then danced about the floor, waving both arms in the air and crowing with delight. I could have crowed too. Strength, wholeness, life: healing. And I had done it, conspired with nature to produce it. Medicine may have its limits, I thought, but it’s a lot better than nothing.
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