The Secret World of Christoval Alvarez

by Ann Swinfen

‘Yes.’

  ‘Well, if you tire of potions and poultices, I daresay we could find you employment, could we not, Master Burgess?’

  I glanced round to see the fine gentleman I had encountered on my last visit to the theatre. He was smiling broadly.

  ‘If he can play the comic parts as well, you may find yourself out of employment, Guy.’

  ‘Never fear!’ I laughed. ‘If I had to stand up on that stage, before all those peering faces, I should faint from sheer terror. You are all a wonder to me. I shall stay with my potions and poultices.’

  They laughed and clapped me on the back, then set about preparing for the afternoon’s play.

  ‘Come,’ said Simon, ‘I will find you a good position to watch the play.’

  We went out on to the stage.

  ‘I meant it,’ I said. ‘I truly admire what you do.’

  ‘I think your father does not,’ he said. ‘He does not like me.’

  ‘He will change his mind. Give him time.’

  ‘And as for admiration, I did not know you were such a fine musician, Kit.’

  I shrugged and smiled. ‘Music is a great consolation to me,’ I said. ‘My life has not always been easy, and music has comforted me. My old lute was left behind in Portugal, but almost the first thing my father bought for me in England was a new one. He is not a hard man, you known, but we have no one else. He worries for me.’

  ‘Well, you have others now. You have me as a friend.’ He squeezed my shoulder.

  My heart was so filled with happiness I could not answer.

  Chapter Nine

  When I had spoken of not being expected to return to the hospital for another week, I had not meant that I intended to stay away from my work so long, whatever Sir Francis might have arranged with the governors. The next morning I was out of my bed, dressed and breaking my fast when my father came into the kitchen.

  ‘I am coming to the hospital today, Father,’ I said. ‘I only ever meant to take one day of holiday.’

  He laid his hand on my head. ‘Good, good. I’m glad we are back to our old ways.’

  I had told him of my visit to the Theatre and while he had said nothing to chide me, he still looked unhappy. One day I would take him there to see this new play that Kyd was writing. Simon had read me parts of it and I had every hope that if my father saw the serious subjects in the new plays, he might be weaned away from his disapproval of actors and theatres. I did not mention that I had played the lute for a group of these disreputable fellows.

  ‘Your services are certainly required at the hospital,’ my father said, as we set off companionably, each with a satchel of medicines. ‘Dr Stevens has broken his leg in two places, and will be unable to work for several weeks, so I have been alone on the wards.’

  ‘Oh, Father, why did you not say? I would have come yesterday if I had known.’

  He smiled. ‘I think you had earned your holiday, however you chose to spend it, but I’m afraid the work will be hard until Dr Stevens returns.’

  Jeremiah Stevens was the only other physician at St Bartholomew’s. An elderly man, properly trained (as he would have it) in the medical school at Oxford, he was constantly suspicious of my father’s foreign ways, his ‘modern’ Arabic medicine and his studies of Vesalius. The ancient works of Galen had been good enough for physicians down the centuries, and were good enough for Jeremiah Stevens. The anatomical studies carried out by surgeons in Italy for the last century – or longer – he regarded with contempt, as little better than licensed butchery. They had no relevance for a physician. As for the advanced studies of the Arabs, he shuddered at the thought of such heathenish practices.

  Despite all this he was a good, kind man. His long experience had taught him much, so that while he maintained that he followed Galen to the letter, in fact he was often guided by his own instincts in the care of patients. However, he did practice bleeding in many cases, something my father disapproved of, and they had many polite arguments about its effectiveness. Underneath it all, they were good friends and respected each other. I am not quite sure what he thought of me. I was too young and unqualified to be worthy of serious notice, although I had worked with him as well as with my father for more than two years now.

  ‘Poor Dr Stevens,’ I said. ‘How did he manage to break his leg in two places?’

  ‘Slipped on a puddle of cooking fat spilled by his cook. Not a fall that would have troubled a younger man, but he is no longer young and his bones are growing brittle.’

  ‘When did it happen?’

  ‘Last Wednesday. His wife sent for me and I set the leg, but he will be confined to bed for some time.’

  ‘Did you bleed him?’ I asked with a grin.

  ‘I did not, despite his demands. I hope he does not attempt to do it himself.’

  ‘Do you think he might?’

  ‘Anything is possible with a man so obsessed.’

  I laughed. Even at a distance the two of them would keep sparring.

  ‘So we must care for his patients as well as our own,’ I said.

  ‘Yes. And as he has not replaced his last assistant, it will mean long hours, I’m afraid, Kit.’

  ‘I do not mind, as long as Phelippes does not send for me as well.’

  ‘Indeed, I hope he does not.’

  It was fortunate that there was no epidemic at the moment, however mild. We had not yet reached the heat of summer, which always brought typhus and the sweating sickness and – in the bad years – the plague. Food poisoning was also worst in hot weather, when meat and fish quickly turned rancid. In winter it was agues and congestion of the lungs. Childhood illnesses could strike at any time, but since the outbreak of measles we had been free of them. The spring and autumn weather was often the healthiest, though food shortages could occur in spring, as the last of the winter food supplies were used up and the new crops were not yet ready. Since we worked amongst the poor of the city, we sometimes found ourselves with cases of malnutrition on our hands at this time of year. It was generally the women and children who arrived at St Bartholomew’s, sometimes so weak they could hardly stand.

  ‘Why do they succumb first?’ I had asked my father when I began working with him. ‘Is it because their constitutions are weaker?’

  He had shaken his head. ‘No, there is a simple explanation. When a family is short of food, it is always the man who is fed first. He is the head of the family and must take priority. He is also usually the breadwinner, so he must keep up his strength. In some families you will find that the woman comes next, as she must care for the others, so the children have nothing but the scraps and leavings. However, I have known many poor women who will starve themselves so that their children may eat.’

  We had some of these malnourished poor at the moment, and as usual they were mostly women and children. Over the years the hospital had become accustomed to dealing with these cases and kept stores of food for the periods of spring shortage. With a week or two of nourishing soups and fresh bread, most of them made a good recovery, unless there was some other underlying illness, in which case the weakened body might give up its struggle to survive.

  It was indeed a busy day at the hospital, which turned into a busy week. There were no very serious cases and no epidemics, just many of the usual minor injuries and infections, women suffering post-natal problems, workmen with gouged hands or broken limbs, and more of the victims of malnutrition. One of these was the mother of the baby who had been so ill with measles. She brought the baby with her, although he was well enough.

  ‘I had not expected to see you again so soon,’ I said.

  She seemed surprised that I remembered her and gave me a wan smile. Her cheeks were sunken and I noticed that several teeth had fallen out since I had seen her last.

  ‘My man was lost at sea,’ she said. ‘Times have been hard since, with the little I can earn.’

  ‘What work do you do?’ I asked. I was holding the baby while one of our nurses washed the mother. We take care
to keep our patients clean. My father is strict about this, for he believes that dirt and lice spread the ill humours that breed infection.

  ‘I am a seamstress, but work is difficult to come by these days, if you have a baby and cannot leave him behind while you work for one of the tailors.’

  ‘I am sorry to hear about your man.’

  So many are lost at sea, but who cares for their families? None that I had ever heard of. I remembered that she had no other family. Perhaps there was no good neighbour with whom she could leave the child while she found work.

  Once she was dressed in a clean hospital shift and one of the women servants had brought her soup, bread and ale, I laid the baby beside her on the bed.

  ‘Dickon is doing well, I see.’

  Her eyes lit up. ‘You remember his name!’

  ‘But I do not know yours.’

  ‘It is Margaret, doctor. Margaret Jenkins. My man was Welsh, a Welsh archer serving on one of Sir Francis Drake’s ships.’ She said it with pride.

  Drake the famous captain, hero of Englishmen. Drake the pirate.

  ‘Well, Margaret, there is much plain sewing done here at the hospital. I will see if we can find work for you in the sewing room. I am sure you could bring Dickon with you.’

  Later that day I spoke to the mistress of the sewing women, who agreed to employ Margaret, if her skills with the needle passed muster. She was doubtful at first about the baby, but when I insisted that the child was well behaved and his mother near starvation, she agreed.

  After a week of long days and little sleep at night, I was glad to sit quietly in St Bartholomew’s church on Sunday. Because of all the work at the hospital, we had been unable to attend synagogue at the Nuñez house on the previous day, which had given me a guilty sense of relief. I was never sure in my own mind whether I was Jew or Christian, but being obliged to worship amongst the men on the Sabbath troubled me ever more as I grew older. Here in church, men and women sat together and I felt I could worship without deceit. And surely the One God is the same for both? There was, however, the question of the man Jesus. As far as I could understand, being no theologian, to the Jews he was an imposter, to the Arabs he was a prophet but not the Messiah, to the Christians he was the Son of God.

  As I knelt in prayer, I caught sight of the old man who came every week, supported by his granddaughter, and I remembered my conversation with Sir Francis. He had said that matters of faith had been difficult for people of his own generation and those even older. Yet his experiences during the fearful massacre of Protestants in Paris must have shaped his decisions. I wished I could lay my own dilemma before him, for I believed him to be a wise man. Once I had tried to explain my own confusion to my father, but he could not understand my doubts. He was a Jew by birth, descent and conviction. Baptism as a New Christian was no more than a disguise, a means of survival, as was this attendance at a Christian church, compulsory under Elizabethan law. Yet I yearned toward the kindness of the man called Jesus. A kindness I felt had been there in his lifetime, but had been perverted in the centuries since, by violent religious wars and the horrors of the Inquisition. Sir Francis had said every man should judge for himself by reading, without the intervention of a priest. Perhaps that was where I would find the answers to my questions.

  All this went through my head while I was meant to be praying, leaving me no less confused when we rose to our feet for the final blessing and left the church. As usual we gathered to gossip with our neighbours afterwards in the spring sunshine outside.

  ‘So, you are returned, Kit. We missed you last week at service.’ It was Mistress Long, wife of one of the master bakers in Pie Lane and the greatest gossip in the parish.

  ‘Oh, I was sent down into Surrey for a week,’ I said, as casually as possible, ‘I attended church there. I have been back in London since Monday evening.’

  Her eyes gleamed, sensing a story to be prodded out of me. ‘And what were you doing in Surrey? Surely you were needed at the hospital here?’

  ‘Nothing of importance,’ I said, trying to think quickly. ‘Acting briefly as a mathematics tutor to two children of a gentleman’s family. Just for a week. You know that I study mathematics with Master Harriot? With the older child I was discussing the mathematics of musical harmony. It is a fascinating subject.’ I took her by the arm. ‘Let me tell you about it.’

  To my satisfaction, I saw her eyes cloud over.

  ‘No, no. Thank you, Kit. I see my husband is wanting to make our way home. My daughter and her husband are visiting this afternoon . . .’ She eased her arm from mine and hurried away.

  ‘A neat strategy,’ my father murmured in my ear as we turned our own steps toward Duck Lane and dinner.

  ‘Foolproof,’ I said. ‘Now, if I had spoken about medical matters I would never have been able to shake her off.’

  On Monday morning we had nearly completed our examination of the new patients who had arrived at the hospital since Saturday, when the gatekeeper came breathlessly into the ward.

  ‘Dr Alvarez,’ he said, ‘there is a messenger at the gate asking for you. From Lord Burghley. He has been seized with another severe attack of the gout.’

  ‘Dr Nuñez is his usual physician,’ my father said. This was true, but my father had attended Lord Burghley before.

  ‘Will you speak to the man, sir? He is waiting.’

  ‘Of course. Kit, you had better come until we see what this is about.’

  I followed the two men to the gate, where a servant in Burghley’s livery stood holding two horses. He quickly explained that his lordship was in great pain and needed a physician at once.

  ‘And Dr Nuñez?’ my father asked.

  ‘Dr Nuñez is in attendance on the Earl of Leicester at Greenwich, sir. Can you come?’

  The man was sweating with nerves.

  ‘Certainly. I will need to collect the appropriate medicines. Peter?’ he called.

  Peter Lambert was just crossing the courtyard and was sent running to fetch what was needed. As my father mounted the spare horse, I laid a hand on his stirrup.

  ‘Will you be long away, do you think? I shall be the only physician here.’ I felt a sense of panic at being left in charge of all medical treatment.

  ‘A few hours. I should return before the day is out. There are no serious cases to worry you. And Peter will act as your assistant.’

  The messenger was anxious to be off. As they rode away I looked at Peter.

  He shrugged and smiled. ‘Nothing to worry us?’

  ‘God willing,’ I said.

  The day passed easily enough. I did not go home as usual at midday, but took a bowl of soup with the apothecaries and the mistress of the nursing sisters, as we call the women who carry out the daily care of the patients. In the old days, when there was a monastery here, the nursing work was done by nuns and the term ‘sister’ has lingered on. As I spooned up my soup hastily, eager to be back on the wards, I saw one or two of the more senior apothecaries eyeing me with pursed lips which told all too clearly what they thought of a young assistant physician being left in sole charge of medical care. As for myself, I was relieved to find that no one had died while I was eating my soup. Perhaps Father was right, and I had nothing to worry about.

  Except that it was the day the governors made their monthly inspection of the hospital and they would arrive before my father returned. We had all worked hard. The servants had scoured the wards, the nursing sisters had made all the patients clean and tidy, and I had been twice round the wards, with Peter at my heels, checking every aspect of their medical condition. When the six governors arrived I could tell that they were not pleased that I was the only physician present, but Dr Stevens’s accident and Lord Burghley’s summons were explained to them, and they could find no fault in the running of the hospital and the treatment of the patients. They were about to withdraw for wine and refreshments in their meeting room, when I noticed that one of them, Sir Jonathan Langley, was looking very pale. Beads of sweat sto
od out on his brow, and he had taken hold of the bedpost of the end cot, as if he needed support.

  Distinguished gentleman he might be, but I knew he needed help quickly. I went swiftly to his side.

  ‘Sir Jonathan,’ I said, ‘you are not well. Come with me.’

  I took him by the arm and led him out of the ward to one of the small rooms we sometimes used when we needed to isolate a patient. The other governors were so taken aback they simply stared after me, but Peter followed me into the room. Sir Jonathan sank down on the bed.

  ‘Tell me quickly,’ I said, ‘what ails you?’

  ‘My stomach is heaving,’ he said, ‘and my head . . . I feel dizzy. I . . . eurch . . .’

  I managed to insert a bowl hastily under his chin. He vomited three or four times before he could speak again.

  ‘What have you eaten?’ I said.

  He looked at me with pleading eyes. ‘Am I poisoned?’

  ‘Does anyone have a reason to poison you?’ I was brisk, but impersonal.

  ‘No. I don’t know. There are always men jealous of those in positions at court. And I have had some law cases lately . . .’

  ‘Tell me,’ I said. ‘This is urgent. Have you eaten or drunk anything away from home in the last six hours?’

  His eyes were blurred and I could tell that he was feeling faint again.

  ‘I . . . I took some refreshment at an inn this morning. But there was no one . . . at least, only the inn servants.’

  ‘Did you feel ill before?’

  ‘No. It came on me about an hour ago, just as we were starting our inspection.’

  ‘What did you eat and drink at the inn?’

  ‘A good Rhenish wine. I saw the bottle opened. And duck prepared in the French fashion. It was a rather rich sauce, a strong flavour . . .’ As though the thought of it was too much for him, he vomited again.’

  I turned aside to Peter and told him what to fetch. He hurried away to the storerooms.

  ‘I think it was more than the sauce that was strong,’ I said. ‘I suspect the sauce was used to disguise tainted meat. You have food poisoning, Sir Jonathan. I’m afraid it will mean a purge.’