by Anthology
"You must always look for lesions here and here," the mukalamba said, pointing them out on his models and projecting a ghostly image of how they appeared in a long-ago case, "and for labored breathing, loss of weight, progressive wasting of muscles…" Mutende listened, but he knew them all. He saw them every time he visited his landlady, growing worse by the week and month.
"Your patients will ask you if there is a cure," said the professor suddenly. The lecture had moved from luwuko, the art of diagnosis, to uganga—treatment. "There was none known to our ancestors, and none known to us. But there are palliatives. Your book describes several kinds of pills, and other remedies that are inhaled, and you will learn to compound them and what to watch for…"
Mutende listened with the other basambilila and dutifully wrote down lists of ingredients, the places where they could be bought or ordered, the steps that must be taken to prepare them. He knew them too, all of them, and at that moment, the classroom carried the memory of a butcher's icebox much more than any of its other incarnations.
All the pills, all the rubs, all the vapors—they were the ones that did his landlady no good at all.
***
Mutende had an examination three hours after his class, and it was in another building across the Katwe near the old Mwata's Gardens. That was far from the port district and he couldn't afford a moto-taxi, so he had no time to go home between classes. He went anyway.
He lived on the edge of the port, in one of the three- and four-story houses that had been built in the interstices of ancient buildings. There were six of them in a row, with water-towers hanging precariously from the upper stories and clotheslines and crazy angles between them, and somehow they looked less solid than the remnants of steel girders that towered over them. There were market-stalls set up in the street, and men in sober agbadas and women in bright dresses and hair-ties swirled around them, but none tried to claim Mutende's attention: anyone who wore a gray student's robe and lived here was likely to be even poorer than his neighbors.
Mapalo, the landlady, lived in two rooms on the first floor. The outer one, where she slept, was decorated with masks and dolls from the north country where she came from; next to them, beside the sewing machine, was a picture of her husband who had traded between worlds. He was lost to pirates ten years past, but not before he'd picked up the ichiyawafu-fever from a prostitute in a distant port and brought it home to his wife.
She stirred when Mutende came in, and he helped her sit up and put a plate of lamb and a cup of shake-shake beer before her. The tip of his index finger touched her facial scars, shaped many years ago to suggest a bird's wing: the sign of the Hornbill clan, one of the old clans that traced its ancestry to before the Migrations. His own face bore the same scars, and that was why she'd agreed to rent a room to him when he finished his fostering, but in the time since, she had become not only a clanswoman but a friend.
"How is it with you, mbuya?" he asked. She wasn't his grandmother, but as an elder woman of his clan, she was entitled to the honorific, and now, as they said in the north, it was a heart-title as well.
"A little better," she answered. Mutende felt of her forehead and knew it was a lie. Her temperature was higher and her lesions hadn't improved. He wasn't sure if she'd lost more weight, but she certainly hadn't gained any back, and this latest attack was taking vitality from her practically by the day.
"I made you something to reduce the fever," he said. He held a cup to her mouth, watched her drink, and pressed a wet cloth to her brow. He put the bottle down next to the half-full container of pills, the kind that the mukalamba had talked about in class. Mapalo had taken them religiously, and she was still getting worse.
"Can you make me a blue-leaf tisane too?" she asked. "The umulaye told me it would help against witchcraft."
Mutende fought hard not to sigh. Mapalo had found a street-doctor, no doubt one who was from the Kabwe country like she was, and he'd given her a folk remedy. Out in the countryside, many people still believed that imfwiti—witches—caused all sickness and death, and his landlady evidently thought a specific against them would do her more good than a treatment for her illness.
Maybe, Mutende thought ruefully, she was right.
He clapped once—it was a way of saying yes—and went to the kitchen. It was one of the hours when the power was on, so he could boil water in the hotpot, and he found some sprigs of blue-leaf in the herb cabinet. He made the infusion, and a smell like cinnamon and pepper filled the room. It would give Mapalo pleasure, if nothing else.
In a moment, she smelled it too. "Kaweme said that blue-leaf was one of the best cargoes he could carry. On one world, the awantu used it for money…"
She launched into a story of her husband's exploits among the stars. Mutende brought the tisane to her and listened for a while, but her stories could go on for hours, and that was time he didn't have.
"I'm sorry, mbuya," he said, "but I have to go to my test."
"Go! Go!" She waved a hand in dismissal. "You have to take your test. You can't let me keep you."
He bowed his head and left the room. Barely an hour remained before the exam: he would have to take a moto-taxi or else run the whole way. He felt in his pocket and found a two-indalama coin and three half-ndalama pieces: if he didn't eat lunch today, he had enough.
There were taxis by the market-stalls outside—there always were—and by instinct, the drivers knew when they were needed. Mutende bargained between two of them and, the contract made, sat behind the winning bidder and felt the wind in his face.
***
The examination room was in a very different part of the city: a place of gardens, public buildings, and stately homes, where the ancient structures had retained much of their glory. The people who lived here were imwinamulende or even imwinamishishi; there was power all the time and running water, as there had been in the days of the Union and as the government promised there would one day be again.
The moto-taxi stopped on one end of a plaza, near the House of Kingmakers and the Chamber of the Ifapemba. The building here had always been a hospital, and the testing room had always been an operating theater: inganga had labored to save Lukwesa the Great's life here after his defense of the system, and Chinkonkole the Navigator's crew had found treatment here for the maladies of a hundred distant worlds. This place was sacred to Eyinle, the orisha of medicine, and thus was it where oaths were made and tests were taken.
Mutende got to the testing ground barely five minutes before the appointed time. The preceptor was already waiting and registered him in the book: Mutende, second-year student, examination in surgery on the fourteenth day of the fifth month of the Year of Migration 31,779.
At the word "surgery," Mutende's foreboding suddenly turned to elation. He hadn't been told in advance of the subject in which he would be tested, but this one, of all of them, he knew he could pass. The surgeons of today were as good as any of their ancestors—not everything had been forgotten when the Union fell, and tools had survived much better than burned books or plague-ravaged computers—and Mutende, with mechanic-trained hands, counted himself as good as any of his teachers.
Beyond the door, sanitized and dressed in sterile clothing, he saw the patient on whom he would be tested: a child of eight years, already anesthetized with drugs and needles and connected to fluids and plasma. He read through the records and films that the preceptor proffered, and saw that she had a brain tumor: a dangerous one that would surely kill her in a few months if left untreated. His elation wavered slightly—this was beyond the tests normally given to a student in his second or even third year, and the others in the room would intervene only to save the child's life—but he found a calm place within and steeled himself to the work.
He checked his instruments, making sure each was sterile and sharp, and made the initial incision. He clamped down a flap of scalp and cut away a piece of the skull; he probed the membranes inside and opened them carefully. The brain was exposed, and behind him,
the machine waited.
Mutende had used such machines before: he had trained with one until it was part of him. A movable arm protruding from the machine held tiny tools, and a light and camera so he could see what the tools saw; below was a seat and a sleeve with which he would manipulate the instruments. If he put his arm and hand in the sleeve and moved a centimeter, one of the tools could be set to move a hundredth or a thousandth of a centimeter or even less. A surgeon with a steel nerve could use the instruments with an almost incredibly fine touch: once, on a dare, Mutende had written his name on a single cell sampled from his skin without breaking the membrane.
He placed the end of the arm on the surface of the brain, took his seat, and put on the mask that connected him to the camera. He probed, looking for the tumor: time took on a dreamlike quality as he found it, excised it, and set his tools finer so that only the cancerous cells would be cut away. He probed again, looking for fragments that the imaging might have missed, keeping iron control of his movements lest he break a blood vessel. Finally—was it minutes later, or hours?—he was satisfied that the tumor was gone, and with a shock that was almost pain, he withdrew his instruments and returned to the real world.
The preceptor, and the other inganga who were watching, said nothing as he closed up the opening he had made. He would know whether he passed when they chose to tell him. But he trusted his eyes and his hands, and he knew the child would live.
He thought of his landlady, and wondered why fevers were so much more elusive.
***
In the morning, Mapalo was sweeping the downstairs hallway. She sang a north-country song as she worked, but her movements were slow and painful and her breathing labored.
"You should be in bed," Mutende said.
"Inchito talala tulo," she said—"the work doesn't sleep." They said that in the Kabwe country, and they also said that about Hornbill clanswomen. Hornbills were supposed to work hard: that was as true as any other saying, but Mapalo had always taken it to heart.
"The work might not. But you're sick. You should."
"What would I be if I did nothing but sleep? And I had another tisane this morning, and I felt better."
Mutende mentally cursed his landlady's umulaye again, but then he stopped short. The other day, he'd learned that a substance distilled from the blue-leaf plant was used in drugs that strengthened the immune system, and didn't they say that repeated attacks of ichiyawafu-fever eroded the victims' immunity? He'd been taught, long before medical school, that an umulaye was good only for stitching up cuts and easing women's pains, but there was long experience in the street-doctors' fostering lines, and sometimes experience was wisdom…
"You should rest even if you feel better," he said, taking a different tack. "Get your strength back if you want to fight this attack off." He took care not to mention the next one.
"Don't mind me, I can…" Mapalo's voice trailed off, and Mutende turned to see her leaning heavily against a wall. She'd dropped the broom and was breathing very hard, and he had to catch her to keep her from sliding to the floor.
He helped her back to her rooms and, seeing no water in the jar, went out to pump her some. He made her drink and eat some of the nshima porridge that was on the stove, and after a few minutes her heart stopped racing and her breath came more evenly. He picked up the pill bottle and shook it, but then put it down: what good would it do?
"I forgot—there's a message for you," she said suddenly. "You're to be at the second-year offices at three o'clock."
Now Mutende did curse. He had no classes today, and he'd hoped to find some casual labor in the port, but not if he had to be across the city by three. He wondered why the summons had come: surely something hadn't gone wrong after the examination…
He would worry about it, he knew. And he did worry, through five hours of fetching and carrying for the market-women, past the university and the derelict towers of the city center, all the way to the ancient factory of which the medical school now occupied two floors.
The professor was waiting by the door and conducted him to a back office. He took the chair that was offered and waited to hear why he had been summoned, but the professor seemed strangely diffident, in no hurry to speak. For a long moment, Mutende watched as the teacher busied himself around the office, straightening books and dusting sculptures.
Finally, the moment stretched on too long. "Mukalamba," he said, "have you called me here to talk about the test?"
The professor straightened, as if suddenly reminded that Mutende was there. "The test? Oh yes, you did well. The child will live long. But that isn't why I asked you to come here. The other bakalamba and I are concerned about you as a student."
Whatever Mutende had expected, it wasn't this. "Have I failed in anything?" he asked.
"No, there is no single thing. But we have noticed an…irreverence in you. Of late, you have seemed uninterested during lectures, and when the gods of healing were invoked, you have been detached, preoccupied with other things. This is not a correct attitude for a musambilila who wants to qualify as a doctor."
Mutende's first instinct was to be defensive, to say that the gods of medicine weren't his gods. The orishas weren't the original gods of Mutanda: they had come in the ancient days of the Association and the Accord, but there were still people in the far north and west who rejected them. But he swallowed the words. He wasn't a mountain man or an islander; his family had lived in Chambishi Port since the days of the Union rather than being among the latecomers who flocked to the city as it rebuilt its factories. He had been raised with the orishas, although he'd come to doubt them, and if he said otherwise, the mukalamba would know it was a lie.
"The orishas have not protected my landlady," he said instead.
The professor looked at him sharply. "How have they failed her?"
"All of us have failed her. She has the ichiyawafu-fever, and the pills and remedies in the Book of Maladies—none of them have worked."
"Ah," the mukalamba said. He was on familiar ground now. "I have seen many students with your doubt. You must understand that nothing ever works in all cases…your landlady's husband was a free trader, was he not?"
"Yes," Mutende answered, too surprised by the sudden shift in questioning to say anything more.
"You have learned that pathogens evolve…good, good. The remedies we have were created in the ancestors' days, the days of the Union, and some strains of the ichiyawafu-fever have evolved to resist them. Much was lost when the Union fell, and many worlds fell out of communication, and in centuries without contact, their illnesses changed."
Mutende felt a sudden epiphany: the professor had never examined his landlady, but he was sure that his luwuko was true, and he cursed himself for not thinking of it before. "Why don't we look for remedies that do work, then? Why don't we find out what might kill the new pathogens?"
"That would be foolish, wouldn't it?" The professor spoke as if his words should be self-evident even to a child. "We haven't yet learned everything the ancestors knew—it would be dangerous to try to go beyond them."
It seemed to Mutende that there was something wrong with the mukalamba's premise, but in his confusion, he couldn't put a finger on what it was. "What are we doing, then, to learn all that the Union knew?"
"We find fragments of new books every year, and we recover computer files—sometimes even from other worlds. Everything that comes to us, we add to our texts…"
"But we don't study cases?"
"Of course we do. We have the cases that the Union doctors treated, and even some of those from the Commonwealth and the Accord."
"New cases. Cases to recreate what was in their books rather than looking for them in holes in the ground." He trailed off, suddenly deflated. "Then Mapalo is in the care of Babalu, not Eyinle?"
"She must be. Where we have not the knowledge to follow the god of health, then only the god of sickness can help."
"Where we refuse to find the knowledge, you mean."
"Be careful, musambilila," the professor said, his voice calm but with an edge of iron. "I know your anger. Many students have it. But if you don't grow beyond it, then you will never be a nganga. You didn't come this far, sacrifice this much, to be an umulaye."
"No," Mutende said. "I will think about your words."
"See that you do."
***
That night, Mutende didn't go home. His feet took him to the port district instead, and into a shebeen only blocks from the landing fields. He wanted to be among those who knew the ichiyawafu, those to whom it was a highway rather than a fearful mystery, and he wanted to grieve with those who had passed through the land of the dead and lived.
The shebeen was a free traders' bar: that was confirmed by the patrons' florid clothing, and also by the tapestries that hung between the tables so that merchants and sailors could keep their secrets. The hangings were in blue and white, the colors of Yemoja of the Waters and Stars, with scenes from foreign worlds or abstract patterns that recalled ichiyawafu-dreams.
He bought a cup of imbote and sat at one of the long tables outside the curtains, sipping the honey-beer in the candlelight and listening to the others' stories. A few looked at him sharply—a man with no ship-clan had no place here—but one of them was a Hornbill and he was quiet in the shadows, so they let him stay.
"Kaweme," one of them said when he spoke at last. "Yes, I remember him. He always wanted to find something—the world the orishas came from, the lost colonies of the Second Migration, the jewel of an awantu-king a million years dead. He was going to find the universe and bring it home to sell…you say his woman has the fever?"