by Mel Starr
Once in my surgery, I directed the injured man to lie on my bed, then cut away the ripped fabric from the wound. The groom arrived with wine, and I washed the wound. Lord Gilbert winced but slightly, then bade me sternly to proceed. I threaded a needle and began to stitch the gash, careful to do my neatest work and keep my patient as free from pain as possible, which was not actually possible. I made twenty stitches, more than might have been necessary, but when I saw he bore it well, I thought a neatly healed leg might, in future, be good advertising for my skills.
I tightened and knotted the last suture, then stood to stretch my aching back.
“Do not walk over much on that leg for four days, and do not ride a horse for three weeks,” I told Lord Gilbert, who, while I spoke, was tentatively stretching his injured limb. “In three weeks I will remove the stitches.”
“And I can ride then?” Lord Gilbert demanded.
“I do not advise it. A wound so deep as this will need careful treatment. A young man heals quickly. Were you but a squire I might say yes, but you seem a man of thirty years and more.” He frowned and nodded. “So my advice, for proper healing, would be to keep from a horse for a month.” He grimaced again.
“Will you dress this now?" he asked, and nodded toward his leg.
“No. I follow the practice of Henry de Mondeville. It was his observation that a dry wound heals best. Do not cover the wound. I will lend you chauces of mine to see you through the streets and home, but when you are at home you should leave the leg uncovered. Watch if the wound produces pus. If such be white and thick, there is no great harm, but if the pus be thin and watery, call for me at once.”
“Nothing more, then?” he asked.
“No, m’lord. I have finished.”
Lord Gilbert pulled his good leg under him and the groom rushed to help him stand.
“Help me down to the inn,” he said, pointing to the stairs. My room was above a cheap establishment intended to serve students, not nobles. Its soup was thin, its meat was gristle, and its ale sour. I ate there often.
“I will wait there. Find a litter to swing between two horses. I will go home that way.”
From my chest I drew chauces with which Lord Gilbert might cover himself. He drew them on and hobbled to my door to descend to the inn. I wanted to follow, for a pint of even bad ale seemed a good idea, but thought he might consider my continued presence an affront, or a bold request for payment. I assumed I would be paid, though the man had said no word about it.
Nearly an hour later I heard footsteps at my door, followed by a manly thumping on its panels. It was the groom who had first sought me. He held out a small purse.
“Lord Gilbert will have you receive this for your service to him. If this is not sufficient, he will make up the difference when you visit him to remove the stitches. I will call for you in three weeks to take you to him. God be with you.”
“And with you.”
The groom turned and tumbled down the stairs in the same fashion he’d done an hour earlier. Lord Gilbert must be a man, I thought, who does not like to wait.
When his back was turned I emptied the purse into my hand. It held ten silver pennies! And the man was willing to pay more. I resolved to eat well that day, and not at my landlord’s table.
The following two weeks brought little business. A woodcutter sheared off two toes with his axe. I could do little but clean and dress the wound, and advise him to be more careful. Certainly he appreciated the advice.
I tried to seem busy when Lord Gilbert’s man called for me twenty days later. “I am Arthur, here to fetch you to Lord Gilbert Talbot. You sewed him up a fortnight and more ago.”
I followed him down the stairs to where he had tied two horses in the street. I thought that polite of Lord Gilbert; don’t make the surgeon walk. But when we crossed Castle Mill Stream and put the town behind us, I realized the horse under me was more than good manners.
“Where are we going?”
“To Lord Gilbert,” Arthur replied. That was helpful.
“And where might he be found?”
“Oh…You don’t know? In Bampton, at the castle there,” he answered.
I’d heard of the town, that was all. “How far must we travel?”
“Fifteen miles…Perhaps sixteen.”
I settled myself as comfortably in the saddle as I could. I had not ridden a horse for many years. I knew that by the time I returned to Oxford in the evening I would be sore in the nether regions. Perhaps, I thought, I should volunteer to walk home.
The first thing I saw of Bampton was the spire of the Church of St Beornwald rising above the fields and forests surrounding the village. The spire was visible before we reached Aston, more than two miles distant. We passed an ancient chapel dedicated to St Andrew, and entered the town on the High Street. I felt at home already. Does every English town have a High Street? At the center of town we took the left fork and followed Mill Street to the bridge across Shill Brook.
I attracted a good deal of attention as we rode through the village. Strangers in small towns tend to do that. The town and people seemed prosperous enough. I even saw a few houses made of stone, although most were wattle and daub, with thatched roofs.
Bampton Castle is an impressive structure, all the more so when one views it for the first time. A curtain wall twenty feet high and six feet thick surrounds one of the largest castle yards in all the realm, for the wall is 360 feet long on each of its four sides. At each corner are round towers three stories high, with arrow loops at each level. Four more towers stand on the sides, and a gatehouse in the west wall permits entry. To the northwest of the castle, near a turf close, is the famous Lady Well, whose waters are of miraculous reputation.
Lord Gilbert’s chamberlain showed me to the solar, where I found my patient. The wound was healed well. There was no pus and, according to my patient, never had been. Some physicians prefer a wound to issue white – laudable – pus, but I hold with Mondeville that, although white pus is much to be preferred over watery, stinking pus, no purulence at all is best.
It was but a matter of minutes to remove the sutures. The seam across Lord Gilbert’s thigh was neat and straight. Not, unfortunately, in a readily visible location so as to proclaim my skills. Word of mouth in this case would have to suffice.
“Remember, no riding for another week,” I reminded him.
Lord Gilbert puffed his cheeks skeptically, glanced at my bag, and said, “I have two villeins in need of a surgeon’s care. Will you see them before you go?”
Clients! Of course I would see them.
The first man brought to me was a simple case. He had a large, fleshy wart on his neck. He had tried the usual remedies: rubbing with the skin of a bean pod; touching the wart with a knotted cord, then burying the cord; rubbing with a slug, then impaling the slug on a thorn bush. These had been unsuccessful. If a wart disappears after such treatment it is, I am convinced, mere happenstance. Such a wart would have faded anyway. I tied a bit of string tightly around the base of the wart, and gave the man another.
“If the wart does not wither and fall away in two weeks, loose the string and have your wife tie this other on, and tightly.”
The ploughman nodded understanding, but turned away with a skeptical expression on his weathered face. This cure was effective, however. I saw the fellow some weeks later, and he was free of the growth. Blood is cut off to the wart. It shrivels and dies and falls away.
The second man I was to see was more seriously afflicted. Arthur showed me to his hut and waited uneasily at the door. The fellow was a large, beefy man, with a broad back and legs made strong following a plow. His brow was crevassed in pain. His wife hovered, fidgeting, near the bed, which sagged beneath his weight.
“He has a stone,” Arthur said by way of introduction. The villein nodded agreement.
“Had one before,” he explained through clenched teeth. “Two years past…at Candlemas. I drank from the Lady Well and the blessed virgin interceded
for me. The stone passed after a week or so. But this…since Lammas Day I’m barely able to rise from my bed.”
Nearly two months. This stone was too large to pass. It would become larger, more painful, and weaken the man to an early grave. Well, not all that early. He appeared to be about forty, although the illness might influence his features. He would not expect to live many more years.
“Lord Gilbert’s man said he’d send you. Can you do aught for me?”
“I can remove the stone. But such surgery is dangerous. You might not live.”
“I cannot live in such torment as this. I would rather see God this day than live another hour as I have these past weeks.”
“I will speak the truth – that may happen. And if not today, then tomorrow or next day.”
“But if I live, the pain will be gone?”
“Aye.”
Alfred glanced at his wife. Her pursed lips indicated the decision she would make. But he turned from her and said, “When will you do this?”
“Today. Now, if you are determined.”
He peered at his wife again briefly, then sighed, “I am.”
I had seen a lithotomy performed once, in Paris. That patient did not survive. But he was near sixty years old, and my instructor assured me that many times he had performed such surgery successfully. I was eager to try my skills, and to relieve the man’s suffering. But I will tell no lies: I was anxious both for my patient and for my reputation should I fail. Lord Gilbert’s sound leg would not balance a new corpse in St Beornwald’s Churchyard. It troubled me to think that I was as concerned for my reputation as for my patient’s life, but that was the truth of it. This attitude began to change when I came to know the people of Bampton well. It is difficult to look clinically upon a patient who has been a friend for a year or two.
I heard a voice at the door of the hut, and turned to see Arthur approach through the haze produced by the smoky hearth.
“A message from Lord Gilbert; will you be long here? He would have you join him for dinner.”
Six hours had passed since I ate a crust of bread and drank a half-pint of ale to begin the day. The knot in my stomach might have been hunger as well as apprehension for what I was about to do. If I accepted Lord Gilbert’s invitation, I could put off the surgery. I accepted.
Arthur led me to the castle yard, through the inner gatehouse to the hall. Tables erected in a “U” shape now occupied most of the room. Trenchers and loaves of bread – white bread! – sat, one at each place, on the cloth. Twelve places were set around the tables. I passed a hand over the nearest loaf: yet warm from the oven!
Arthur left me in the hall. As he passed out one door, my dinner companions entered through another.
She was among them: the beauty I had seen on horseback a year earlier. You may wonder that I would remember and recognize her after a year. If you had seen the lady, you would wonder no more.
Lord Gilbert saw me standing alone, probably looking as awkward as I felt, and spoke to his companions. “Ah, here is the surgeon who has put me back together. Master Hugh de Singleton; my wife, Lady Petronilla; my sister, Lady Joan.” I heard other names vaguely, obscured as they were by the lovely Joan – sister, not wife, to Lord Gilbert.
I remember little of the meal. I ate well: even love has seldom been able to suppress my appetite. She smiled at me once. I spent most of the meal trying not to be obvious about her charms and their influence on me. This was most difficult between removes, for there was no food then to occupy my eye or thoughts.
Lord Gilbert placed me beside a guest, Sir William Fitzherbert, but two places removed from himself at the high table. I was cognizant of the honor.
“Are you able to relieve my villeins?” Lord Gilbert asked, between the first and second removes. I told him what I had done for the first, and what I proposed for the other. I did not think it the proper time or place to explain the procedure in detail, however.
“I pray you succeed. Alfred has been in torment for months, and he’s no good to me as he is.”
“He may die,” I warned.
“So may we all,” Lord Gilbert laughed.
“The surgery may not succeed.”
“Alfred knows this?” Lord Gilbert frowned.
“He does.”
“Yet he desires you to proceed?”
“He said he would rather see God this day than live longer with his pain.”
Lord Gilbert toyed with a crust from his trencher: “Well, it must be his choice. Will you need assistance?”
“Some strong lads to hold him quiet; four, I think. Some hot water, ale, and a flagon of wine.”
“Wine? Will not ale suffice? A man may be made as drunk on ale as on wine.”
Lord Gilbert, I was to learn, is a bit miserly. Ale is cheap, wine is expensive.
“To wash the incision. Do you remember how I cleansed your wound?”
“Ah…yes. Well, you shall have your wine.”
I caught one last glimpse of Lady Joan Talbot as she left the hall for her chamber and I departed the room through the entry hall to make or mar my reputation.
Lord Gilbert acted quickly on my request. I had but stepped through the door of Alfred’s hut when four men arrived: two valets I had not seen before, and the two grooms who had accompanied Lord Gilbert to Oxford. Arthur had a flagon of wine and another of ale.
“Cicely is heating water. She’ll send a girl ’round with it as soon as she can.”
“Cicely?” I asked.
“My wife, Master Hugh. She be in charge of Lord Gilbert’s scullery.” I caught just a faint note of pride in Arthur’s voice.
I took from my bag two pouches: one contained willow bark, ground fine; the other held hemp seeds and roots, also crushed fine. The willow and hemp I mixed freely with the ale. Lord Gilbert’s ale was of good quality; Alfred drank the mixture with relish. Willow and hemp can relieve pain. In the surgery I was about to do, there would be great pain, willow and hemp or not.
I explained to my four assistants what I was about to do, and where I intended to do it. Not in the dim hut: I would need all the light I could get, for where I planned to work the sun did not shine much. One of the valets went quite pale when I finished my instructions.
I asked for the toft behind Alfred’s hut to be cleared and for his bed to be taken there, with him in it. I got him maneuvered across the bed with his kirtle pulled up and his buttocks pointed toward the sky. He must have been mortified to be made to assume such a position, and in great need to do so willingly.
A girl, blushing at the sight of Alfred – or what she could see of him – brought the water and I set to work. One man seized each of Alfred’s arms and legs, as I had instructed them. I will spare you details of the procedure and list the events of Alfred’s surgery in rudimentary fashion.
I asked his wife for lard, and with it greased several fingers. These I must then insert in Alfred’s rectum until I felt his bladder. With luck, I would also feel the stone.
God was with me, or with both of us, for I found the stone immediately. It was large, and so easy to locate. No wonder that he could not pass it, and that it caused him such torment. Using my finger, I worked the stone down to the neck of the bladder. Alfred grunted several times, but bore the pain stoically.
I took several deep breaths to steady myself for the hazardous work I must now do. I used the hot water and a fragment of linen to wash Alfred’s private parts, then bathed the area in wine. There is no precedent for this, and I know most consider it a waste of good wine. But it seems to me that, if washing a wound with wine aids healing, washing the skin with wine before a wound is made might do so as well.
I made an incision between Alfred’s rectum and scrotum, and deepened it carefully, trying to avoid damage to the complex plumbing in that place. I wanted to cut no deeper than necessary, so several times probed the incision with my finger, to see if I had got to the bladder yet. Alfred twitched and gasped a few times, but gave his captors no serious stru
ggle.
This was good, for just as I felt the stone through the wound, the valet holding Alfred’s left leg shuddered, rolled back his eyes, and dropped to the ground. Alfred’s wife, who had been standing apprehensively in the door of the hut, rushed out. But rather than tend to the fallen man, she took his place at Alfred’s leg and attached herself to it like a leech.
I used a tiny razor to slice into the bladder and pried out the stone with a finger. Alfred gasped again. Reader, you would, also. Most would probably scream. I suspect I would have. Alfred had lived with pain for so long that additional distress seemed to torment him little.
All that remained was to once again wash the incision with wine, and sew him up. I made few stitches. Alfred needed no more pain, and where I was working Alfred was unlikely to show off my handiwork. Four stitches would work there as well as ten.
The fallen assistant came out of his swoon as we rolled Alfred to his back and replaced his bed in the hut. I left instructions with his teary-eyed wife, washed my bloodied hands in what remained of the warm water, and departed the house. I have rarely been so glad of leaving a place.
“Lord Gilbert would see you before you return to Oxford,” Arthur told me as we walked across the castle yard. It was now past the ninth hour, and gray clouds hung low in the autumn sky. It would be dark before I would see the High Street and Oxford. But when a lord wishes to see me, I usually make time for him.
We found Lord Gilbert in the solar, sitting with his wife before a small fire. It was a picture of connubial bliss. I hoped to insert myself into a more modest version of such a scene one day, but to that point had made no progress toward the goal.
“You have done with Alfred, then? Did the surgery go well?” Lord Gilbert asked.
“I am optimistic. I left him resting without pain. Not much pain, anyway.”
“Good…good; well done. I have directed a room be prepared for you. It is too late to pack you back to Oxford tonight. We will share a light supper shortly. I will send John for you. John!” he called to his chamberlain. “Show Master Hugh to his chamber.” John did so.