The Cole Trilogy: The Physician, Shaman, and Matters of Choice

by Noah Gordon

  So he worried and waited for a royal summons that didn’t come.

  In the meantime he worked hard. Qasim’s abdominal pains had disappeared; to the former drover’s delight Rob continued to prescribe a daily portion of wine and returned him to his duties in the charnel house. Rob was caring for more patients than ever, for al-Juzjani had taken on many of the duties of Chief Physician and had turned over a number of his patients to other physicians, Rob among them.

  He was stunned to hear that Ibn Sina had volunteered to lead the surgeons who would accompany Alā’s army north. Al-Juzjani, who had gotten over his anger or hidden it, told him.

  “A waste, to send such a mind to war.”

  Al-Juzjani shrugged. “The Master wishes one last campaign.”

  “He is old and won’t survive.”

  “He has looked old forever but he hasn’t yet lived sixty years.” Al-Juzjani sighed bitterly. “I believe he hopes an arrow or a spear will find him. It wouldn’t be tragedy to meet a quicker death than now appears to lie in store for him.”

  The Prince of Physicians quickly let it be known that he had chosen a party of eleven to accompany him as surgeons to the Persian army. Four were medical students, three were the newest of the young doctors, and four were veteran physicians.

  Now al-Juzjani became Chief Physician in title as well as in fact. It was a grim promotion in that it caused the medical community to realize that Ibn Sina would not be back as their leader.

  To Rob’s surprise and consternation he was named to fill some of the duties al-Juzjani had performed for Ibn Sina, although there were a number of more experienced physicians al-Juzjani could have selected. Also, since five of the twelve who had gone with the army were teachers, he was told he would be expected to lecture more often and to teach when he visited his patients in the maristan.

  In addition, he was made a permanent member of the examining board and was asked to serve on the committee that oversaw the cooperation between the hospital and the school. His first meeting on the committee was held in the lavish home of Rotun bin Nasr, governor of the school. The title was an honorific and the governor didn’t bother to attend, but he had made his home available and had left orders that a fine meal should be served to the gathered physicians.

  The first course consisted of slices of large green-fleshed melons of singular flavor and melting sweetness. Rob had tasted this type of melon only once before and was about to remark on it when his former teacher, Jalal-ul-Din, grinned widely at him. “We may thank the governor’s new bride for the delicious fruit.”

  Rob didn’t understand.

  The bonesetter winked. “Rotun bin Nasr is a general and the Shah’s cousin, as you may know. Alā visited here last week to plan the war and no doubt met the youngest wife. After royal seeds have been planted, there is always a gift of Alā’s special melons. And if the seeds result in a male crop, then there is a princely gift, a Samanid rug.”

  He didn’t manage to get through the meal but pleaded illness and left the meeting. With his mind in turmoil he rode straight to the house in Yehuddiyyeh. Rob J. was off playing in the garden with his mother but the infant was in the cradle and Rob took Tam into his arms and inspected him.

  Just a small, new baby. The same child he had loved when he left the house that morning.

  He returned the boy and went to the sandalwood chest and removed the carpet bestowed by the Shah. He spread it on the floor next to the cradle.

  When he glanced up, Mary was in the doorway.

  They looked at one another. It became a fact then, and the pain and pity he experienced for her was wrenching.

  He went to her, intending to take her into his arms, but instead he found that both of his hands were gripping her very tightly. He tried to speak but no words came.

  She tore away and kneaded her upper arms.

  “You have kept us here. I have kept us alive,” she said with contempt. The sadness in her eyes had changed to something cold, the reverse of love.

  That afternoon she moved out of his chamber. She bought a narrow pallet and set it down between the sleeping places of her children, next to the carpet of the Samanid princes.

  70

  QASIM’S ROOM

  Unable to sleep all that night, he felt bewitched, as if the ground had disappeared beneath his feet and he must walk a long way on air. It wasn’t unusual for someone in his situation to kill the mother and the child, he reflected, but he knew Tam and Mary were safe in the next room. He was haunted by mad thoughts but he wasn’t mad.

  In the morning he rose and went to the maristan, where all was not well either. Four of the nurses had been taken into the army by Ibn Sina as litter bearers and collectors of the wounded, and al-Juzjani had not yet found four more who met his standards. The nurses who were left in the maristan were overworked and sullen, and Rob visited his patients and did his physician’s work unassisted, sometimes pausing to clean up what a nurse had not had time to set right, or bathe a feverish face or fetch water to ease a dry and thirsty mouth.

  He came upon Qasim ibn Sahdi lying whey-faced and groaning, the floor next to him soiled with vomitus.

  Ill, Qasim had left his room next to the charnel house and given himself a place as a patient, aware that Rob would find him as he made his way through the maristan.

  He had been afflicted several times within the past week, Qasim said.

  “But why have you not told me!”

  “Lord, I had my wine. I took my wine and the pain went away. But now the wine doesn’t help, Hakim, and I cannot bear it.”

  He felt feverish but not burning, and his abdomen was tender but soft. Sometimes in his pain he panted like a dog; his tongue was coated and his breath was strong.

  “I’ll make you an infusion.”

  “Allah will bless you, lord.”

  Rob went directly to the pharmacy. In the red wine Qasim loved he steeped opiates and buing, then hurried back to his patient. The eyes of the old keeper of the charnel house were filled with fearful portent as he swallowed the potion.

  Through the thin fabric screens of the open windows, sounds had been invading the maristan in increasing volume, and when Rob went outside he saw that the city had turned out to bid its army farewell.

  He followed the people to the maidans. This army was too large to be contained in the squares. It spilled over and filled the streets throughout the central portion of the city. Not hundreds, as in the raiding party that had gone to India, but thousands. Long ranks of heavy infantry, longer ranks of lightly armed men. Javelin hurlers. Lancers on horses, and sword cavalry on ponies and camels. The press of the crowd was tremendous, as was the hubbub: cries of farewell, weeping, the screams of women, obscene badinage, commands, words of farewell and encouragement.

  He pushed his way forward like a man swimming against the human tide, through the stink, an amalgam of human odor and camel sweat and horseshit. The sun-glitter on the polished weapons was blinding. At the head of the line were the elephants. Rob counted thirty-four. Alā was committing all the war elephants he owned.

  Rob didn’t see Ibn Sina. He had made his farewells to several of the departing physicians in the maristan, but Ibn Sina hadn’t come to say goodbye nor had he summoned Rob, and it was obvious he preferred no words of leavetaking.

  Here came the royal musicians. Some blew long golden trumpets and others rang silver bells, heralding the swaying approach of the great elephant Zi, a ponderous force. The mahout Harsha was dressed in white and the Shah clad in the blue silks and red turban that was his costume for going to war.

  The people roared in ecstasy at seeing their warrior king. As he raised his hand in royal greeting, they knew he was promising them Ghazna. Rob studied the Shah’s rigid back; at that moment, Alā was not Alā—he had become Xerxes, he had become Darius, he had become Cyrus the Great. He was all conquerors to all men.

  We are four friends. We are four friends. Rob felt dizzy, thinking of the occasions when it would have been so
easy to kill him.

  He was far back in the crowd. Even if he had been up front, he would have been cut down the moment he hurled himself at the king.

  He turned away. He didn’t wait with the others to see the departing parade of those bound to glory or to death. He struggled out of the crowd and walked unseeingly until he came to the banks of Zayendeh, the River of Life.

  He took from his finger the ring of massy gold Alā had given him for his service in India and dropped it into the brown water. Then, while in the distance the crowd roared and roared, he walked back to the maristan.

  Qasim had been dosed heavily with the infusion but he appeared to be very ill. His eyes were vacant, his countenance pale and sunken. Though the day was warm he was shivering, and Rob covered him with a blanket. Soon the blanket was soaked and when he felt Qasim’s face, it was hot.

  By late afternoon the pain had become so powerful that when Rob touched his abdomen, the old man screamed.

  Rob didn’t go home. He stayed in the maristan, returning often to Qasim’s pallet.

  That evening, in the midst of Qasim’s agony, there was complete relief. For a time his breathing was quiet and even, and he slept. Rob dared hope, but within a few hours he was reclaimed by fever and his body became ever hotter, his pulse rapid and at times barely perceptible.

  He tossed and thrashed in delirium. “Nuwas,” he called. “Ah, Nuwas.” Sometimes he spoke to his father or to his uncle Nili, and again and again to the unknown Nuwas.

  Rob took his hands and his heart sank; he didn’t let go, for now he could offer only his presence and the meager comfort of a human touch. At length the labored breathing simply slowed and then stopped. He was still holding the callused hands when Qasim died.

  He placed one arm beneath the knobby knees and the other under the bare bony shoulders and carried the body into the charnel house, then he went into the room next door. It stank; he would have to see that it was scrubbed. He sat among Qasim’s belongings, which were few: one extra garment, shabby; a prayer rug, tattered; some paper sheets and a tanned leather on which Qasim had paid a scribe to copy several prayers from the Qu’ran. Two flasks of forbidden wine. A loaf of stale Armenian bread and a bowl of rancid green olives. A cheap dagger with a nicked blade.

  It was past midnight and most of the hospital slept. Now and again a patient cried out or wept. Nobody saw him remove Qasim’s meager belongings from the little room. While he was carrying in the wooden table he met a nurse, but the shortage of help had given the man courage to look the other way and hurry past the hakim before he could be given more work than he already had.

  In the room, under two of the legs at one end Rob placed a board so the table tilted, and on the floor under the lower end he set a basin. He needed ample light and he prowled the hospital, stealing four lamps and a dozen candles, which he set around the table as though it were an altar. Then he brought Qasim from the charnel house and laid him on the table.

  Even as Qasim lay dying, Rob had known he would break the commandment.

  Yet now the moment was at hand and he found it difficult to breathe. He wasn’t an ancient Egyptian embalmer who could call in a despised paraschiste to open the body and absorb the sin. The act and the sin, if any, must be his own.

  He picked up a curved, probe-tipped surgical knife called a bistoury and made the incision, slicing open the abdomen from the groin to the sternum. The flesh parted crisply and began to ooze blood.

  He didn’t know how to proceed and he flayed the skin away from the sternum, then he lost his nerve. In all his life he had had but two peer friends and each had died by having his body cavity cruelly violated. If he were caught he would die the same way but in addition there would be flaying, the ultimate agony. He left the little room and nervously prowled the hospital, but those who were awake paid him no heed. He still felt as though the ground had opened up and he walked on air, but now he believed he was peering deep into the abyss.

  He fetched a small-toothed bone saw to the makeshift little laboratory and sawed through the sternum in imitation of the wound that had killed Mirdin in India. At the bottom of the incision he cut from the groin to the inside of the thigh, making a large, clumsy flap that he was able to fold back, exposing the abdominal cavity. Beneath the pink belly the stomach wall was red meat and whitish strands of muscle, and even in skinny Qasim there were yellow globules of fat.

  The thin inner lining of the abdominal wall was inflamed and covered with a coagulable substance. The organs appeared healthy to his dazzled eyes except for the small intestine, which was reddened and angry in many places. Even the smallest vessels were so filled with blood they looked as if they had been injected with red wax. A little pouchy part of the gut was unusually black and adhered to the abdominal lining; when he attempted to separate them gently by pulling, the membranes broke and exposed two or three spoonfuls of pus, the infection that had caused Qasim so much pain. He suspected that Qasim’s agony had stopped when the diseased tissue had ruptured. A thin, dark-colored, fetid fluid had escaped from the inflammation into the cavity of the abdomen. He dipped a fingertip into it and sniffed it with interest, for this might be the poison that had produced fever and death.

  He wanted to examine the other organs but he was afraid.

  He sewed up the opening carefully, so that if the holy men were right and Qasim ibn Sahdi should be resurrected from the grave, he would be whole. Then he crossed the wrists and tied them and used a large cloth to bind the old man’s loins. He carefully wrapped the body in a shroud and returned it to the charnel house to await burial in the morning.

  “Thank you, Qasim,” he said somberly. “May you rest.”

  Taking a single candle to the maristan baths, he scrubbed himself clean and changed his garments. But still he fancied the odor of death remained on him and he rinsed his hands and arms in perfume.

  Outside, in the darkness, he was still afraid. He could not believe what he had done.

  It was almost dawn when he settled himself onto his pallet. In the morning he slept deeply and Mary’s face turned to stone as she breathed another woman’s flowery scent that seemed to foul their house.

  71

  IBN SINA’S ERROR

  Yussuf-ul-Gamal beckoned Rob into the scholarly shade of the library. “I want to show you a treasure.”

  It was a thick book, an obviously new copy of Ibn Sina’s masterwork, Canon of Medicine.

  “This Qanūn isn’t owned by the House of Wisdom. It is a copy made by a scribe of my acquaintance. It is for sale.”

  Ah. Rob picked it up. It was lovingly done, the letters black and crisp on each ivory-colored page. It was a codex, a book with many gatherings—large sheets of vellum folded and then cut so each page could be freely turned. The gatherings had been finely stitched between covers of soft tanned lambskin.

  “It is costly?”

  Yussuf nodded.

  “How much?”

  “He will sell for eighty silver bestis. Because he needs money.” He pursed his lips, aware he didn’t have that much. Mary had a large sum, her father’s money, but he and Mary no longer …

  Rob shook his head.

  Yussuf sighed. “I felt you should own it.”

  “When must it be sold?”

  Yussuf shrugged. “I can keep it for two weeks.”

  “All right, then. Keep it.”

  The librarian looked at him doubtfully. “Will you have the money then, Hakim?”

  “If it is God’s will.”

  Yussuf smiled. “Yes. Imshallah.”

  He placed a stout hasp and a heavy lock on the door of the chamber next to the charnel house. He brought in a second table, a steel, a fork, a small knife, several sharp scalpels, and the kind of chisel stonecutters call a quarrel; a drawing board, paper and charcoals and leads; thongs, clay and wax, quills, and an inkstand.

  One day he took several strong students to the market and brought back the fresh carcass of a hog, with no little effort. No one appeared
to think it odd when he said he would do some dissecting in the little room.

  That night, alone, he carried in the corpse of a young woman who had died a few hours before and placed her on the empty table. Her name had been Melia.

  This time he was more eager and less afraid. He had thought about his fear and didn’t think he was driven to his actions by witchery or the work of a djinn. He believed he had been allowed to become a physician to work toward the protection of God’s finest creation, and that the Almighty wouldn’t frown at his learning more about so complex and interesting a creature.

  Opening both the pig and the woman, he prepared to make a careful comparison of the two anatomies.

  Because he began his double inspection in the area where abdominal distemper takes place, he was brought up short at once. The pig’s cecum, the pouchlike gut from which the large intestine began, was substantial, almost eighteen inches long. But the woman’s cecum was tiny in comparison, only two or three inches long and as wide as Rob’s little finger. And halloo! … attached to this tiny cecum was … something. It looked like nothing so much as a pink worm, uncovered in the garden, picked up and placed within the woman’s belly.

  The pig on the other table did not have a wormlike attachment, and Rob had never observed a similar appendage on a pig’s bowel.

  He drew no swift conclusions. He thought at first that the small size of the woman’s cecum might be an anomaly, and that the wormlike thing was a rare tumor or some other growth.

  He prepared the corpse of Melia for burial as carefully as he had done with Qasim, and returned her to the charnel house.

  But in the nights that followed he opened the bodies of a stripling youth, a middle-aged woman, and a six-week-old male infant. In each case, with rising excitement, he found that the same tiny appendage was there. The “worm” was a part of every person—one tiny proof that the organs of a human being were not the same as the organs of a swine.