by S. W. Perry
‘Then this fellow is most fortunate that he is not a Christian,’ al-Seddik says mischievously. ‘His chances are good. We have been performing it since the great Ibn Zuhr first attempted it on a goat, four centuries ago. Surgeon Wadoud is very competent. But in the end, it will be up to Allāh to decide if he lives or dies. So it is with us all.’
Squatting along one side of the chamber is a line of assistants, all dressed in similar linen robes. Some carry wooden writing tablets with concave ends that fit comfortably across their thighs. As Nicholas watches them, a young woman enters, dressed in a pale gown sewn with silver thread, a green linen scarf covering her hair. She has huge brown eyes like Hadir’s, and the same quiet thoughtfulness. She walks slowly around the patient, pausing frequently to deliver what Nicholas takes to be observations in a gentle, reflective voice. Above the rasping of the patient’s breath, he hears the sound of chalk sticks on wood as the assistants record her words. He approves, thinking of how many times in the Low Countries he could have done with properly written notes in advance, how many wounded men such preparation might have helped him save. It is only when the woman claps her hands – and an assistant gets up and presents her with a scalpel – that Nicholas realizes the woman is Surgeon Wadoud.
‘You appear surprised, Dr Shelby,’ al-Seddik says with the faintest hint of a smirk.
‘I admit I wasn’t expecting it.’
‘How strange. You Englishmen have a queen to rule over you, yet no women physicians to cure you.’ Al-Seddik makes a little huff of satisfaction. ‘Allāh has blessed us with clever women doctors for centuries. Take the man who first perfected this very procedure, Ibn Zuhr – two of his daughters became royal physicians. It is our usual custom to confine them to caring for their own sex, but when a doctor is as skilled as Surgeon Wadoud, we would be foolish not to make use of the skills Allāh has given her.’
There is a brief exchange between al-Seddik and the woman, during which she glances at Nicholas as though his presence is a matter of complete indifference to her.
‘Surgeon Wadoud is content to have a Christian physician observe her skills, for the greater glory of Allāh, the most merciful, the most bounteous,’ al-Seddik says. ‘I suggest the description of the procedure is best left to Professor de Lisle, given his medical expertise and his command of our language.’
The superior look on de Lisle’s face would not be out of place at the top table of a College feast on Knightrider Street, Nicholas thinks.
The Frenchman translates while Surgeon Wadoud makes what Nicholas takes to be her opening address. She circles the patient with a sinuous, confident grace.
‘The procedure is customarily performed with the patient in a sitting position. Madame Wadoud does not agree with this. It is better that he should be prone.’
‘To bring the trachea close to the surface, I presume,’ says Nicholas.
‘Exactly. And the patient must be calmed to the point of sleep with the juice of poppy and mandrake, or it is likely that he will struggle. If he does, there is too great a risk of severing the carotid arteries, leading to death. The sedative must be carefully mixed, or the patient may die before the procedure can begin. If performed correctly, there should be little loss of blood.’ He pauses to concentrate on what Surgeon Wadoud is saying. When he has it in his head, he nods. ‘Madame Wadoud explains it is wise to have close by a paste of spiders’ webs and rabbit hair mixed in egg-white – lest a mistake is made and the patient bleeds profusely.’
Nicholas nods to show he has absorbed this crucial information.
‘Also, she has taken the precaution of consulting a horoscope to ensure the stars are propitious.’
Nicholas can hear Elizabeth Cecil’s accusing voice in his ear: Is it true you abjure casting a horoscope before you make a diagnosis?… that flies in the face of all received wisdom… He says to de Lisle innocently, ‘Let’s hope that Capricorn was in the ascendency then.’
De Lisle looks at him blankly. ‘Capricorn?’
‘The horned goat. Master Ibn Zuhr learned this procedure by practising on a—’ He pauses. ‘Oh, never mind.’
Surgeon Wadoud advances on her patient, the long iron scalpel held between her slender fingers like a quill. Save for her mouth, her face is immobile, determined yet utterly calm. Nicholas has never witnessed such controlled beauty. De Lisle translates her brisk commentary.
‘Also, Surgeon Wadoud has ensured that to favour the outcome, a square of magic numbers has been provided,’ he says as one of the attendants holds up a wooden square about the size of a large book. Written across the top are five lines of Moorish writing. Beneath, in each square of a chalked grid, is drawn a symbol that Nicholas takes to be a number.
‘At the top is a charm,’ de Lisle continues, ‘to strengthen the courage of the patient. The numbers in the grid add up to the same sum, no matter which way you do it – up, down or across. The Moors hold this phenomenon to be magic.’
With an unexpected pang of pain, Nicholas recalls how the midwife tried to stop Eleanor’s descent towards death, putting her faith in holy stones that she claimed had been washed in the blood of St Margaret. It occurs to him now that while their hospitals might leave England’s in the shade, the Moors share the same reliance on mystic hogwash.
Surgeon Wadoud snaps her fingers. An attendant places a rolled cloth beneath the patient’s neck, arching the throat as though preparing him for an execution. The tortured breathing becomes deeper, slower. Now Nicholas can see what’s causing the man to slowly suffocate – a large swelling on one side of his neck, just above the Adam’s apple.
Wadoud places her free index finger on the man’s throat and nods an invitation to Nicholas to do likewise. The flesh is still damp from washing, he notices.
Wadoud guides his fingers until Nicholas can feel the ring of cartilage above the trachea. Her touch sends a pulse through his body. Her face is very close to his. He can smell the rose oil on her skin, reminding him of Bianca. She gives him one short glance with her extraordinary eyes and presses his fingers down on the patient’s throat, saying something to him in her language. It could be an instruction. It could be a lover’s endearment. Nicholas forces himself to concentrate.
‘Keep pressing, and watch closely,’ de Lisle translates at his shoulder.
Surgeon Wadoud moves her index finger to a spot midway between where Nicholas is pressing and the top of the patient’s sternum, talking all the while.
‘The cut must be made on the centreline,’ de Lisle says as the scalpel tip touches the flesh like a jewel placed against a lover’s throat. ‘Or else when the reed is inserted, it can slip under the surrounding tissue. And it should be vertical – with enough force to penetrate the trachea – thus.’
Surgeon Wadoud’s scalpel slices downwards into the patient’s throat. His body gives no more than a brief tremor.
For a moment she leaves the blade there, as though she’s testing the centre of a joint of meat to see if it’s cooked. When she removes it, the pink edges of the wound draw back like morning-glory petals opening to the rising sun. Just as she’d promised, there is little bleeding.
An assistant produces a short length of reed, neatly trimmed at each end. He rolls one end in honey smeared on a small trencher and hands it to Surgeon Wadoud, who deftly inserts it into the open wound, inspects the results of her labours, nods to show she is content and steps aside.
Two more helpers hurry forward to anoint the wound with a balm of oliban, aloe and myrrh, sprinkling it with red iron oxide. They bandage the patient’s neck with clean linen, leaving the tip of the reed exposed. Nicholas notices the rasping sound of his breathing has been replaced by a soft whistle with each exhalation. If Surgeon Wadoud is pleased with her efforts, the deep-set eyes do not show it.
De Lisle says, ‘Now there is a chance he will live – God willing – while his tumour is treated with…’ a quick exchange with Surgeon Wadoud to get the correct words, ‘regular cupping to draw out the black bile. Th
e wound should be washed daily with water and honey. Provided that he is fed only cold broth, he should recover his speech.’
‘Such a simple procedure,’ says Nicholas, impressed. ‘We could have made use of it in the Low Countries.’
‘Aside from the risk of severing the carotid artery, there is also the danger that the wound becomes foul. The trick is in keeping it clean.’
‘That would put us at a disadvantage,’ Nicholas agrees. ‘It could be a while before we get marble and fountains in our hospitals.’
Surgeon Wadoud receives Nicholas’s expressions of thanks and admiration with what appears to be supreme indifference. But al-Seddik is visibly excited.
‘After the work must come the play, yes?’
The minister makes it sound as though he’s performed the laryngotomy himself. He beams with self-congratulatory pleasure.
‘I have arranged a visit to the hammam, the bathhouse.’ He lays a regretful hand across his ample breast. ‘Sadly, it is not permitted for someone who is not a follower of the Prophet – peace be upon him – to bathe amongst the faithful. So I have arranged for Professor de Lisle to take you to the hammam in the Aduana, where the Christians bathe. Then we shall all feast together at my house. You can tell me how Lord Burghley and his son are faring in their dealings with your queen.’ He takes a final look at the patient wheezing gently on the table and sighs. ‘It must be difficult for such clever men to have to step so cautiously across the shadow of a woman who can end their lives on a whim.’
And just for a moment Nicholas’s isn’t certain whether the woman he’s referring to is Queen Elizabeth or Surgeon Wadoud.
The hammam is a nondescript building set deep in the Aduana, with nothing to show its purpose other than a faded hand brandishing a strigil painted beside the entrance. Nicholas is unsure what to expect; the queen’s father shut down the Southwark bathhouses long before he was born, for being dens of vice and lascivity. And he’s not asked Arnoult de Lisle, for fear of looking like a country green-pate.
At the doorway the Frenchman gives way to a departing customer, a man who stops Nicholas dead in his tracks for reasons that go far beyond mere courtesy.
He is a studious-looking fellow of about thirty, whose benign, freshly cleansed face glows with rapturous contentment, though whether from piety or from the exertions of the masseur it is hard to tell. What concerns Nicholas is his dress: the black gown and broad-brimmed hat of the Society of Jesus – the Jesuits. Nicholas tries not to stare.
To the Cecils – indeed, to the Privy Council and the queen herself – a Jesuit is a wasp to be stamped upon, before it has a chance to sting you. It is the Jesuit order that sends papist agents into England to plot against the woman they consider a heretic. If they are here in Morocco, Nicholas thinks, who knows what mischief they could be about. What will Robert Cecil expect him to do, he wonders: follow the Jesuit home and garrotte him in a dark alley?
De Lisle greets the man in French, and Nicholas hears the physician mention his name. The priest looks his way and makes a polite little nod. Unsmiling, Nicholas returns it. Then, sparing him further consternation, the Jesuit goes on his way, clean in body if not in religious conviction.
Once inside the hammam they are greeted by the owner, a large, glistening fellow, whose smile of welcome reveals a row of extraordinarily uneven teeth. His tunic is stained with cleansing oil and his heavy hands have the calloused palms of a vigorous masseur. He’s a Melkite Christian from Aleppo, de Lisle explains, though it means little to Nicholas.
After Nicholas and de Lisle have undressed, wrapping themselves in silk towels for modesty, they are ushered into a warm antechamber where atay is served. When they have drunk, they move on into a broad, hexagonal space with a domed roof and a circle of pillars. It is as hot here as it is outside, under the full glare of the sun. But the air is steamy, thickly laden with the scent of foreign unguents. On wooden benches a score of bathers sit, conversing in almost as many languages, their voices echoing off the dripping plaster walls: business talk, by the earnest tone of it, offers and counter-offers, protests at an inflated asking price, laughter as hands shake on the deal. From somewhere beyond a doorway arched in the Ottoman manner comes the slap of fists pummelling flesh, and the groans of tortured ecstasy that escape the mouth when muscles suddenly unknot.
As they take their places on a vacant bench, Nicholas feels the sweat streaming down his body. For a moment he feels lightheaded. De Lisle leans closer and, with a knowing smile, says casually, ‘You need have no fear. Fra Cyprien is a negotiator.’
Caught off-guard by both the atmosphere and the Frenchman’s words, Nicholas feigns innocence. ‘You have me at a loss, sir. I know of no such person.’
‘The Jesuit. I saw the look on your face – like a man who’s noticed he’s about to step on a scorpion.’
Nicholas gives his host a grim smile. He feels a pool of perspiration overflow his top lip. ‘We have a certain distrust of Jesuits in my country.’
‘And so you thought he and I might be in league, yes?’
Nicholas’s reply feels like the most transparent thing he’s ever said. ‘Of course not. Why would I think that?’
De Lisle claps him wetly on the shoulder. ‘You can relax, Dr Shelby. Fra Cyprien has come to Marrakech to arrange a ransom. It is a regular occurrence.’
‘A ransom? For whom?’
‘Did you not see the slave market when you arrived? Fra Cyprien has come to negotiate the return of a fellow Catholic taken by Moor corsairs. They stopped his ship off Sagres last September.’
Amongst the echoing voices, Nicholas thinks he can hear Cathal Connell’s: You can’t traffic with the Moor and not come to appreciate his proficiency in the meat trade, Dr Shelby…
‘The man’s family can afford one thousand marks,’ de Lisle continues. ‘The slave owner wants fifteen hundred. Hopefully, Fra Cyprien will negotiate a compromise. A slave’s value is sometimes greater than his worth as a mere beast of burden – if he has resources to call upon.’
‘And if there is no agreement?’
‘Then Fra Cyprien will return home a disappointed man. And the poor Catholic will remain a slave – unless he can find someone else to pay the ransom.’
It seems a plausible explanation for the Jesuit’s presence, Nicholas thinks. The only question in his mind is: is it the truth?
When they have taken enough ease in the heat, the two men pass into a chamber where attendants ladle cold water over them from polished bronze bowls. From there, it is but a few steps to the alcoves from which Nicholas had heard the groans and cries emanating. He and de Lisle stretch out on stone plinths while the masseurs go to work, showing neither man much mercy.
Giving himself up to the unfamiliar mix of agony and ecstasy, Nicholas notices an attendant moving amongst the plinths. The man is dispensing oil from a clay jar to the masseurs. He moves with a strange lopsided gait.
‘See? That’s what can happen if you don’t have a rich family and a Fra Cyprien to call upon,’ says de Lisle, once again catching the focus of his guest’s gaze.
‘An accident?’
‘Castration,’ de Lisle says brutally. ‘Marcu is from Sicily. The poor fellow came here in payment of the devshirme. He was then unwise enough to attempt an escape.’
Nicholas gives de Lisle a blank look. ‘The devshirme – what is that?’
‘The blood-tax. Every year young men from the Christian coastal villages around the Mediterranean are given up by their families to the Moors. In return, the corsairs spare those same villages from destruction. The boys have a simple choice: renounce their Christian faith, become a Mohammedan and serve the Moors as warriors – or die.’ A sad shake of the head. ‘Being poor, they have no need of a negotiator like Fra Cyprien. They have nothing with which to pay a ransom.’
‘It’s not much of a choice, this blood-tax,’ Nicholas says, suppressing a groan as the masseur harrows the flesh between his shoulders.
‘On the contra
ry. It can be a good life, better than the one they left behind. They are enlisted as janissaries – the sultan’s elite warriors. They are fed well. They have status. They can take their own slaves in conquest. All they have to do is forget that their immortal souls have been damned by apostasy.’
Nicholas glances again at the hobbling, butchered Marcu. ‘If someone was threatening to do that to me – or worse – then I might consider turning my back on the Almighty,’ he says. ‘Few of us have no limit to the courage in our hearts.’
De Lisle turns his head and smiles. ‘Never fear, Dr Shelby. No one will ask us to pay the blood-tax. You and I, we are useful to powerful men. Best we keep it that way, eh?’
Nicholas’s education continues the following morning. It continues in much the same vein for almost a week. By day, he spends his time in the Bimaristan al-Mansur, with Arnoult de Lisle and Surgeon Wadoud as his guides. He tours the wards, which Surgeon Wadoud calls iwans, and speaks through the Frenchman to the patients. He visits the iwan where maladies of the eye are treated, and the ward reserved for women, though he is not permitted further than the delicately arched entrance. He sees where those who are sick of mind are cared for, and it is as unlike London’s Bedlam – where the mad dwell in a misery that is by no means confined to the spirit – as he can possibly imagine. When he lingers in the spacious gardens, watching the recuperating patients sitting in the shade of the orange trees while they recite passages from holy texts in gratitude for the wisdom that Allāh has revealed to his physicians, he cannot help wondering what old Baronsdale and the fellows of the College in London would make of it all.
Sometimes he catches Surgeon Wadoud glancing at him with cool interest, as though she cannot quite fathom the foreigner who has appeared in her domain. She seems disinclined to ask him about physic in his world. But then what would he tell her – that far from benefiting from a system like al-waqf, English hospitals have scarcely prospered since the queen’s late father threw down the monasteries and forced the sick to search for relief elsewhere? What could he offer her that would match the fabled Bimaristans of Damascus, Cairo and Baghdad, which she tells him have existed for almost a millennium?