Al-Seddik laughs. ‘The builder of a hospital must lay out pieces of meat in the places he is considering.’
‘Meat? As an offering?’
‘We are not heathens, Dr Shelby,’ al-Seddik protests amiably. ‘The builder should choose the place where the meat lasts longest before spoiling. This indicates a location conducive to healing. It suggests good air.’
‘In London it’s hard to escape the smell of spoiling meat wherever you live.’
‘Do you also have fountains in your hospitals?’ al-Seddik asks, dropping a coin for the musician.
‘Only if the barber-surgeon accidentally cuts through an artery,’ Nicholas replies. He takes another look around the hall of gleaming stone. ‘Surely only the richest can afford treatment in a place like this.’
‘On the contrary. Thanks to our system of al-waqf, where rich men give a portion of their treasure, anyone may come here. Man; woman; sultan or pilgrim; even slaves are treated here.’
‘And the procedure you wish to show me – Professor de Lisle says it is a laryngotomy.’
‘Given its rarity in Christendom, I thought you would find it of interest. Come.’
Al-Seddik leads them through more cool high-vaulted chambers to a large room in the heart of the Bimaristan. At its centre is a waist-high platform, tiled with the same intricate patterns that cover the floor, each tiny square so polished that Nicholas thinks he could be standing in a treasury full of rubies, emeralds and topaz. Set into the ceiling is an opening – again in the shape of a six-pointed star – and beyond it an awning on the roof to keep out the worst of the sun.
But it is the man lying on the platform that draws Nicholas’s gaze. Clad in a simple cloth shirt that comes almost to his knees, he seems to be in the grip of a trance. Surrounded by such beauty, he would make Nicholas think of a dead pharaoh in his tomb, were it not for the slow, desperate sawing of his breath.
‘The patient is slowly suffocating because of a tumour in his throat,’ al-Seddik tells him.
‘Do you expect him to survive the procedure?’ Nicholas asks, knowing the chances are slim.
‘Inshā Allāh. In England I think you say, “If God wills it”.’
‘It has been performed successfully only once in Europe – by Signor Brassavola, in Ferrara,’ Nicholas says. ‘And that was before my queen ascended the throne. We hold it to be too risky a procedure to attempt.’
‘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.