“I think of the separation between life and Paradise as a river,” Mirdin said. “If there are many bridges that cross the river, should it be of great concern to God which bridge the traveler chooses?”
“I believe not,” Rob said.
The two friends parted warmly and hurried off, each to his own labor.
Rob sat in the surgery with two other clerks and listened to al-Juzjani warn them of the need for discretion regarding the operation that would follow. He wouldn’t give the patient’s identity in order to protect her reputation, but he let it be known that she was the close relative of a powerful and famous man, and that she had cancer of the breast.
Because of the gravity of the disease, the theological prohibition known as aurat—which forbade any but a woman’s husband to look upon her body from neck to knee—would be disregarded to enable them to operate.
The woman had been plied with opiates and wine and was carried in to them unconscious. She was full-formed and heavy, with wisps of gray hair escaping from the cloth that bound her head. She was loosely veiled and fully draped save for her breasts, which were large, soft, and flaccid, indicating a patient no longer young.
Al-Juzjani ordered each of the clerks in turn to palpate both breasts gently in order to learn what a breast tumor feels like. It was detectable even without palpation, a visible growth in the side of the left breast, as long as Rob’s thumb and three times as thick.
He was very interested in watching; he had never seen a human breast opened before. Blood welled as al-Juzjani pressed the knife into the yielding flesh and cut well below the bottom of the lump, desiring to get it all. The woman moaned and the surgeon worked quickly, eager to finish before she awoke.
Rob saw that the inside of the breast contained muscle, cellular gray flesh, and clumps of yellow fat like that in a dressed chicken. He could clearly make out several pink lactiferous ducts running to join at the nipple like the branches of a river merging at a bay. Perhaps al-Juzjani had nicked one of the ducts; reddened liquid welled from the nipple like a drop of rosy milk.
Al-Juzjani had the tumor out and was sewing rapidly. If such a thing were possible, Rob would have said the surgeon was nervous.
She is related to the Shah, he told himself. Perhaps an aunt; maybe even the very woman of whom the Shah had told him in the cave, the aunt who had inducted Alā into sexual life.
Groaning and almost fully awake, she was carried away as soon as the breast was closed.
Al-Juzjani sighed. “There is no cure. The cancer will kill her in the end, but we can attempt to slow its progress.” He saw Ibn Sina outside and went to report on the operation while the clerks tidied the surgery.
Soon Ibn Sina entered the surgery and spoke briefly to Rob, patting his shoulder before taking leave of him.
He was dazed by what the Chief Physician had told him. He left the surgery and walked toward the khazanat-ul-sharaf, where Mirdin was working. They met in the corridor leading from the pharmacy. Rob saw in Mirdin’s face all the emotions that were churning within him. “You also?”
Mirdin nodded. “In two weeks?”
“Yes.” He tasted panic. “I’m not ready for testing, Mirdin. You’ve been here four years, but I’ve been here only three years and I’m not yet ready.”
Mirdin forgot his own nervousness, and smiled. “You are ready. You’ve been a barber-surgeon and all who have taught you have come to know what you are. We have two weeks to study together, and then we shall have our examination.”
55
THE PICTURE OF A LIMB
Ibn Sina was born in a tiny settlement called Afshanah, outside the village of Kharmaythan, and soon after his birth his family moved to the nearby city of Bukhara. While he was still a small boy his father, a tax collector, arranged for him to study with a teacher of Qu’ran and a teacher of literature, and by the time he was ten he had memorized the entire Qu’ran and absorbed much of Muslim culture. His father met a learned vegetable peddler named Mahmud the Mathematician, who taught the child Indian calculation and algebra. Before the gifted youth grew his first facial hairs he had qualified in law and delved into Euclid and geometry, and his teachers begged his father to allow him to devote his life to scholarship.
He began the study of medicine at eleven and by the time he was sixteen he was lecturing to older physicians and spending much of his time in the practice of law. All his life he would be both jurist and philosopher, but he noted that although these learned pursuits were given deference and respect by the Persian world in which he lived, nothing mattered more to an individual than his well-being and whether he would live or die. At an early age, fate made Ibn Sina the servant of a series of rulers who used his genius to guard their health, and though he wrote dozens of volumes on law and philosophy—enough to win him the affectionate sobriquet of Second Teacher (First Teacher being Mohammed)—it was as the Prince of Physicians that he gained the fame and adulation that followed him wherever he traveled.
In Ispahan, where he had gone at once from political refugee to hakimbashi, Chief Physician, he found a city with a large supply of physicians, and more men constantly becoming healers by means of simple declaration. Few of these would-be physicians shared the dogged scholarship or intellectual genius that had marked his own entry into medicine, and he realized that a means was needed to determine who was qualified to practice and who was not. For more than a century, examinations had been given to potential physicians in Baghdad, and Ibn Sina convinced the medical community that in Ispahan the qualifying examination at the madrassa should create or reject physicians, with himself as chief medical examiner.
Ibn Sina was the foremost physician in the Eastern and Western Caliphates, yet he worked in an educational environment that did not have the prestige of the largest facilities. The academy at Toledo had its House of Science, the university in Baghdad had its school for translators, Cairo boasted a rich and solid medical tradition that went back many centuries. Each of these places had a famous and magnificent library. In contrast, in Ispahan there was the small madrassa and a library that depended on the charity of the larger and richer institution in Baghdad. The maristan was a smaller, paler version of the great Azudi hospital in Baghdad. The presence of Ibn Sina had to make up for a lack of institutional size and grandeur.
Ibn Sina admitted to the sin of pride. While his own reputation was so towering as to be untouchable, he was sensitive about the standing of the physicians he trained.
On the eighth day of the month of Shawwa, a caravan from Baghdad brought him a letter from Ibn Sabur Yāqūt, the chief medical examiner of Baghdad. Ibn Sabur was coming to Ispahan and would visit the maristan the first half of the month of Zulkadah. Ibn Sina had met Ibn Sabur before and steeled himself to withstand the condescension and constant smug comparisons of his Baghdad rival.
Despite all the costly advantages medicine enjoyed in Baghdad, he knew that the examining there was often notoriously lax. But here at the maristan were two medical clerks as sound as any he had seen. And at once he knew how he could send word back to the Baghdad medical community about the kind of physicians Ibn Sina made in Ispahan.
Thus, because Ibn Sabur Yāqūt was coming to the maristan, Jesse ben Benjamin and Mirdin Askari were called to the examining that would grant or deny their right to be called hakim.
Ibn Sabur Yāqūt was as Ibn Sina remembered him. Success had made his eyes slightly imperious beneath his puffy lids. There was more gray in his hair than had been there when the two of them had met in Hamadhān twelve years before, and now he wore a flamboyant, costly costume of particolored stuff that proclaimed his position and prosperity but, despite its exquisite workmanship, couldn’t hide the fact that he had added greatly to his girth since his younger days. He toured the madrassa and the maristan with a smile on his lips and lofty good humor, sighing and commenting that it must be luxury to be able to deal with problems on so small a scale.
The distinguished visitor seemed pleased to be asked to sit on the examining boar
d that would question two candidate clerks.
The scholastic community of Ispahan didn’t have a depth of excellence but there was sufficient brilliance at the top of most disciplines to make it easy for Ibn Sina to enlist an examining board that would have been respected in Cairo or Toledo. Al-Juzjani would question on surgery. The Imam Yussef Gamali of the Friday Mosque would test on theology. Musa Ibn Abbas, a mullah who was on the staff of the Imam Mirza-aboul Qandrasseh, Vizier of Persia, would test on law and jurisprudence. Ibn Sina himself would deal with philosophy; and in medicine, the visitor from Baghdad was subtly encouraged to present his most difficult questions.
Ibn Sina was unbothered by the fact that both his candidates were Jews. Some Hebrews, of course, were dullards who made poor doctors, but in his experience the most intelligent of the Dhimmis who came to medicine had already traveled half the distance, for inquiry and intellectual argument and a delving after truths and proofs were part of their religion, ingrained in them in their study houses long before they became medical clerks.
Mirdin Askari was summoned first. The homely, long-jawed face was alert but calm, and when Musa Ibn Abbas asked a question regarding the laws of property he answered without flamboyance but fully and completely, citing examples and precedents in Fiqh and Sharī’a. The other examiners sat a little straighter when Yussef Gamali’s questions merged law with theology, but any thought that the candidate was at a disadvantage because he was not a True Believer was dispelled by Mirdin’s profundity. He used examples from Mohammed’s life and recorded thoughts as his arguments, acknowledging the legal and social differences between Islam and his own religion where they were relevant, and where they were not, weaving Torah into his answers as a shoring up of Qu’ran, or Qu’ran as a buttressing of Torah. He used his mind like a sword, Ibn Sina thought, feinting, parrying, now and then sinking a point home as if it were made of cold steel. So many-layered was his scholarship that, although each man who listened shared erudition with him to a greater or lesser degree, nonetheless it numbed them and filled them with an admiration for the revealed mind.
When his chance came, Ibn Sabur loosed question after question like arrows. The answers always were given without hesitation, but they were never the opinion of Mirdin Askari. Instead, they were citations from Ibn Sina or Rhazes or Galen or Hippocrates, and once Mirdin quoted from On Low Fevers by Ibn Sabur Yāqût, and the physician from Baghdad kept his face impassive as he sat and listened to his own words come back at him.
The examining went on far longer than most, until finally the candidate fell silent and looked at them and no more questions came from the seated men.
Ibn Sina dismissed Mirdin gently and sent for Jesse ben Benjamin.
He could feel a subtle change in the atmosphere as the new candidate came in, tall and broad enough to be a visual challenge to older, ascetic men, with skin leathered by the sun of West and East, wide-set brown eyes that held a wary innocence, and a fierce broken nose that made him look more like a spear-carrier than a physician. His large, square hands seemed fashioned to bend iron but Ibn Sina had seen them stroke fevered faces with great gentleness and cut into bleeding flesh with an absolutely controlled knife. His mind had long been a physician’s.
Ibn Sina purposely had brought Mirdin to testing first, to set the stage and because Jesse ben Benjamin was different from the clerks to whom these authorities were accustomed, with qualities that couldn’t be revealed in an academic examination. He had covered material prodigiously in three years but his scholarship wasn’t as deep as Mirdin’s. He had presence, even now in his nervousness.
He was staring at Musa Ibn Abbas and appeared white about the mouth, more nervous than Askari had been.
The Imam Qandrasseh’s aide had noted the stare, which was almost rude, and abruptly the mullah began with a political question whose dangers he didn’t bother to hide.
“Does the kingdom belong to the mosque or to the palace?”
Rob did not answer with the swift and unhesitating surety that had been so impressive in Mirdin. “It is spelled out in Qu’ran,” he said in his accented Persian. “Allah says in Sura Two, ‘I am setting in the earth a viceroy.’ And in Sura Thirty-eight, a Shah’s task is stated in these words: ‘David, behold, We have appointed thee a viceroy in the earth, therefore judge between men justly, and follow not caprice, lest it lead thee astray from the way of God.’ Therefore, the kingdom belongs to God.”
In giving the kingdom to God, the reply had avoided the choice between Qandrasseh and Alā, yet it was a good and clever answer. The mullah did not argue.
Ibn Sabur asked the candidate to differentiate between smallpox and measles.
Rob quoted from Rhazes’ treatise entitled Division of Diseases, pointing out that the premonitory symptoms of smallpox are fever and pain in the back, while in measles the heat is greater and there is marked mental distress. He cited Ibn Sina as if the physician were not there, saying that Book Four of the Qanūn suggests that the rash of measles usually emerges all at once, while the rash of smallpox appears spot after spot.
He was steady and unwavering and didn’t try to draw into his answer his experience with the plague, as a lesser man might have done. Ibn Sina knew him to be worthy; of all the examiners, only he and al-Juzjani knew the magnitude of the effort this man had put into the past three years.
“What if you must treat a fractured knee?” al-Juzjani asked.
“If the leg is straight, one must immobilize it by binding it between two rigid splints. If it is bent, Hakim Jalal-ul-Din has devised a way of splinting which serves well for a knee as well as for a fractured or dislocated elbow.” There was paper and ink and a quill next to the visitor from Baghdad, and the candidate moved to these materials. “I can draw a limb so that you may see the placement of the splint,” he said.
Ibn Sina was horrified. Though the Dhimmi was a European, surely he must know that one who drew a picture of a human form, in whole or in part, would burn in the hottest of hell’s fires. It was sin and transgression for a strict Muslim even to glance at such a picture. Given the presence of the mullah and the Imam, the artist who mocked God and seduced their morality by re-creating man would go to an Islamic court and never be named a hakim.
The seated examiners reflected a variety of emotions. Al-Juzjani’s face indicated vast regret, a small smile trembled on Ibn Sabur’s mouth, the Imam was perturbed, the mullah already angry.
The quill flew between inkpot and paper. It made a quick scratching and in a moment it was too late, the drawing was done. Rob handed it to Ibn Sabur and the man from Baghdad studied it, transparently disbelieving. When he passed it to al-Juzjani, the surgeon could not prevent a grin.
It seemed to take a long time to reach Ibn Sina but when the paper arrived he saw that the limb depicted was … a limb! The bent branch of an apricot tree without doubt, for it was drawn in leaf. A knotted gnarl cleverly took the place of the injured knee joint, and the ends of the splint were shown tied well above and below the knot.
There were no questions regarding the splint.
Ibn Sina looked at Jesse, taking care to mask both his relief and his affection. He vastly enjoyed glancing at the face of the visitor from Baghdad. Settling back, he began to ask his student the most intriguing philosophical question he could formulate, secure that the maristan of Ispahan could afford to show off just a little more.
* * *
Rob had been shaken when he recognized Musa Ibn Abbas as the Vizier’s aide, whom he had seen in secret meeting with the Seljuk ambassador. But he had quickly realized that on that occasion he himself hadn’t been observed, and the mullah’s presence on the examining committee posed no special threat.
When the examination was finished he went directly to the wing of the maristan that contained the surgical patients, for he and Mirdin had agreed that simply to sit and wait together to learn their fate would be too hard. The interval was best spent working, and he threw himself into a variety of tasks, examining patient
s, changing dressings, removing stitchings—the homely jobs to which he had become accustomed.
Time passed, but there was no word.
Presently Jalal-ul-Din came into the surgery—which surely must mean the examiners had dispersed. Rob was tempted to ask if Jalal knew their decision but couldn’t bring himself to do so. As Jalal gave his customary greeting he offered no indication that he was aware of the clerk’s agony of waiting.
The day before, they had labored together over a herdsman who had been savaged by a bull. The man’s forearm had snapped like a willow in two places when the beast trod on it, and then the bull had gored his victim before being diverted by other herdsmen.
Rob had trimmed and sewn the torn muscles and flesh of the shoulder and arm and Jalal had reduced the fractures and applied splints. Now after they examined their patient, Jalal complained that the bulky rag dressings made a clumsy juxtaposition with the splints.
“Can the dressings not be removed?”
It puzzled Rob, for Jalal knew better. “It is too soon.”
Jalal shrugged. He looked at Rob warmly and smiled. “It must be as you say, Hakim,” he said, and left the chamber.
Thus was Rob informed. It dizzied him, so that for a time he stood without moving.
Eventually he was claimed by his routine. Four sick men remained to be seen and he went on, forcing himself to give the care of a good physician, as though his mind were the sun focusing on each of them small and hot through the crystal of his concentration.
But when the last patient had been tended he allowed his feelings to take him again, the purest pleasure he had experienced in his life. Walking almost drunkenly, he hurried home to tell Mary.
56
THE COMMAND
Rob had become hakim six days before his twenty-fourth natal day, and the glow lasted for weeks. To his satisfaction, Mirdin didn’t suggest that they go to the maidans to celebrate their new status as physicians; without making too much of it, he felt that the change in their lives was too important to be marked by an evening of drunkenness. Instead, the two families met at the Askaris’ house and rejoiced together over an evening meal.