CHAPTER THIRTY-ONE

A HARD DAY’S WORK

Only a few weeks after the examination Nuño turned over a number of their patients to him. Day by day, Yonah felt more like a physician and less like an apprentice.

Late in February Nuño told him that an annual gathering of the physicians of Aragon would be held in Saragossa. “It will be good for you to go to the gathering, and to meet your colleagues,” he told Yonah, and both of them arranged their schedules so they might attend.

When they reached the inn they found seven other physicians drinking wine and eating garlicky roasted duck. Both Pedro de Calca and Miguel de Montenegro greeted them, and Nuño derived obvious pleasure in introducing Yonah to the other five, practitioners from the outer edge of the district. When they were finished eating, Calca gave a talk on the role of the pulse in illness. Yonah thought it was ill prepared and was troubled that one of the men who had so recently examined him could present so poor a lecture. Yet when Calca finished, the other physicians stamped their feet in apparent approval, and when he asked if anyone there had a question, no man ventured to rise.

Yonah had been amazed to hear Calca state that there were three types of pulse: strong, weak, and bounding. Dare I contradict? Yonah wondered, painfully aware how new a physician he was. Yet he could not resist, and he lifted his hand.

“Señor Callicó?” Calca said, in evident amusement.

“I would like to add … to point out … that Avicenna wrote that there are nine kinds of pulse. The first, an even, ample signal of healthy equilibrium. A steady pulse that is stronger still, signaling power in the heart. A weak pulse that is just the opposite, denoting a weak force. And varieties of weakness—a long and a short, a narrow and a full, a superficial and a deep.”

He saw with dismay that Calca was scowling at him. Next to him he could feel Nuño struggling to his feet.

“How good that we have at our meeting both a new physician fresh from book studies and an excellent and seasoned practitioner who well knows that in the daily treatment of folk, the rules of our art are made simpler by experience and hard-gained wisdom.” There were a few chuckles and a resumed stamping of feet while Calca smiled, mollified. Yonah could feel the blood risen to his face as he took his seat.

*   *   *

After they had arrived home, his complaint burst from him. “How could you speak in such a manner, when you knew well that Calca was wrong and I was right?”

“Because Calca is precisely the kind of man who might go to the Inquisition and charge a rival with heresy if he is sufficiently provoked, which every physician who was there fully understood,” Nuño said. “I pray the day may come in our Spain when a physician may disagree with impunity and safely argue in public, but now is not that day, nor shall it arrive tomorrow.”

At once Yonah understood that he had been a fool, and presently he muttered his thanks and an apology. Nuño didn’t make light of the incident. “You came to me aware of the dangers that exist for you from religion. You must also be vigilant against aspects of our profession that might bring catastrophe.”

He grinned suddenly at Yonah. “Besides, you were not completely accurate in your remarks. In the translated pages of the Canon you have given to me, Avicenna said there are ten different kinds of pulse—and then listed only nine! He also wrote that subtle differences in the pulse are useful only to skillful physicians. You will discover that this description fits only a few of the men with whom we have broken bread this day.”

*   *   *

Three weeks later, Nuño had a severe attack. He had been in the process of climbing the stairs to his room when a grinding pain in his chest struck him a wild and sudden blow that left him weak and gasping, so that he had to sit in order to avoid a nasty fall. Yonah had been out seeing patients and was in the barn, unsaddling the gray Arab, when a distraught Reyna opened the door. “He is badly taken,” she said, and Yonah hurried into the house with her. Between them they managed to get Nuño into bed where, in a drenching sweat, he gasped out signs as if he were standing over a patient and lecturing to Yonah.

“Pain is dull … dull, not … sharp. But … pronounced. Very pronounced…”

When Yonah checked the pulse, it was so irregular it frightened him. It seemed to beat in fits and starts, to no rhythm he could perceive. He gave Nuño sips of camphor in apple liquor against the pain, which persisted strongly nevertheless for almost four hours. In the evening it lifted and then was gone, leaving Nuño lying abed with no strength at all.

But he was calm, and able to speak. He bade Reyna to kill a hen and make a broth for his dinner that day, and then he fell into a deep sleep. For a time Yonah watched him, realizing too well the limitations of the physician, because he wanted to do anything that would make Nuño well but had not the slightest idea what to do.

*   *   *

Within three days Nuño was able to make his way slowly down the stairs with Yonah’s help, to sit during the day in his chair. For ten more days Yonah held on to hope for him, but by the end of the second week it was clear he had met with serious trouble. His chest was congested and his legs had begun to swell. At first Yonah tried raising his head and chest at night, propping him up in bed against several pillows. But soon both the swelling and the breathing grew worse, and day or night, Nuño refused to be moved from his chair by the fire. At night Yonah lay on the floor a few feet away from him, listening to the bubbling respirations of the seated man.

By the third week the signs of final illness were indisputable. The liquid that gurgled in his lungs seemed to have pervaded all the tissues of his body so that he had taken on the appearance of obesity, with legs like posts and a pendulous abdomen that drooped over itself. He had tried not to speak, finding it an effort even to breathe, but at last, in breathless spurts, he gave Yonah instruction.

He was to be buried on his own property, on the crest of the hill. There was to be no memorial stone.

Yonah could only nod.

“My will. Write it … down.”

So Yonah fetched paper and ink and quill, and Nuño dictated terms in breathless spurts.

To Reyna Fadique he left the savings he had accrued in his career as a medical practitioner.

To Ramón Callicó he left his land and hacienda, his medical books and instruments, and the leather chest and contents that had belonged to Nuño’s departed brother, the late Manuel Fierro.

Yonah was unable to absorb it without protest. “It is far too much. I have no need…”

But Nuño closed his eyes. “No relatives…” he said, and with a weak hand, gestured the subject closed. He reached out for the pen, and when he signed the will the signature was a scrawl.

“Something … more. You must … study me.”

Yonah knew what Nuño meant but didn’t think he could do it. It was one thing to cut into the flesh of strangers while his maestro was inducting him into the secrets of anatomy. But this was Nuño.

Nuño’s eyes blazed. “You wish … to be … like Calca … or like me?”

What he wished was to be able to do this man’s dying for him.

“Like you. I love you and thank you. I do promise.”

*   *   *

Nuño died sitting in his chair, somewhere between the rainy darkness of January 17, 1507, and the gray dawn of January 18.

Yonah sat on his pallet and looked at him for a time. Then he rose and kissed his maestro’s forehead, which was still warm, and closed his eyes.

Despite his own size and strength he staggered under the weight as he took the body into the barn, where he carried out the dead physician’s wishes as though he could hear his voice.

First he put quill to paper, making note of what he had observed before mortality. He wrote of the coughing that produced blood-tinged sputum. Of skin that was sometimes purple tinged. Of neck veins that had been enlarged and pulsating, of drenching sweats, of a heart that seemed to beat as quickly and erratically as a running mouse. Of rapid, noisy, and labored breathing, and of the softly swelling skin.

After he finished writing he picked up one of the scalpels that Manuel Fierro had made and, for only a moment, studied Nuño’s face as he lay on the table.

When he opened the chest he saw that the heart had a different appearance from the other hearts he and Nuño had examined. There was a blackened area on the outer surface, as if the tissue had been burned. When he sliced it open, the four chambers looked wrong. On the left side, a portion of one of the chambers was blackened and eaten away, part of the damaged section that went all the way to the exterior. In order to study it, he had to use cloths to soak up and wipe away the blood. He thought it had not been able to pump properly, because blood apparently had backed up and had been jammed into both of the left chambers and some neighboring veins. Yonah knew from Avicenna’s Canon that to maintain life the blood must be pumped by the heart so that it perfused the whole body, coursing through large arteries and a network of veins that became finer and ever finer until they ended in the very fine, hairlike channels called capillaries. Nuño’s ruined heart had destroyed that blood-distribution system and had cost him his life.

When he cut into the swollen tissue of the abdomen he found it was wet, and so were the lungs. Nuño had drowned in his own juices. But from where had all the wetness come?

Yonah hadn’t the slightest idea.

He went through the routine he had learned well, weighing the organs and recording the statistics before he put things back into place and closed Nuño up. Then he bathed with raw soap and the bucket of water that was kept by the table, as he had been taught, and added his observations to the writing. Only when that was done did he allow himself to go into the house.

Reyna was calmly making a gruel, but she had known Nuño was dead the moment she had seen the empty chair.

“Where is he?”

“In the barn.”

“Had I best go and see him?”

“No,” Yonah said, and she breathed in sharply and crossed herself, but made no objection. Nuño had told Yonah that almost three decades of serving physicians in this hacienda had made Reyna fully aware of what went on there, and that she could be trusted absolutely. Still, Yonah hadn’t known her all his life, and he worried that she might denounce him.

“I’ll give you some gruel.”

“No. I have no hunger.”

“You have much to do this day,” she said quietly, and she filled two bowls. They sat together and ate without speaking, and when he was finished he asked her if there was anyone else Nuño would have wanted at his burial, but she shook her head.

“There is just us,” she said, and he went outside and began to work.

There were sawn planks in one of the animal stalls, quite old but still sound, and Yonah measured Nuño with a piece of cord and then cut the wood to size. It took him most of the morning to make the coffin. He had to ask her if there were nails anywhere about, and she found them for him.

Then he took a mattock and a spade and went up to the crest of the hill and dug the hole. The winter was upon Saragossa but the ground was unfrozen, and the grave took shape under his steady labor. It had been years since he was a peón and he knew his body would remind him of that the next day. He worked slowly and carefully, making the sides even and smooth, and deep enough so he had to exert himself to get out of it, heaving himself up and sending a shower of dirt and small stones back into the hole.

In the barn he rolled up the bloody rags inside a clean cloth and stuffed them into the coffin next to Nuño. It was the safest way to be rid of them, and as he hammered the top pieces onto the box he knew it was exactly what Nuño would have had him do. Even without the rags to dispose of he would have a difficult time cleaning up to leave no trace of the dissection.

The work took him the whole day. Dusk was near when he hitched Nuño’s brown horse and the gray Arab to the farm wagon. Reyna had to help him carry the heavy burden from the barn.

It was devilishly hard for the two of them to get the casket into the earth. He stretched two ropes across the hole and then tied the ends into loops that he slipped over stout pegs driven into the ground. When they settled the box over the hole, the ropes held, but they had to work the loops off the pegs and hold the ropes taut on both sides of the grave, so the coffin could be lowered a little at a time. Reyna struggled with one of the loops. She was strong and work hardened, but when finally the loop came free of the peg she lost control of the other rope long enough so a corner of the coffin dipped and dug into the side of the hole.

“Pull back hard on the rope,” he said, speaking much more calmly than he felt. But she had started to do that even before he spoke. The box still was not quite level, but there was no disaster.

“Take a step,” he said, and they both did so. That way, step by step, they advanced and lowered the coffin until it rested on the bottom.

He was able to pull up one of the rope strands but the other rope caught on something beneath the coffin. Perhaps the loop had snagged on a root; after a few hard tugs he threw his end of the rope back into the grave.

She said a Paternoster and an Ave María, crying quietly now, as if ashamed of her grief.

“Drive the wagon horses back to the barn,” he said gently. “Then you go back into the house. I will finish things here.”

She was a country woman who knew how to handle horses, but he waited until the wagon was halfway down the hill before he picked up the spade. He took the first shovelsful of dirt on the back side of the spade, the Jewish custom symbolizing that it was a hard duty to bury someone who would be sorely missed. Then he turned the spade right side up and drove it hard into the dirt pile, grunting. At first the rain of dirt rattled hollowly against the box but soon the sound was quieter, dirt falling on dirt.

The hole was only half filled when full night came, but there was a high white moon in the sky, and he could see well enough to work steadily and with few pauses.

He was almost finished when Reyna came back up the hill. She stopped before she reached him. “How long shall you be?” she called.

“Only a little while now,” he said, and she didn’t reply but turned around and went back to the house.

When he had mounded the grave as best he could, he placed his hand on his uncovered head and said the Kaddish for the dead, and then carried the spade and the mattock back to the barn. Inside the house, he saw that she had already gone to her room. She had carried in the copper tub and had placed it before the fire. The water it held was still hot, and there were two more kettles of water over the fire. On the table she had left him wine, bread, cheese, and olives.

He undressed near the crackling fire and left his damp and grimy clothing in a pile, then he sat scrunched in the tub with a piece of Reyna’s strong brown soap in his hand, thinking of Nuño—of his wisdom and tolerance, of his love for the people he had doctored and his dedication to the practice of medicine. Of the kindness he had shown a battered young man who had drifted into his life. Of the difference Nuño Fierro had made in the life of Yonah Toledano. Long, long thoughts … until he realized the water was growing cold, and he began to wash himself.