On a hot sunless morning Paul Coldwater the butcher had stopped him on the corner of Addle Hill.
‘You’re Mr Mendel – the surgeon.’
‘I am Mr Mendel,’ Mendel had said, inclining his head, ‘but I am no surgeon. A surgeon must be a member of the Company, and the Company, I fear, would not have me. I have not,’ he added, with a brief bitter grimace, ‘the Latin.’
‘You cut open my dad,’ the butcher had insisted. ‘You cut him a new arsehole, he said, and pulled a stone out of his kidney, and all in the time it took him to say a dozen Hail Marys. If you ain’t a surgeon, sir, I don’t know what you are.’
‘I might for all you know be a brother butcher.’
‘It’s my wife, Mr Mendel, sir. She’s got summink rotten. She screams. Screams summink rotten.’
Mendel squinted doubtfully at the wideshouldered young man. The cheeks and chin skewbald with chestnut beard; the eyes dozy with strabismus.
This was no Company agent.
‘You will pay?’
Coldwater’s eyes focussed for the first time: the unforgiving focus of the City merchant.
‘Well. I got – I got a pound of sausage, sir, if you make her right.’
Mendel moodily nodded and in his head spoke Shylock’s lines: The pound of flesh that I demand of him is dearly bought; ‘tis mine and I shall have it. It was better earnings than he had grown used to.
The warm air of the Long Walk shop was flushed with the stink of animal blood. On a scarred elmwood table the butcher’s boy was intently skinning hares. Mendel let himself be led by the sleeve through the shop and up a narrow flight of uncarpeted stairs.
‘I hear no screaming,’ he murmured.
‘A blessing,’ said Coldwater, the butcher.
‘An absence of screaming, sir, may indicate an absence of breathing,’ said Mendel. They emerged on to a windowless landing. ‘Would that be a blessing?’
Coldwater led on to a doorway at the landing’s end.
‘She’s suffered, sir, I swear she has,’ he said, by way of answer.
Stood at the foot of the Coldwaters’ bed Mendel looked down at the woman doubled moaning beneath the blanket. The white skin of her cheek glistened like a scallop. The floorboards creaked as beside him Coldwater shifted from foot to foot.
‘There’s no child?’
‘I swear I ain’t even been in her since the last boy was born,’ Coldwater said.
‘And the pain is constant?’
‘I can only go by the screaming, sir. But I’d say so, sir, going by the screaming.’
Mendel took off his coat and peeled back the damp sleeves of his shirt.
‘I will need to see her body,’ he said in a regretful undertone. ‘And also, perhaps, to touch it.’
‘You do what you must, Mr Mendel,’ Coldwater nodded stoutly. Mendel moved to the side of the bed, and drew back the blanket.
Pol Coldwater’s body was naked, white and sodden. She lay on her left side, forearms crossed across her breasts, knees drawn up. Her face was half-buried in a pillow of grey cotton drenched blue-black with sweat. The green eye that looked up at Mendel was fearful.
‘On to your back, Mrs Coldwater, if you would,’ Mendel said quietly. ‘On to your back, now.’
She hesitated until Coldwater muttered: ‘Do as Mr Mendel says, Pol. Or you’re for it.’
Rolling obediently on to her back Pol Coldwater said: ‘I reckon I’m for it anyway,’ and then sucked with a hiss at her tea-coloured teeth.
Mendel considered the shape of her bare body and the colours of her skin. Ribs evident. Breasts shrunken to a bare handful apiece. Blonde pubic hair dense and straggling almost to her bulbous navel. A yellow part-healed bruise above her left hip.
Mendel leaned forward and extended a hand to her belly. The skin was warm even to his warm fingertips.
‘The pain – here?’ A gentle palpation.
‘And – ’ another – ‘here?’
He withdrew his hand.
‘You have spirits in the house, Mr Coldwater?’
‘Gin, is all.’
‘Gin will do. A halfpint in a cup, please. And a gill in a clean glass.’
‘Partly,’ said Mendel, ‘for Pol.’
He thought of the fat old man Coldwater as thin Pol Coldwater lolled drunkenly on the stripped bed. But that was only a stone, a calculus from a bladder. This –
‘Ought I pray, Mr Mendel?’ offered Coldwater solicitously.
Mendel’s gin-washed blades in their leather case were spread on a side table behind Mendel’s back. Also an empty cup and an empty glass. Mendel had pulled the curtains from the high window. On the bed Pol Coldwater lay in a crossed rectangle of white light.
‘Do you love your wife, Mr Coldwater?’
Coldwater’s feet ceased to creak the boards.
‘I give her four boys, didn’t I?’ Defensiveness wound the butcher’s voice to a querulous pitch. ‘I said I’d pray for her, Mr Mendel, didn’t I?’
‘You did,’ Mendel nodded. He unsheathed from the leather case a scalpel and Coldwater fell silent. The boards creaked beneath his feet. ‘Love may have a place here,’ Mendel murmured, bending over Pol’s body. ‘Prayer has not.’ He looked up, meeting the eye of Coldwater at the foot of the bed. ‘Hold her,’ he said.
Coldwater, moving to the opposite side of the bed, leaned and laid pink hands on Pol’s bare white shoulders.
It has been done before, Mendel reminded himself. The gentleman Claudius Amyan performed the operation at Saint George and it was said the child lived.
As for the disease: Heister and Mestevier have spoken of it in the dead. As also the Frenchman Fernel in the days of Henry the jouster. The caecal worm turns bad and must be removed like a grub from an apple. The belly of Mendel’s scalpel-blade touched Pol’s skin. Pol giggled, and, slobberingly, kissed the air.
Again Mendel said: ‘Hold her.’
A heartbeat’s pause. A breath. The surgeon must breathe. Incision.
Pol Coldwater bled before she screamed: a wet red line following the scalpel edge.
‘We must be swift,’ Mendel muttered, prising open the three-inch wound. ‘Many die from the wounds but as many die from fright.’
Pol, now screaming, kicked against the torn sheets that bound her by her ankles to her bedposts.
‘No, Pol,’ Coldwater said sternly. He bore down hard on her shoulders.
‘A nightmare, Mrs Coldwater, from which you will soon wake,’ Mendel said. He licked his lips and tasted sweat. Pol screamed on without words. In the screaming Mendel heard an interrogative note. Why. What.
‘Stifle her, sir,’ he shouted.
Coldwater’s weight shook the bed. With one knee on the bed’s timber frame and a hand gripping each wrist he had dropped his body on to Pol’s, pressing his chest across her face, forcing her into stillness. Still her feet kicked but Mendel’s knots held.
‘Bold work, sir,’ Mendel smiled bleakly. ‘But see that the woman can breathe.’
The screams now were muffled by Coldwater’s chest and Mendel paid them no mind. He peeled aside skin and fat and holding apart the lips of the wound with his left forefinger he eased the blade through the tripelike peritoneum. In here lies the worm. But where? Mendel’s third finger pushed beneath the omentum majus, slid across the ribbed skin of Pol Coldwater’s lower bowel, groped for the caecum. In his mind Mendel recalled his researches, his rootling in the vitals of dog and monkey: from gut to caecum, and from caecum – yes. Here the muscular ribbons of the teniae coli converged: here was the worm, here the disease. With two fingers Mendel loosed the appendix from its bed of warm, oily tissue. He brought it to the wound.
‘Dear God,’ panting Coldwater wheezed. Beneath him his wife sobbed. The appendix held between Mendel’s knuckles was black with blood.
‘The worm,’ Mendel announced.
At the first blow the scalpel snagged. We must take great care, great care. Mendel tugged, chopped again. Thin blood welled around his finger-ends. The worm came away.
‘Praise God,’ gasped Coldwater.
Mendel, throwing the black appendix to the floor, said: ‘The work is not God’s and, besides, the work is not yet done.’ He set his scalpel down carefully on Pol’s belly and with his left hand reached for a threaded needle. Through the fingers that held the seeping stump of the gut he could feel the beat of Pol’s heart. ‘Hold her still, now, sir, still as still,’ he said.
Mendel’s snaking wrist drew figures in the damp air as the needle was drawn through the gutskin in a purse-string stitch, closing off the severance. Then the fibrous belly muscle, resistant to the poking needle point. Then the white skin.
Mendel straightened carefully, touching one hand to his lower back. The fabric of his shirt was wet. He turned and pushed the soiled needle into the leather of his scalpel case. With care he opened his cramped right hand and flexed the fingers.
Coldwater’s voice was hesitant and low.
‘Over.’ Mendel wiped fingers on breeches.
‘And she’ll live?’ The sweating butcher lifted himself on to his elbows. Pol beneath him rolled her head on the pillow and gulped air.
‘She breathes, her heart beats.’ Mendel shrugged. He glanced to the floor. The black caecal worm lay rolled in grey dust and half-propped in a puddle of blood against the skirting-board. He stooped, picked up and pocketed it, wrapping it first in a handkerchief.
‘You’re taking it with you, Mr Mendel?’ Coldwater had released his wife. Still with one knee on the bedstead the boss-eyed butcher smoothed his palms on his shirt-front.
Mendel watched drunk Pol’s right hand fumble flutteringly towards the puckered indentation between hip and navel. She moaned but didn’t scream.
‘Better than that it be left here to take its chances among your blood sausages,’ he smiled thinly.
Coldwater nodded. Mendel lifted the empty glass from the side table.
‘A drink, sir,’ he said. The glass quivered in his hand. ‘I would drink to your wife’s good health.’
Coldwater, watching his naked wife stir on the bed, continued to nod.
‘Yes, Mr Mendel. There’s more gin in the parlour. I shall fetch it.’
Mendel, drunk, with his paper bag of unfresh pork sausage and Pol Coldwater’s appendix in his pocket, half-tripped as on the corner of Paternoster Row he skirted a heap of horseshit.
By God, Mendel, he told himself. You are quite a fellow. You sliced open the woman’s gut, sir! You cut away a portion of her damn’ bowel – and yet she lives and breathes.
A surgeon you are, Mendel, he thought, smiling, unsteady on his feet, sauntering into Cheapside.
‘You’re Mr Mendel – the surgeon,’ someone said.
Another wideshouldered man blocking the pavement. Mendel wondered what he might be asked to remove from this gentleman’s wife. He wondered if he might pick up in payment a sack of carrots, to go with the sausage – or a quart of gin, just as well, to wash it down.
‘I am, sir. I am Mendel the surgeon.’
‘The Company,’ said the wideshouldered man, ‘don’t take kindly to no unqualified persons making a mockery of their business.’
Mendel felt the cartilage of his nose crumple under the man’s fist – the cartilago lateralibus, he thought, confusedly, as he fell to the cobbles, and would have cried: ‘How’s that for anatomist’s Latin, sir!’, had his mouth not filled with blood. His sausages spilled from the paper bag.
‘No more, the Company says,’ said the man.
Mendel pressed his shirtcuff to his nose and watched the white linen turn red. This is not a trade for the squeamish, he thought. I am fortunate. I am fortunate that I do not jib at the sight of blood. Even when it is my own.
He rolled on to his back. He pressed a hand to the bulge made in his pocket by the appendix of the butcher’s wife, and smiled.