Authors: Mel Starr
I
left Paris and returned to Oxford in 1363, at Michaelmas. Trees were beginning to show autumn brown, reapers were completing their labors in the fields as I passed, and horn dancers pranced in the marketplace.
I understood that Oxford might be a poor place for an untried surgeon, there being many others who followed the profession there, and physicians as well. But I felt at home in no other place but Little Singleton, and there would be no custom for me there in such a small village. I shudder to think all I might have missed had I set up my shop in Ashford or Canterbury, as I was tempted while passing through those towns. Of course, I may have missed much by not remaining in one of those places. Who can know? I believe I have served God’s will, but have wondered occasionally if God’s will might be variable.
I found lodging on the upper floor of an inn, the Stag and Hounds, on the High Street; an establishment where I had often supped in my student days, but not by choice. The rent of such a location was sixpence each month – more than I could afford, but I wished to hang my sign in a visible, well-traveled place. I unpacked my meager possessions, aligned my surgical instruments, hung a board above my window with my name and profession emblazoned on it, and waited for patients.
Much of the next week I spent realigning my scalpels, razors, and forceps. There was little custom. A mother brought in her child, a lad of seven years or so, who had fallen from a wall and dislocated his elbow. With some tugging and much screeching, I put it right, fashioned a sling, and sent them on their way. Fee: twopence. For the most part I stayed in my room, fearing to be out when a supplicant might call.
From my window I was distractedly watching the bustle on the High Street when opportunity found me. A gentleman and two grooms rode through the throng toward St Aldgate’s. As they passed the inn a cat darted across the street just before them. The horse of the first groom started, then bucked and wheeled, scattering pedestrians like fallen leaves. His rider did not lose his seat, but neither did he quickly regain control. As the horse spun, he wheeled against the noble. I heard a shouted curse over the neighing horse and bawling crowd, and while I watched a great stain of blood spread from the noble’s thigh to his calf, and dripped from his stirrup. The groom’s horse had kicked the aristocrat, and badly, from the look of it.
I gathered some instruments and threw them into a leather bag, made certain I had thread and bandages, and bounded for my door.
Someone in the crowd must have noticed my sign and told the other groom of it. As I hastened down the stairs I met him coming up, taking the steps two at a time. He brushed me aside without slowing.
“Out of my way, lad,” he gasped, and charged on up the stairs.
“Who do you seek?” I called after him. I was sure I knew the answer to that.
“The surgeon who lives above.”
“That’s me. I saw your master hurt.”
“Then come,” he cried, and preceded me down the staircase as rapidly as he had come up, two at a time. I thought I might add a fee for setting a broken leg, but he arrived at the landing unmarred.
I should have recognized Lord Gilbert. I had seen him once, a year and more before. But the lady with him had distracted me. He was a solid man, squarely built, square in the face. He wore a neatly trimmed beard just beginning to show gray against reddened cheeks. His face was lined from years of squinting into the sun from horseback. It was a handsome face, in a blunt fashion.
At the moment my interest in him was professional, not social. With aid from bystanders, he had dismounted. I knelt over his leg, which flowed blood freely from a gash six inches long, halfway up his thigh. His chauces were torn open, so the wound was clearly visible.
He sat on the cobbles, his legs stretched before him, his solid body propped on his hands. There was no grimace on his face or quiver to his voice.
“Are you the surgeon?” he asked, nodding toward my sign.
“I am.”
“Can you repair this dent I’ve received, or should I seek another?”
I probably seemed young to a man whose future ability to walk, whose life, even, might be in my hands.
“I can.”
“Best get on with it, then,” he replied.
I felt first round the wound to learn if the bone was broken. When I was satisfied it was not, I chose two onlookers to assist Lord Gilbert, whose name I did not yet know, up the stairs to my room. I sent the still-puffing groom – the other had a frozen grip on the three horses, including his own recalcitrant beast – to the inn for a flagon of wine while I followed the grunting baron and his helpers up the uneven stairs.
Once in my surgery, I directed the injured man to lie on my bed, then cut away the ripped fabric from the wound. The groom arrived with wine, and I washed the wound. Lord Gilbert winced but slightly, then bade me sternly to proceed. I threaded a needle and began to stitch the gash, careful to do my neatest work and keep my patient as free from pain as possible, which was not actually possible. I made twenty stitches, more than might have been necessary, but when I saw he bore it well, I thought a neatly healed leg might, in future, be good advertising for my skills.
I tightened and knotted the last suture, then stood to stretch my aching back.
“Do not walk over much on that leg for four days, and do not ride a horse for three weeks,” I told Lord Gilbert, who, while I spoke, was tentatively stretching his injured limb. “In three weeks I will remove the stitches.”
“And I can ride then?” Lord Gilbert demanded.
“I do not advise it. A wound so deep as this will need careful treatment. A young man heals quickly. Were you but a squire I might say yes, but you seem a man of thirty years and more.” He frowned and nodded. “So my advice, for proper healing, would be to keep from a horse for a month.” He grimaced again.
“Will you dress this now?" he asked, and nodded toward his leg.
“No. I follow the practice of Henry de Mondeville. It was his observation that a dry wound heals best. Do not cover the wound. I will lend you chauces of mine to see you through the streets and home, but when you are at home you should leave the leg uncovered. Watch if the wound produces pus. If such be white and thick, there is no great harm, but if the pus be thin and watery, call for me at once.”
“Nothing more, then?” he asked.
“No, m’lord. I have finished.”
Lord Gilbert pulled his good leg under him and the groom rushed to help him stand.
“Help me down to the inn,” he said, pointing to the stairs. My room was above a cheap establishment intended to serve students, not nobles. Its soup was thin, its meat was gristle, and its ale sour. I ate there often.
“I will wait there. Find a litter to swing between two horses. I will go home that way.”
From my chest I drew chauces with which Lord Gilbert might cover himself. He drew them on and hobbled to my door to descend to the inn. I wanted to follow, for a pint of even bad ale seemed a good idea, but thought he might consider my continued presence an affront, or a bold request for payment. I assumed I would be paid, though the man had said no word about it.
Nearly an hour later I heard footsteps at my door, followed by a manly thumping on its panels. It was the groom who had first sought me. He held out a small purse.
“Lord Gilbert will have you receive this for your service to him. If this is not sufficient, he will make up the difference when you visit him to remove the stitches. I will call for you in three weeks to take you to him. God be with you.”
“And with you.”
The groom turned and tumbled down the stairs in the same fashion he’d done an hour earlier. Lord Gilbert must be a man, I thought, who does not like to wait.
When his back was turned I emptied the purse into my hand. It held ten silver pennies! And the man was willing to pay more. I resolved to eat well that day, and not at my landlord’s table.
The following two weeks brought little business. A woodcutter sheared off two toes with his axe. I could do little but clean and dress the wound, and advise him to be more careful. Certainly he appreciated the advice.
I tried to seem busy when Lord Gilbert’s man called for me twenty days later. “I am Arthur, here to fetch you to Lord Gilbert Talbot. You sewed him up a fortnight and more ago.”
I followed him down the stairs to where he had tied two horses in the street. I thought that polite of Lord Gilbert; don’t make the surgeon walk. But when we crossed Castle Mill Stream and put the town behind us, I realized the horse under me was more than good manners.
“Where are we going?”
“To Lord Gilbert,” Arthur replied. That was helpful.
“And where might he be found?”
“Oh…You don’t know? In Bampton, at the castle there,” he answered.
I’d heard of the town, that was all. “How far must we travel?”
“Fifteen miles…Perhaps sixteen.”
I settled myself as comfortably in the saddle as I could. I had not ridden a horse for many years. I knew that by the time I returned to Oxford in the evening I would be sore in the nether regions. Perhaps, I thought, I should volunteer to walk home.
The first thing I saw of Bampton was the spire of the Church of St Beornwald rising above the fields and forests surrounding the village. The spire was visible before we reached Aston, more than two miles distant. We passed an ancient chapel dedicated to St Andrew, and entered the town on the High Street. I felt at home already. Does every English town have a High Street? At the center of town we took the left fork and followed Mill Street to the bridge across Shill Brook.
I attracted a good deal of attention as we rode through the village. Strangers in small towns tend to do that. The town and people seemed prosperous enough. I even saw a few houses made of stone, although most were wattle and daub, with thatched roofs.
Bampton Castle is an impressive structure, all the more so when one views it for the first time. A curtain wall twenty feet high and six feet thick surrounds one of the largest castle yards in all the realm, for the wall is 360 feet long on each of its four sides. At each corner are round towers three stories high, with arrow loops at each level. Four more towers stand on the sides, and a gatehouse in the west wall permits entry. To the northwest of the castle, near a turf close, is the famous Lady Well, whose waters are of miraculous reputation.
Lord Gilbert’s chamberlain showed me to the solar, where I found my patient. The wound was healed well. There was no pus and, according to my patient, never had been. Some physicians prefer a wound to issue white – laudable – pus, but I hold with Mondeville that, although white pus is much to be preferred over watery, stinking pus, no purulence at all is best.
It was but a matter of minutes to remove the sutures. The seam across Lord Gilbert’s thigh was neat and straight. Not, unfortunately, in a readily visible location so as to proclaim my skills. Word of mouth in this case would have to suffice.
“Remember, no riding for another week,” I reminded him.
Lord Gilbert puffed his cheeks skeptically, glanced at my bag, and said, “I have two villeins in need of a surgeon’s care. Will you see them before you go?”
Clients! Of course I would see them.
The first man brought to me was a simple case. He had a large, fleshy wart on his neck. He had tried the usual remedies: rubbing with the skin of a bean pod; touching the wart with a knotted cord, then burying the cord; rubbing with a slug, then impaling the slug on a thorn bush. These had been unsuccessful. If a wart disappears after such treatment it is, I am convinced, mere happenstance. Such a wart would have faded anyway. I tied a bit of string tightly around the base of the wart, and gave the man another.
“If the wart does not wither and fall away in two weeks, loose the string and have your wife tie this other on, and tightly.”
The ploughman nodded understanding, but turned away with a skeptical expression on his weathered face. This cure was effective, however. I saw the fellow some weeks later, and he was free of the growth. Blood is cut off to the wart. It shrivels and dies and falls away.
The second man I was to see was more seriously afflicted. Arthur showed me to his hut and waited uneasily at the door. The fellow was a large, beefy man, with a broad back and legs made strong following a plow. His brow was crevassed in pain. His wife hovered, fidgeting, near the bed, which sagged beneath his weight.
“He has a stone,” Arthur said by way of introduction. The villein nodded agreement.
“Had one before,” he explained through clenched teeth. “Two years past…at Candlemas. I drank from the Lady Well and the blessed virgin interceded for me. The stone passed after a week or so. But this…since Lammas Day I’m barely able to rise from my bed.”
Nearly two months. This stone was too large to pass. It would become larger, more painful, and weaken the man to an early grave. Well, not all that early. He appeared to be about forty, although the illness might influence his features. He would not expect to live many more years.
“Lord Gilbert’s man said he’d send you. Can you do aught for me?”
“I can remove the stone. But such surgery is dangerous. You might not live.”
“I cannot live in such torment as this. I would rather see God this day than live another hour as I have these past weeks.”
“I will speak the truth – that may happen. And if not today, then tomorrow or next day.”
“But if I live, the pain will be gone?”
“Aye.”
Alfred glanced at his wife. Her pursed lips indicated the decision she would make. But he turned from her and said, “When will you do this?”
“Today. Now, if you are determined.”
He peered at his wife again briefly, then sighed, “I am.”
I had seen a lithotomy performed once, in Paris. That patient did not survive. But he was near sixty years old, and my instructor assured me that many times he had performed such surgery successfully. I was eager to try my skills, and to relieve the man’s suffering. But I will tell no lies: I was anxious both for my patient and for my reputation should I fail. Lord Gilbert’s sound leg would not balance a new corpse in St Beornwald’s Churchyard. It troubled me to think that I was as concerned for my reputation as for my patient’s life, but that was the truth of it. This attitude began to change when I came to know the people of Bampton well. It is difficult to look clinically upon a patient who has been a friend for a year or two.