“You are unhappy, sir,” the old lady said in a frail voice from her bed. “I’m afraid that I am a great trouble to you.”

“No, no. Not at all,” I said with the flatness of deliberate insincerity.

“It is kind of you to say so. But we both know that we cannot pay you money for your help, as you deserve. And I saw from the look in your face that you are not a rich man yourself at the moment, despite your dress. Where do you come from? You are not from around here.”

Within a few minutes, I found myself perched on one of the rickety stools by the bedstead, pouring out my heart about my father, my lack of money, my reception in London, my hopes and fears for the future. There was something about her that encouraged such confidences, almost as though I were talking to my old mother, not to some poor, dying, heretical Englishwoman.

Throughout she nodded patiently and spoke to me with such wisdom that I felt comforted. It pleased God to send us trials, just as He did with Job. Our duty is to bear them quietly, use the skills He has given us to overcome them, and never to abandon our faith that His design was good and necessary. More practically, she told me I must certainly visit Mr. Boyle; he was known as a good Christian gentleman.

I suppose I should have scorned this combination of puritanical piety and impertinent advice. But I could see that, in her way, she was trying to make amends. She could offer no money, and no service. What she could give was understanding, and in the coin that she had, she paid freely.

“I shall soon be dead, shall I not?” she asked after she had listened to my woes for a good long while and I had exhausted the topic of my hardship.

My master in Padua had always warned about such questions—not least because one might be wrong. He always believed that the patient has no right to confront the physician in such a way; if one is right and the patient does die, it merely makes them morose for the last few days of their life. Rather than composing themselves for their imminent ascent into the Presence of God (an event to be desired rather than regretted, one might think) most people complain bitterly at having this divine goodness thrust upon them. On top of this, they do tend to believe their physicians. In moments of frankness, I confess that I do not know why this is the case; nonetheless, it seems that if a physician tells them they will die, many dutifully oblige, even though there may be little wrong with them.

“We will all die in due course, madam,” I said gravely, in the vain hope that this might satisfy her.

However, she was not the sort of person who could be fobbed off. She had asked the question calmly and was plainly able to tell truth from the opposite.

“But some sooner than others,” she replied with a little smile. “And my turn is near, is it not?”

‘ ‘I really cannot say. It may be that no corruption will set in, and you will recover. But, in truth, I fear that you are very weak.” I could not actually say to her—Yes, you will die, and very soon. But the sense was clear enough.

She nodded placidly. “I thought so,” she said. “And I rejoice in God’s will. I am a burden to my Sarah.”

Come I’oro nel foco, così la fede nel dolor s’affina. I hardly felt like defending the daughter, but muttered that I was sure she performed her obligations with a happy heart.

“Yes,” she said. “She is too dutiful.” She was a woman who spoke with a decorum far beyond her station and education. I know that it is not impossible for rude surroundings and coarseness of upbringing to bring forth gentleness, but experience teaches us that it is rare. Just as refinement of thought naturally requires refinement of circumstance, so brutality and squalor in life beget the same in the soul. Yet this old woman, although surrounded by the meanest of states, talked with a sympathy and understanding I have often failed to meet with in the very best of people. It made me take an unwonted interest in her as a patient. Subtly, and without even becoming aware of it, I moved from seeing her as a hopeless case—I may not be able to cheat Death, I found myself thinking grimly, but at least I will make him work for his prize.

Then the girl returned with the little packet of medicines that I had demanded. Staring at me, as though challenging me to criticize, she said that I had not given her enough—but Mr. Crosse the apothecary had allowed her to have two pence credit, when she had promised I would settle the account. I was speechless with indignation at this, because the girl seemed to be rebuking me for some failure on my part. But what could I do about it? The money was spent, the patient was waiting, and it was beneath me to enter an argument.

Maintaining an outward show of imperturbability, I took my portable pestle and mortar and began to grind up the ingredients; some mastick for sticking, a grain of sal ammoniack, two of frankincense, a dram of white vitriol and two grains of niter and verdigris both. Once these were pounded into a smooth paste, I then added the linseed oil, drop by drop, until the mixture had reached the right degree.

“Where is the powder of worms?” I asked, searching in the bag for the final ingredients. “Did they not have any?”

“Yes,” she said. “At least I imagine so. But it is no use, you know, so I decided not to buy it. It saved some money for you.”

This was too much. To be treated with insolence was one thing and quite common with daughters, but to be questioned and doubted in one’s area of skill was quite another.

“I told you I needed it. It is a crucial ingredient. Are you a physician, girl? Have you trained at the best schools in medicine? Do physicians come to you asking for advice?” I asked with a superior sneer in my voice.

“Yes, they do,” she replied calmly.

I snorted. “I don’t know whether it is worse to be dealing with a fool or a liar,” I said angrily.

“Nor do I. All I know is that I am neither. Putting worm powder on a wound is tantamount to making sure my mother loses her leg and dies.”

“Are you Galen then? Paracelsus? Perhaps Hippocrates himself?” I stormed. “How dare you question the authority of your betters? This is a salve that has been in use for centuries.”

“Even though it is useless?”

While this was going on I had been applying the salve to her mother’s wound, then rebandaging it. I was doubtful about whether it would work, incomplete as it was, but would have to do until I could make it up properly. Once finished, I stood up to my full height, and, of course, bumped my head against the low ceiling. The girl suppressed a giggle, which made me the more angry.

“Let me tell you one thing,” I said with barely suppressed fury. “I have treated your mother to the best of my ability, even though I was not obliged to. I will come back later to give her a sleeping draft and to air the wound. This I do knowing that I will receive nothing in return but your contempt, although I cannot see that I have deserved it or that you have any right to speak to me in such a fashion.”

She curtseyed. “Thank you, kind sir. And as for payment, I’m sure you will be satisfied. You said we can deal with that later, and I’ve no doubt we will.”

With that I walked out of the house and back into the street, shaking my head and wondering what den of lunatics I had tumbled into so carelessly.