I hurried off as soon as the play was over, making my way around the north side of the town wall to Smithfield instead of going through the crowds of the City, for I thought to save myself some time. I had been gone several hours longer than I should have been and my father might have begun to worry. As I hastened along the tenters’ fields and past Cripplegate, my mind seethed with confusion. Simon had looked so delicate and convincing as a girl, yet he surely believed me to be a boy, and one who could never pass for a maid. Maid or man? Jew or Gentile? Portuguese or English? My meeting with Simon had left me floundering in my own muddy thoughts.
After this encounter, I tried to put Simon out of my mind, together with the confusion in my mind prompted by it. We were busy at the hospital after an outbreak of measles, a dreadful disease which seems to prefer to attack children. It heralds its entrance into the body with fever and sweating and the child complains of terrible pains in the head. With a young baby, too young to speak, there is constant crying and thrashing about. Indeed, once the epidemic had taken hold, the wards of St Bartholomew’s reverberated with the constant crying of babies and children. We had to move many of our other cases, who needed peacefulness and rest, away from the stress of the unrelieved noise. My own head throbbed with it.
We treated the outbreak of fevers with the usual febrifuge herbs – borage is good and readily available and the extract from the bark of willow – but by the end of the first week it had become clear that it was not just fever we were dealing with, but measles. The telltale rashes were beginning to appear, first on the chests of our young patients, then spreading to faces and all other parts of their bodies, driving them mad with the itching. It is very difficult indeed to stop a young child from scratching, and of course the scratching causes the rash to explode into pustules which grow inflamed and infected, oozing pus and causing pain as well as the itch.
It seemed as though we made bucketsful of the salve which is mainly composed of the ground root of camomile, a task in which I leant a hand to Peter Lambert, one of the young assistant apothecaries who had been assigned to help us. We were of much the same age and had started work at St Bartholomew’s within a month of each other. He was a charity boy, but one of the senior apothecaries had noticed how quick and neat he was, working as a servant in the hospital. He had been taken on as an apprentice and trained up. In a few years he would be licensed himself.
‘We need to shade the windows,’ my father said, as soon as we had ascertained that it was measles we were dealing with. I looked at him questioningly. Peter also raised his eyes from the mortar where he was grinding yet more camomile root.
‘Strong light is dangerous for the eyes of those suffering from measles,’ my father explained. ‘What are the worst effects of measles, Kit?’
‘Oh, I see,’ I said. ‘Blindness, of course. And deafness. In very severe cases it can cause serious damage to the brain, leaving the victim forever confused and childlike.’
‘Quite correct.’
I noticed that Peter was listening carefully, with a horrified look on his face. He glanced around at the rows of cots and small beds.
‘You mean it will happen to these children, Dr Alvarez?’
‘To some of them, yes. I’m afraid whatever we do, some of them will suffer these terrible after-effects. That is why it is so important to detect and treat measles quickly, and to try to stop the outbreak from spreading. So you see, I am not being cruel when I ban visitors to our young patients. We cannot risk the disease being carried to others who are not yet infected. Now I must see about ordering the cloth for the windows.’
By the next morning all the windows in the measles wards had been covered with red cloth, nailed to the frames, and we worked in the strange rosy glow they cast over everything. It was noticeable that the children seemed less distressed in the dimmer light, though the fever and the painful rash continued to torment them.
At the end of the first week, we had our first death, a little boy about three years old. We had feared for him from the start, because he had been very ill when the parents brought him to the hospital, already in a dangerously high fever and unconscious. After that, three babies died. I began to dread going to the hospital, though I only left it for about three hours during the night, to go home and snatch a little sleep, before changing places with my father, so he could do the same.
During the second week, my father called me over to the bed of a little girl of about ten. She was sitting up quietly, having come through the worst of the rash, which had begun to fade from her cheeks. Instead of a mass of ugly red weals, her forehead and cheeks were now spotted with small red bumps, each with a tiny scab at the centre. As one of the older children, she had understood she must not scratch and had done what she could to stop herself, sitting on her hands. Indeed she was one of our best patients, quiet and uncomplaining.
My father had a candle in his hand and was moving it back and forth in front of the girl’s face. Her eyes were open, but they did not follow the movement of the flame.
‘What do you think, Kit?’
I swallowed. ‘I think her eyes are affected,’ I murmured softly, not wanting the child to hear me use the word ‘blind’.
My father nodded and sighed. He blew out the candle and set it down on the stool at the foot of the bed.
‘Yes, you are right. And you do not need to whisper. She cannot hear you.’ He turned to the child and raised his voice slightly. ‘Can you hear me, Lizzy?’
She did not respond.
I turned away, filled with a sudden great rage. Her parents had brought her in quickly, we had treated her at once, and she had done everything we told her to do. Now, this. Not only blind, but deaf as well.
For the rest of the time the epidemic lasted, another ten days, I went about my work in a kind of numb fury. Four more children died. Two others were blind. And one boy of twelve babbled and dribbled like an infant.
When at last the wards were clear of measles cases, the rooms washed from top to bottom under my father’s severe scrutiny, and the red cloth taken down, we moved the regular patients back in from other wards where they had been crowded together. We went home late that evening and as soon as we were through the door, I sank down on a kitchen bench. I felt like a cloth doll which has lost its stuffing and hung my head between my knees. The iron grip in which I had held myself for so long collapsed and I began sobbing uncontrollably.
My father sat down beside me and put his arms around me.
‘Hush, Kit, hush, child. It’s over.’
‘But it will never be truly over, will it?’ My voice came out thick and blurred and shaking with anger. ‘How can God visit such suffering and punishment on innocent children? Killing some. Leaving others blind or deaf or mad? Is that the work of a benign God? I do not think so! How can I go on being a doctor in a world of such wickedness, a world where even God seems evil?’
He said nothing for a while, letting me sob into his shoulder. At last he said, ‘I cannot understand the ways of God, or His plan for any of us. Do not give way to despair, Kit, because you cannot understand Him either. All we can do, as doctors, is to relieve suffering and to cure those we can. Remember, far more of those who came to us were cured than endured the effects we all grieve over. A doctor must be courageous and carry on, in the face of distress and agony. Our strength must uphold our patients and give them strength and hope. I know that you can do this, or I would never have allowed you to take up medicine.’
His words comforted me a little. I vowed I would try to be strong and not allow distress to undermine my work. But I would never forget that epidemic of measles, or the girl sitting up in bed, neither seeing the flame of a candles before her eyes nor hearing our voices when we spoke to her.