The Doctor turned to Edgar. “Mr. Drake, I am going to need your help. The salve should numb some of the pain, but he is going to start to scream when he sees the saw. I usually have a nurse but she is with other patients now. That is if you don’t mind helping, of course. I did think it might be interesting for you to observe our surgery at work, seeing how important such projects are for local relations.”

“Local relations?” Edgar said faintly. “You are going to amputate?”

“I have no other choice. I have seen wounds like this turn a whole arm gangrenous. I am just going to take off the injured fingers. The wound on his hand doesn’t look deep. I wish I had ether here, but my supply ran out only last week and they haven’t sent me more. We could have him smoke opium, but it will still hurt. I would rather be finished with this as quickly as possible.”

“What can I do?”

“Just hold his arm. He is small, but you will be surprised how fiercely he will try to throw you off.”

Carroll rose, as did Edgar behind him. The Doctor gently took the boy’s hand and laid it on the table. He tied a tourniquet above the boy’s elbow and motioned for Edgar to hold his arm. He did so, but his actions felt rough and cruel. Then Carroll turned to Nok Lek and nodded and Nok Lek reached over and twisted the boy’s ear. The boy shrieked and shot his free hand up to his ear, and before Edgar could turn back to the table, the doctor had cut off one, two, and then a third finger. The boy looked at them, perplexed, and then screamed again, but Carroll had already wrapped the bloody hand in the cloth.

The morning wore on, patient after patient filed into the examining chair before the window: a middle-aged man with a limp, a pregnant woman and a woman who could not conceive, a child Carroll diagnosed as deaf. There were three people with goiters, two with diarrhea, and five with fevers, all of which Carroll attributed to malaria. From each of the feverish patients, he drew a drop of blood and placed it on a slide and examined it beneath a small microscope that reflected light from the window up through the eyepiece.

“What are you looking for?” asked Edgar, still shaken from seeing the amputation. Carroll let him look through the microscope.

“Do you see the small circles?” he asked.

“Yes, everywhere.”

“Those are red blood cells. Everyone has them. But if you look closely, you can see that inside of the cells are darker objects, like blemishes.”

“I don’t see anything,” Edgar said, and sat back in frustration.

“Don’t worry, it is difficult at first. Until about seven years ago, no one knew what they were, until a Frenchman discovered that they are the parasites that cause the disease. I have been very interested because most Europeans think that the disease is caused by breathing bad air from the swamps, that is why the Italians named the disease mala aria, ‘bad air.’ But when I was in India, I had a friend, an Indian doctor who translated for me some of the Hindu Vedas, where they call malaria ‘the king of diseases’ and attribute it to the anger of the god Shiva. As for transmission, the Vedas implicate the lowly mosquito. But no one has found this parasite in the mosquito yet, so we can’t be certain. And since mosquitoes live in the swamps, it is difficult to dissociate the two. Actually, it is difficult to dissociate any of its possible sources in the jungle. The Burmese, for example, call it hnget pyhar, it means ’bird fever.‘”

“And what do you think?”

“I have been collecting mosquitoes, dissecting them, grinding them up, peering at their innards through the microscope, but I haven’t found anything yet.”

Carroll gave each of the malaria patients quinine tablets and an extract of a plant he said came from China, as well as a local root to ease the intensity of the fevers. For the diarrhea, he gave laudanum or ground papaya seeds; for the goiters, tablets of salt. He instructed the man with a limp how to make crutches. For the pregnant woman, he rubbed an ointment on her swollen belly. For the deaf child he could do nothing, and told Edgar how seeing such a child saddened him like almost no other disease, for the Shan had no sign language, and even if they had, the boy could never hear the songs of the night festivals. Edgar thought of another little boy, the deaf son of a client, who would push his face against the piano case when his mother played, to feel the vibrations. He thought of the steamer to Aden as well, and of the Man with One Story, There are causes of deafness that perhaps even medicine cannot understand.

For the woman who could not conceive, Carroll turned to Nok Lek and spoke at length. When Edgar asked what he had recommended, Carroll said, “This is confusing. She is barren, and she walks through her village muttering to a make-believe child. I do not know how to cure her. I have told Nok Lek to take her to a monk in the north who specializes in cures for such diseases. Maybe he can help.”

Close to noon, they saw their last patient, a thin man who was led to the chair by a woman who looked half his age. After talking briefly to the woman, Carroll turned to the room and announced something in Shan. Slowly, those waiting rose and filed out of the room. “This could take some time. It is a shame I cannot see them all,” he said. “But there are so many who are sick.”

Edgar studied the patient more closely. He wore a moth-eaten shirt and a pair of torn trousers. He was barefoot, and his toes were callused and gnarled. He wasn’t wearing a turban. His head was shaved smooth, his face and eyes hollowed. As he stared at Edgar he made slow rhythmic motions with his jaw, as if chewing his tongue or the inside of his cheeks. His hands shook, slowly and rhythmically.

Carroll spoke at length with the woman, and then finally turned to Edgar. “She says he is possessed,” he said. “They come from the mountains, nearly a week’s journey from here, from a village near Kengtung.”

“Why come here?” asked Edgar.

“The Shan say there are ninety-six diseases. This isn’t one of them. She has seen all the medicine men near Kengtung, and they can do nothing. Now word of this man’s disease has spread, and medicine men fear him because they think that the spirit is too strong. So she came here.”

“Surely you don’t believe he is possessed…”

“I don’t know, there are things here that I have seen which I never could have believed before.” He paused. “In some areas of the Shan States, men like this are worshiped, as spirit mediums. I have been to festivals where hundreds of villagers have come to watch them dance. In England we would have called the writhing movements Saint Vitus’ dance, for Saint Vitus is the patron saint of hysterical and nervous diseases. But I don’t know what to call this dance, Saint Vitus cannot hear prayers from Mae Lwin. And I do not know what spirits cause this possession.”

He turned back to the man, and this time addressed him directly, and the man stared back with empty eyes. The two remained like this for a long time, until at last Carroll rose and took the man by the arm and led him outside. He gave no medicine.

St. Vitus, thought Edgar, Vitus was the name of Bach’s grandfather, It is strange how all is connected, even if only by a name.

When the old man had shuffled away slowly with his wife, Carroll led Edgar to another building, separate from the headquarters. Inside several patients lay on cots.

“This is our little hospital,” Carroll explained. “I don’t like to keep patients here; I think they heal better at home. But I feel as if I need to watch some of the more severe cases, usually diarrhea or malaria. I trained Miss Ma as a nurse.” He pointed to a young woman who sat wiping one of the patients with a wet cloth. “She takes care of the patients when I am away.” Edgar nodded to her and she bowed slightly.