Bartholomew continued.
‘Under certain circumstances there may be a surgical technique that can be used to save a patient’s life. If it were God’s will that these people should die, He would not have made it possible to use the technique in the first place. But the point is that many people who might have died have been saved because a surgeon has known how to do it. You need not perform the operation yourselves, but you should be prepared to hire the services of a barber-surgeon who will do it for you. Your first duty as a physician is always to save life, or to relieve painful symptoms.’
‘My first duty is to God!’ exclaimed Boniface, attempting piety, but betrayed by the malice that glittered in his eyes.
‘Physicians serve God through their patients,’ said Bartholomew immediately, having had this debate many times with Father William. ‘God has given you the gift of healing through knowledge, and the way in which you use it is how you serve Him. If you choose to ignore the knowledge He has made available to you without good reason, then your service to Him is flawed.’
‘Do you believe you serve God without using the
leeches He saw fit to provide for that purpose?’ asked Boniface blithely.
“I try to save my patients’ lives with the most effective method,’ replied Bartholomew. ‘If I was certain leeching a patient would secure his recovery, I would leech him.
But when my own experience dictates that there are other, more effective, cures for certain ailments than leeches, it would be wrong of me not to use them.’
‘Does trepanation hurt the patient?’ asked Robert Deynman suddenly, causing stifled laughter among the other students, and effectively ending Bartholomew’s debate with Boniface. Deynman was Bartholomew’s least able student, who had been accepted by Michaelhouse because his father was rich. Bartholomew eyed him closely, wondering if the question was intended to needle him, but a glance into the boy’s guileless eyes told him that this was just another of his unbelievably stupid questions. Bartholomew felt sorry for him. He tried hard to keep up with the others, but study was entirely beyond him. The thought of Deynman let loose on patients made Bartholomew shudder, and he hoped he would never pass his disputations.
‘Yes,’ he answered slowly. ‘It can be painful.’ He wanted to ask how Deynman thought having a hole sawn in his head would feel, but did not want to embarrass the student in front of the others, especially the Franciscans.
‘But there are things we can do to alleviate some of the discomfort. What are they?’
He stood up again and went back to the fireplace, kicking at the rushes as Bulbeck recited a list of the drugs and potions that might be used to dull the senses. ‘What about laudanum?’ he snapped. They had discussed Dioscorides’ recommendations for doses of laudanum the previous day, and Bulbeck had already forgotten it.
Bulbeck faltered, and then added it to his list.
‘How much would you give to a child you were going to operate on?’ he demanded.
Bulbeck faltered again and the others looked away.
‘Three measures,’ said Deynman.
‘For a child?’ said Bartholomew incredulously, his resolution not to embarrass Deynman forgotten in his frustration. ‘Well, you would certainly solve the problem of pressure on the brain. You would kill it! Master Gray?
Come on! Think!’
‘One measure,’ guessed Gray wildly.
Bartholomew closed his eyes and tipped his head back and then looked at his students in resignation. ‘You will kill your patients with ignorance,’ he said quietly. “I have told you at least twice now how much laudanum is safe to give children and you still do not know. Tomorrow we will discuss Dioscorides’s De Materia Medica and the medicinal properties of opiates. Bulbeck will read it here this afternoon, and I want everyone to attend.
Anyone who does not know correct dosages need not come tomorrow.’
He
‘Under certain circumstances there may be a surgical technique that can be used to save a patient’s life. If it were God’s will that these people should die, He would not have made it possible to use the technique in the first place. But the point is that many people who might have died have been saved because a surgeon has known how to do it. You need not perform the operation yourselves, but you should be prepared to hire the services of a barber-surgeon who will do it for you. Your first duty as a physician is always to save life, or to relieve painful symptoms.’
‘My first duty is to God!’ exclaimed Boniface, attempting piety, but betrayed by the malice that glittered in his eyes.
‘Physicians serve God through their patients,’ said Bartholomew immediately, having had this debate many times with Father William. ‘God has given you the gift of healing through knowledge, and the way in which you use it is how you serve Him. If you choose to ignore the knowledge He has made available to you without good reason, then your service to Him is flawed.’
‘Do you believe you serve God without using the
leeches He saw fit to provide for that purpose?’ asked Boniface blithely.
“I try to save my patients’ lives with the most effective method,’ replied Bartholomew. ‘If I was certain leeching a patient would secure his recovery, I would leech him.
But when my own experience dictates that there are other, more effective, cures for certain ailments than leeches, it would be wrong of me not to use them.’
‘Does trepanation hurt the patient?’ asked Robert Deynman suddenly, causing stifled laughter among the other students, and effectively ending Bartholomew’s debate with Boniface. Deynman was Bartholomew’s least able student, who had been accepted by Michaelhouse because his father was rich. Bartholomew eyed him closely, wondering if the question was intended to needle him, but a glance into the boy’s guileless eyes told him that this was just another of his unbelievably stupid questions. Bartholomew felt sorry for him. He tried hard to keep up with the others, but study was entirely beyond him. The thought of Deynman let loose on patients made Bartholomew shudder, and he hoped he would never pass his disputations.
‘Yes,’ he answered slowly. ‘It can be painful.’ He wanted to ask how Deynman thought having a hole sawn in his head would feel, but did not want to embarrass the student in front of the others, especially the Franciscans.
‘But there are things we can do to alleviate some of the discomfort. What are they?’
He stood up again and went back to the fireplace, kicking at the rushes as Bulbeck recited a list of the drugs and potions that might be used to dull the senses. ‘What about laudanum?’ he snapped. They had discussed Dioscorides’ recommendations for doses of laudanum the previous day, and Bulbeck had already forgotten it.
Bulbeck faltered, and then added it to his list.
‘How much would you give to a child you were going to operate on?’ he demanded.
Bulbeck faltered again and the others looked away.
‘Three measures,’ said Deynman.
‘For a child?’ said Bartholomew incredulously, his resolution not to embarrass Deynman forgotten in his frustration. ‘Well, you would certainly solve the problem of pressure on the brain. You would kill it! Master Gray?
Come on! Think!’
‘One measure,’ guessed Gray wildly.
Bartholomew closed his eyes and tipped his head back and then looked at his students in resignation. ‘You will kill your patients with ignorance,’ he said quietly. “I have told you at least twice now how much laudanum is safe to give children and you still do not know. Tomorrow we will discuss Dioscorides’s De Materia Medica and the medicinal properties of opiates. Bulbeck will read it here this afternoon, and I want everyone to attend.
Anyone who does not know correct dosages need not come tomorrow.’
He
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