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The Book of Madness and Cures

Little, Brown and Company

The Book
of
Madness
and Cures

Prologue

“I don’t know where my own body begins or ends,” said the young girl of Imizmiza. Her mother had summoned me, the only woman physician within hundreds of miles, to tend her twelve-year-old daughter, who suffered the grave consequences of corporeal confusion. The girl sat at a cedar table near a narrow window in the red earthen house. She told me, through a dark veil that flickered as she spoke, that she sensed the fear of entrapment that the tethered horse knew in the field. His visible breath pulsed in the cold air as he drew the rope taut, while the groom approached, currycomb in hand. She told me, “The man who strokes the horse with five different brushes in strict order of succession, the man with a head like the knot at the end of a rope, he is smaller than my thumb—” And then she laughed suddenly, surprising me.

Before I could puzzle this out, her mother approached us and chided, “Come, Lalla, put on your riding skirts. You’re taking the horse out today.”

The girl stared at the plank table where her left arm lay with the grain, her right arm resting bent against it. She whispered, “I’m too heavy today, I can’t move.”

And though she made an effort, she couldn’t budge.

When I placed my hand upon the wood lightly, as if touching the fuzzy scalp of an infant, she sighed and closed her eyes. When I removed my hand, she sensed it immediately. I tried to lift her arms from the table but she was rigid. Later, inclined by some inner urging, she separated herself and wandered as if in a trance, when at last her mother could direct her to her beloved horse or to her bed for an afternoon nap.

Wherever Lalla stopped, she became part of the thing she touched. When she rode her walleyed and snorting animal, she sweated like a horse. Froth gathered at her lips and neck. When she slept, she might not wake for days, for the bed itself was her motionless body. Meals were the most difficult. She refused whatever food she touched, confessing a horror of eating her own flesh. Though her mother fed her like a babe with a small wooden spoon, she grew thinner and thinner.

At length I suggested a slow cure. I would need the assistance of her mother and aunt—though the aunt, a large, choleric woman, obstinately insisted that Lalla was not in need of curing, and certainly (she glared, scrutinizing my face and my dress) not by a foreigner. The girl simply possessed a clairvoyant body, the aunt said, challenging me. “We mustn’t take away the girl’s talent.”

“The girl doesn’t have command of her own life! One must stand apart in order to truly know another,” I said.

Lalla’s mother, a small, dark mountain of a woman, also veiled, asked, “Will she be able to marry and bear children?”

“I don’t know,” I confessed.

The cure, then, consisted of words. I advised her mother to name her hand, to name the distaff upon the table, and the table itself. When I came to visit, I’d ask Lalla, “Where is your arm, your hand, your hip?” Sometimes she could answer and point to that part of her body. Other days she regarded me with a kind of panic, as if she didn’t understand my question and feared terrifying penalties for this. I touched her hand, and then her mother or aunt would repeat the word for hand, to calm her. Gradually she responded with more and more movement until her ability to unfasten herself from her surroundings was accompanied by a kind of plaintive joy. For separation meant that she had changed and that the unknown surged forward to meet her.

I’ve since come to believe that the world is populated by multitudes of women sitting at windows, inseparable from their surroundings. I myself spent many hours at a window on the Zattere, waiting for my father’s return, waiting for my life to appear like one of those great ships that came to harbor, broad sails filled with the wind of providence. I didn’t know then that during those fugitive hours beneath the influence of the damp moon, I was already plotting my future in pursuit of the past. I’d grown transparent as the glass through which I peered, dangerously invisible even to myself. It was then I knew I must set my life in motion or I would disappear.

Chapter 1

God’s Work or the Devil’s Machinations

Venetia, 1590

From the foreign marks and characters in diverse hands and languages upon the sheet of paper that enclosed it, I could see that my father’s present letter had traveled, a lost communiqué, through many of the cities on his route. It had been nearly a year since I’d heard from him. All told, he’d been gone since August of 1580. Olmina, once my nursemaid and now my servant, had slipped the letter lightly on my desk that stifling July afternoon. She may as well have released a viper that gives no warning before it strikes.

“If my mother reads this, you know she’ll twist it into some kind of offense, no matter what it contains,” I warned, tapping the closed letter nervously on my palm as we stood in my shuttered room, the summer tides slopping noisily on the stones below my window, the warm stench of brine stinging the air. Poor Mamma. She’d always perceived the world to be against her. Happiness was never to be trusted. And yet, I thought vaguely, neither was sorrow. Didn’t each come to season in the other? Sometimes our Venetia gleamed a miraculous city on the summer sea, and later during the winter acqua alta, she sank into cheerless facade. Then the floods engendered spring. Someday she might all be submerged, a dark siren whose lamplit eyes have gone out. Yet others might see beauty there where we walked in the place become water.

“Don’t worry, Signorina Gabriella.” Olmina pressed a forefinger beside her broad peasant’s nose, a sign that she knew how to keep a secret. Her pale blue eyes glinted in the dim light, though I’d seen those same lively eyes turn dull as slate when she was questioned by my needling mother.

“I don’t think she’s even missed him these ten years.”

“Ah, signorina. She seems to yearn for the role of widow…”

“So true, dear Olmina. But even there she’s unsuccessful. She’d have to give up her luxuries and frippery.” Though I often sensed a sad futility under her frivolous pursuits. There was more to her, perhaps, than I knew. I’d often seen a fear without cause flickering across her face. If she were a widow, she could wear it more openly, even though the source was still obscure.

“Well, if you don’t mind”—Olmina rolled her hands within her linen skirts, nodding, her gray hair poking out from under her pale, unraveling scarf—“I’ve a stack of dishes to wash in the scullery and my own luxury of a nap waiting for me at the end of that.” She grinned and then stumped down the stairs, her short, formidable figure still strong in middle age.

As I stared at the unopened letter, I thought of the ways my life had shrunk since the departure of my father ten years ago. I didn’t dream of many things anymore, of traveling to distant countries, even with the rare—though ever declining—freedom I could claim as a woman doctor. As we say in Venetia, the world comes to us to beg favor, and I consoled myself with this. Still I could see even now my father’s kindly yet remote ash-brown eyes, his raven-and-carmine robes, and as I held his letter, a small voice that had long been silent within me spoke. Let me accompany you, Papà. Don’t leave me behind.

His previous letter had arrived last year from Scotia, where he expressed his vague intention of traveling even farther north to collect the powdered horn of the unicorn fish, a cure against lethargy. Or perhaps south to the torrid clime of Mauritania or Barbaria, where he might find the rare bezoar stone that takes all sadness into its density and renders lunacy its wisdom. As with the arrival of all his letters over the years, I had marveled at these cures, at the riches his medicine chest must contain by now—and wished deeply to see them for myself, to acquire them for my own. But his words hid something I couldn’t quite name, though they crept like sighs under my breath. Words like lethargy, bezoar, sadness.

I broke the red waxen seal of the letter, which clearly had already been opened several times, the Mondini crest obliterated and then reaffixed. I could make out the smudged name of Tübingen below it, though not in my father’s hand. Was this the city of origin or had it been forwarded or returned there by mistake? How many strangers had read his letter? Looking for evidence of heresy? Surely they were disappointed. As I shook its contents out upon my desk, a single sheet of bone-white paper unfolded. My father’s usual courtesies were absent and his scratchy handwriting appeared labored.

Gabriella,

You may have denounced me or given me up for dead. I cannot justify what has happened any more than I can explain the friction that underlies the harmonious rotations of the spheres. It would be too simple to say, God’s work or the devil’s machinations. I will not be returning and it will be the better for you. I now entirely prefer my own company to that of others. The days perplex my will and yet I have become a perpetual traveler. Do not blame yourself, as you are wont to do. Above all do not send after me.

December

Your father, E. B. Mondini

I let out a long breath.

Then a heat rose in me. Even though my blue room, lit by the slatted green window, gave cooler refuge than most other rooms in our villa on the canal, I felt that I was burning underwater.

After some time, when I folded the missive, I caught a faint whiff of rose attar, my mother’s favored scent. Had she already read my father’s words, or had this essential oil traveled all the way from Mauritania?

I stood up, withdrew from my bodice a chain that held a key warmed by my body, and moved to the foot of my bed. The cassone (once meant for my dowry) now concealed the packets of my father’s letters and could only be unlocked by this key. I turned it and the catch sprang open. The letters were organized in order of arrival rather than creation, because lately I couldn’t tell when he’d penned them. The exact dates no longer appeared on the last few letters. They’d arrived close together but seemed to come from cities as distant from one another as Almodóvar and Edenburg. Had he simply forgotten to note the date? Sometimes the day and month were there, but not the year. Sometimes he wrote only, Winter. And because the letters were entrusted to different couriers, from the princes of Thurn and Taxis’s messengers to traveling merchants, pilgrims, and doctors who’d undertaken scholarly journeys, their dates of arrival were useless in determining his whereabouts at that moment. His words described a meander through Europe that had finally—until today—vanished in silence. My father had become a voice out of time.

A quick, rustling footfall outside my half-open door alerted me to my mother. I slammed the cassone shut, briskly locked it, and fumbled the key back into my blouse.

My plump mother entered in some disarray, her violet red-lined dressing gown flapping about her shoulders, her long, pointed slippers down at the heel though fashionably slashed with many small cuts to reveal the blue beneath purple leather. She came and stood very close to me, setting her green eyes anxiously upon mine.

“So? What did he say?” Her yellow hair (a shocked white at the roots) fell about her face.

I stepped back. “What are you talking about?”

“The messenger left a letter with Olmina.” She waved her white hands. “I followed her and stood outside your door listening to a most charming conversation.”

For the love of the Virgin… “I’m a thirty-year-old woman, a doctor who deserves some privacy and respect.” I spoke calmly but clenched both fists at my sides. Though accustomed to my mother’s petulance, I also felt slivers of panic driven under her words. She didn’t want to be cast aside. Sometimes I forgot that my father had left both of us.

“What does he say? Is he returning home, that profligate husband of mine?” She grew more shrill.

“No,” I said. “In fact, it seems he’s never coming back.”

She brought up a hand as if to strike me, or was it to protect herself? Then she let it fall to her side. For a moment her dejection clenched me. My mother, who’d always loomed large, shrank to a troubled child.

We stared at one another.

Olmina appeared on the landing behind her, hands still dripping with dishwater (for she’d rushed up to my room the minute she’d heard the commotion). She shook her head. “Come, Signora Alessandra,” she murmured to calm my mother. Olmina touched her elbow but my mother stepped back, crying, “Your hands are wet!” as she pushed past her, descending the staircase in a tumult.

“We live on the water,” I said after she’d gone, “and she fears a drop.”

“Oh, we know it’s not just the water.” Olmina shrugged. “She can’t bear the touch of the tide, any hint of change, you know. When one has known too much early on, then any change is a threat.”

I nodded, recalling the swift rot and death of her father from the plague of 1575. Though a young woman of fifteen, I hadn’t been permitted to say good-bye to my grandfather. My father and mother didn’t want me to see him so disfigured (it was all right to view a patient but not one’s kin), and so, oddly, he remained well in my mind, then gone. But my mother had witnessed his end and somehow she was never done with it. We didn’t ever speak of him.

Olmina added, “I’m sorry, signorina. I didn’t think your mother saw me when the messenger came.” She dried her hands vigorously now on the stained brown topskirt that was folded up into her waistband.

“It’s not your fault,” I said. “Olmina, remember Signor Venerio lo Grato? Married to the same woman for fifty-one years. He wanted to mend her distrust, I suppose, with his kindness, though it never seemed to be enough. Then one day he took his slow stroll along the canal, and when he returned he stood at the bottom of their stairs shouting, ‘Finito. Finito. I’m done—do you understand?’ And he left her. They say a spring returned to his step.”

She smiled and said, “Yes—his unreasonably bitter wife now had something to be bitter about. I hear he went to live alone on one of the outer islands. Hmm, he was such a handsome youth, those fine calves and thighs…”

Then Olmina came over to hug me. “Don’t mind her fits. She’s as regular a squawker as the crows, as Lorenzo likes to say.” Lorenzo was Olmina’s husband, a man who usually kept such comments to himself. I laughed a little at his foolishness. I wished it were that simple.

When Olmina ushered the gentleman from the Physicians’ Guild into our courtyard later that day, I’d just awoken to the bells of evening rebounding back and forth across Venetia. One belfry set up a clanging, then another started up slightly off pitch, and others followed until a resonant din shook the air and rang the grogginess from my head. My book of poetry by Veronica Franco lay open on the bench to the passage

Nor does virtue reside in bodily strength,

but in the vigor of the soul and in the mind,

through which all things are known.

I sat up on the bench in the courtyard where I’d been napping, and parted the low branches of pomegranate. There he stood, Dottor Orazio di Zirondi. His ample paunch advertised his wealth. I noted the black robe, the chains of gold and silver, and his doughy hand laden with rings. I quickly gathered my thick hair back into the net from which it had fallen, though I still must have appeared untidy. Out of the corner of my eye I could see my mother sitting in the shade of the wall, fanning herself above the lacy leaves of rue.

“Ah, there you are, Signorina Mondini.” He bowed slightly in my direction, his round face like a poorly kneaded loaf.

“Come and sit over here, dear Dottor. Olmina will bring us some lemon water,” my mother said. “You can join us, Gabriella.”

“Thank you, signora. Very kind, but I have business with your daughter, a communiqué from the Guild of Physicians. Then I regret to say that I must be on my way.”

My mother snapped her fan shut.

I stood up and faced the doctor. “What is it the good doctors wish to tell me?”

“Dear signorina—”

“You may call me Dottoressa Mondini.”

“You cannot expect me to do that, my dear. The title belongs to your father.”

“Ah.” I was starting to suspect why they had sent Dottor Zirondi instead of my friend Dottor Camazarin. “I detect the reek of some scheme—”

“Gabriella! I never taught you this lack of civility,” my mother said, stepping forward to touch his sleeve. “Please excuse her, Dottor Zirondi.”

The man sighed and narrowed his eyes. His gaze flitted uncertainly between the two of us, trying to discern what ancient rivalry he’d interrupted. Then he went on. “Given that it’s been a decade since the departure of your father from this serene city, and especially now that no one has heard a word from him for the past two years…the guild…the Council of the Guild of Physicians can no longer support your membership without the mentorship of your father. We have allowed this to go on too long. Women physicians, as you well know, are not permitted. I am sorry. The guild is sorry. But this is by order of the council.” He gave a peremptory little bow, nodded meekly at my mother, and excused himself.

“Wait!” I cried. “What about the women, my patients?”

He gave me a cool glance. “The women will be looked after, signorina. Have you forgotten the many excellent doctors we have here in Venetia?”

Though the guild had restricted my practice to women after my father departed, then forbidden me to attend their meetings, I didn’t believe that they would expel me altogether. I thought about the young courtesan five months gone and spotting blood (who would tend her during her pregnancy without scorning her for her profession—as some male doctors were known to do?) or the old wife who suffered from chronic catarrh and a drunkard husband who refused to pay for her herbs. I tried to keep my voice level, to maintain my composure. “But they are men. And most women much prefer a woman. Surely, sir, you would want your wife to be looked after by a woman, rather than some prying man, professional though he may be?”

Zirondi sighed. “My wife is in excellent health and I would look after her myself.”

“What about those women who have no doctor as husband, who are sometimes”—I paused—“examined overmuch, if you take my meaning?”

He shot me a look of disdain. “Signorina, you are insulting my colleagues. I’ll listen to no more of this. Good day to you both.” And he swiftly left the courtyard.

After a moment, my mother turned back to glare at me. “See?” she said quietly, snapping open her fan. “This is all the result of your insolence.”

I couldn’t bear to look at her or surely I’d say something I’d regret that would fuel our long-standing dispute over my decision to work as a doctor. How my mother loved the spice of quarrel! I had no wish to feed her anger. Instead I stalked into the kitchen and found Olmina at the table cutting an onion. She dropped her knife when she saw my face. “Walk with me,” I said.

She quickly drew a shawl about her shoulders and took my arm. We walked past my mother, still fanning herself in the courtyard, and left the house to pace the slippery, water-stained stones at the edge of the sea until night forced us indoors. When at last I returned to my room, I reread my father’s letter repeatedly. No, I wanted to tell him, it will not be the better for me if you don’t return. I’ll lose my vocation. And it will not be the better for you. For I could detect in his words that something was off. The days perplex my will and yet I have become a perpetual traveler…Above all do not send after me. It barely seemed that my own father was speaking.

I will not send after you, my father, I decided that evening. I will come myself.

Chapter 2

Salt and Sweet,
Tears and Milk

When I last saw my father, in my twentieth year, he was pacing uneasily near the tall open windows in his study. “I’m planning a journey north,” he’d announced abruptly, his broad back to me as he pulled a book bound in red maroquin from the shelf of his voluminous library. “I’ll be gone for some time.” His black hair, speckled with gray, hung damply about his neck in the noonday heat. “I won’t be able to take you with me.”

He turned and peered at me with hard, indiscernible eyes through round black-rimmed spectacles, holding The Book of Diseases like a small shield and then setting it down upon his slanted desk. As I hesitated to respond, clutching my hands within the pale blue folds of my skirts, he moved closer to the window, his pointed slippers hissing on the smooth terrazzo floor. He removed his jerkin and tossed it on the windowsill, then leaned forward in his linen shirt and claret breeches as if to catch a cooling breeze from the lagoon. None was forthcoming.

I couldn’t find my voice, though I nodded and stared at the reading wheel, which stood at least two meters high, opposite him on the other side of the window. The upright circular device resembled one of those pleasure wheels seen at fairs, hung with little seats (in this case, lecterns) that revolve with much shrieking from the children. It awaited completion by Agostino Ramelli, my father’s friend and an architect of rare literary machines.

“Gabriella. Is that silence of yours…impudence or assent?” my father asked, clasping his hands resolutely behind his back. He would often carry his hands this way, in the manner of men who walk through the city, pondering the silent stones or the rumor of water that lies beneath them.

I shrugged. The air grew closer around us, and though I suffered the heat, I withdrew into a dry, cold temper. I moved toward the reading wheel, edgily tapping one of the larch spokes and setting it in lopsided motion. The oak axle creaked and three small lecterns swung to and fro. There would be eight when it was done.

My father glared at me briefly. Then he sighed, not unkindly, looking back to the sluggish sea. The wheel, motionless now, resembled a large clockwork arrested by neglect. As if the great hub of the sun, to which all other cycles were bound, had lapsed in the sky. The wheel anticipated my father’s volumes on diseases. But his work had come to an unforeseen halt in the universal malaise of August.

“What about Ramelli’s wheel, Papà?” I asked in a pinched voice. “Don’t you want to see it finished? Won’t you complete The Book of Diseases?”

He groaned. He’d been unwell lately and endured a bitter humor. For months I’d devoted time every day to copying his nearly illegible, rapidly scrawled notes on diseases and cures, occasionally taking liberties with those phrases I couldn’t understand and inserting my own. He gently berated me on that account, though he was reluctant to take the time to clarify his intent. So I continued with my own interpretations and simply didn’t show them to him, compiling my own parallel encyclopedia—a mute companion to my father’s volume—which I kept in my chest.

Across the broad canal the gray-green island of the Giudecca shimmered dully in the heat. Thunderclouds lurched upward and sideways, lending their leaden color to the sea and their implausible dead weight to the air.

I spoke again. “You know that I’m your best nurse and scribe. Let me accompany you, Papà. I don’t flinch from a wound; why would I fear a journey?” I placed my hand gently on his thick shoulder. It still conveyed some of the strength of his youth. At that moment one of the great trading vessels slid into view, its sails slack in the windless afternoon.

“I’ve no need for an assistant now. I’ll simply be gathering more notes.”

I removed my hand, leaving a faint, clammy print on his shirt. “But surely you’ll be called upon as a doctor? Who will suture the wounds for you? You know I employ the finest stitch.” It was true, though my hands were rather large and coarse for a woman of my class. What I left unsaid was the fact that his hands were no longer as steady as they had once been. “And the strands of my hair provide the best thread.”

My father once told me affectionately that my wiry red hairs were stronger than threads of linen.

But he shook his head now and placed both arms upon the marble sill, as if struggling to steady his resolve. We watched the mullet fishermen standing in black gondolas upon the water, heard the fletched sound of their arrows stinging the air. How I loved to stand by him in quiet observation of the world. He was my spyglass and magnifying lens, my kind instructor and stern doctor. We witnessed the mingling of cruelty and cure in disease, the loss that redeemed itself in healing and also the loss that never ended. My father possessed no other children and so he had always shared the gifts that were destined for a son with his daughter.

From this distance, the fishermen were almost stationary, planted on a solid gray surface, the tilting of their boats imperceptible. The black cormorants that surrounded them stood out with the certainty of inked type rising from the flat bed of the sea as if they were spelling out the letters of a word. The illusion of I (swallowing fish), S (at rest), T (wings outstretched to catch the sunlight). Was it istante, istanza, istmo? The illusion slipped away when the birds plunged into the water after a stricken fish. From time to time the fishermen struck at the cormorants with poles, oars, nets, or whatever was at hand. The rattle of oars against rowlocks and the cries of the birds disturbed me. My throat tightened suddenly, as if I would cry like a little girl.

“Daughter,” my father finally said, “there will be no discussion on this matter.” He didn’t turn from the window and improbably addressed the air. “You must look after your mother. Your earnings will be hers as well, though I’m leaving ample gold behind to keep the two of you for years. My bags are packed. I need your assistance now in replenishing my medicine chest.”

“I’m occupied this afternoon,” I answered sharply, considering the irascible charge—my mother—being hefted on me. Would she appreciate me finally if I were her support? I doubted it. I clasped my hands upon my stomach. “I have to clean the lancets. We agreed to assist Dr. Torrigiano with a bloodletting while the moon is still in the second quarter, or have you forgotten?”

“You’ll have to go in my place,” muttered my father. “I must attend to the final details of my departure.”

What caused this hasty decision? Or had change formed slowly in the alembic of his discontent?

   We were still beside the edge of the sea

like people who are thinking about their journey

who in their hearts go and their bodies stay

I murmured these lines from Purgatorio more to myself than to my father. Still I wanted him to answer me in the old comradely way, but when he just stood at the window in silence, I did not repeat myself.

The next morning my father slipped away while I slept, without any leave-taking. Though he rose early, he must have been exhausted from the quarrel with my mother the night before.

“Don’t tell me what to do!” I’d heard his voice late at night, roaring through the house.

“Why would I try? You’ve never listened to me,” she said glumly. “All that matters to you is that dusty volume of ailments. Yet you fail to cure your own foul temper!”

“You understand nothing, woman!” The floor shook above me as my father strode back and forth in their chamber.

“You understand less! I’ve tried to hold this household together for the sake of your profession and our little family. But you’re a specter to me, always locked up in your study or out on your rounds. And now you’re going to leave altogether?”

“If it weren’t for my daughter and my peers, I’d have left long ago.”

“She’s my daughter too.”

“She may be your flesh, but she isn’t your daughter.”

I couldn’t hear my mother gasp, but I felt it from the vast intake of silence that sucked all the air from our house for an immeasurable length of time.

Now I began my preparations for my own journey. But my mother suspected that something was afoot. Though it was time to retire, she paced the corridor and after a few turns pushed open the door to my room without knocking. She swiftly took in the scene of my satchel and clothing spread out upon the bed, my medicine chest open, and papers scattered across my desk, and she understood.

“Oh,” she said, her face reddening in the warm light of the candles. “You’re going to abandon me. Just as your father did.”

When I ignored her, she added, “Go ahead, waste your fortune, Gabriella. But don’t expect a dowry when you return.”

I stopped my packing, stung by her insinuation (my lack of marriage prospects). “Mamma,” I finally said. “My dowry is here”—I held out my hands—“and here”—I tapped my forehead.

She walked over to my window and peered out past the shutter at the city’s faint lights smoldering in windows, faltering on the water. “Oh, I see, yes—that will serve you well when you encounter a suitor. I can’t wait to hear what he’ll say.” She turned back to face me in frustration. “Or rather what he won’t say, when he disappears quick as a quenched flame.” She pressed both hands to her heart. “I want you to be content, Gabriella. Bear children. Why not marry a good doctor? Why must you be one?” Tears started to her eyes, for we’d had this conversation many times before and I’d left the room. But this time I simply stared at her, fierce and speechless with hurt. We were on opposite sides of a deep channel, no bridge between us. The sea ran on in the dark. She dropped her eyes and began to pace again back and forth the full length of my floor, heels clicking marble and then going mute across the wide Ciprian carpet.

We heard a sputtering and both of us swung to the open doorway. My mother’s gaunt young maidservant hovered nervously with a guttered candle, hooded by a large shadow in the corridor behind her. “Your bed is turned, my lady,” ventured Milena. She fidgeted, rubbing her skeletal neck with her free hand, her long fingers strangely delicate.

I sighed and said, “I’m not abandoning you, Mamma. I will find your husband and make our family whole again.” I spoke with willful sincerity, as if I could claim the distant harmony from childhood, if I hadn’t imagined it in the way a child will construct peace out of necessity. I pushed my extra skirts and blouses down into the leather satchel with my fists to make room for more clothing, to counter my mother’s rancor.

She touched my shoulder. “Gabriella. Don’t leave. I…I need you here.”

I’d never heard my mother say those words. Without looking at her, I answered, “Mamma. My mind and heart are set on this.”

My mother, for once, fell silent. Then she left me.

My mother also left me the day I became a woman. I was thirteen and undressing for bed with Olmina’s help, under my mother’s watchful gaze—a rare occasion. She’d been instructing me as to what gown I should wear for an upcoming wedding when Olmina cried out happily as she tugged my chemise over my head. The dark red streak on my garment announced the change. I hadn’t even sensed it, though now I felt a vague thrill and confusion. She laid the chemise tenderly on the bed. I hugged my sleeping smock to my body, shivering. Tears sprang to Olmina’s eyes—but my mother froze.

“You’re no longer a girl!” she moaned, as if it were an unforeseen calamity. She must have observed my distress at her words, for then she said, “It’s only the beginning of desires you’ll never quell, my daughter. The end of simple pastimes.” She must have been speaking of her own change, for had she forgotten that I assisted my father in his work and engaged in few simple pastimes? That I’d observed disease and death? But she didn’t wish to hear of those things. She bit her lip and fled the room. My body had betrayed her dream of me and it could not be taken back. Salt water had seeped into the well. I no longer belonged to her, if ever I had.

Olmina, not my mother, taught me how to use the sea sponge, how to tie it up under my smock with a silk ribbon (once round my waist, between the legs, then fastened to the waistband) to catch the flow. My mother never spoke of it again.

Late the next afternoon, I continued packing, taking my father’s letters and a small bottle full of ashes from the chest to pack in my satchel.

The previous November, I’d returned from tending an ailing friend to find the letters from my beloved Maurizio (twelve years dead of tertian fever) cast upon the grate, glowing packets of ash, with the string that bound them a hot and shrinking vein. I thought of the fine blue veins beneath his temples, which I’d liked to kiss. His cheek. The perfect cowrie of his ear.

“If you don’t rid yourself of the past, you’ll never possess a life in the present!” my mother had exclaimed as she stood near the charred letters. “I did it for you. Love wants a scorched field for the new seeds to take. Otherwise you’ll never find a husband.”

I’d clasped the fire shovel with such force that she stepped backward in fear and fell against the kitchen table, crying out for her maidservant. I could have struck her. But I turned away to scoop the ashes from the hearth. Later, when I was alone, I poured them gently through a parchment cone into a bottle that I keep in my medicine chest. What a small heap of ashes for so many letters! My lover’s words weighed no more than a few breaths. My father’s letters wouldn’t follow such a fate. I planned to deliver all but a few into the hands of a dear friend, Dr. Cardano, for safekeeping on the first leg of my journey.

Soon, I heard a flamboyant voice from downstairs. It was Cousin Lavinia, who wanted to bid me farewell, for I’d sent her a message by way of Lorenzo.

“Come up to my chamber,” I called out. My mother, not one to miss a conversation, followed her on the stairs.

Lavinia cut a messy figure in the streets of Venetia, for she loved drawing, and as a girl, she reveled with me in copying the various bones and skulls my father kept in his study. “What’s this one, Dottor Mondini?” she’d cry out to him as he wrote at his desk. And though he’d feign annoyance, he usually answered her questions with a smile—questions that I was often too reticent to ask, preferring instead to consult the Vesalius Epitome. Often he’d put down his quill and watch us for a while, as if it gave him great joy. Lavinia studied the bones’ forms for the art of beauty while I learned their names and contours for the art of physick. Thus we often kept each other company on long afternoons in our separate worship of bones.

“Gabriella, you’re really leaving?” she asked. I recalled former visits, Lavinia with rolls of paper under her arm and charcoal stubs in her pockets, the dust smeared on her hands, arms, face, and clothing. Today she was merely out of breath, for—though I envied her ripe beauty—her ample body often slowed her down. My own body, neither full nor thin, seemed ordinary by comparison. She turned briefly to greet my mother, who chided, “My dear, I’d greatly appreciate it if you could resuscitate my daughter’s reason.”

“Ah, you should know better, Signora Mondini,” Lavinia teased, “than to ask me to restore her senses, when you’ve often decried me as lacking my own!”

But my mother was in no humor to smile in reply. Instead she looked down, brooding, as if there beneath the floor in the shifting island mud there might be a god to answer her prayer, to bind a mother and daughter. But finding no answer, she clutched her skirts and left my room.

“So?” Lavinia kissed me on each cheek expectantly.

“Yes, it’s true.” We sat together on my bed. “I’ve resolved to find my father, to bring him back, and to help him complete his encyclopedia, The Book of Diseases.”

“But won’t it be dangerous?”

“Staying here may be more dangerous,” I said, placing my pale hand over hers, with its habitually blackened nails, now also flecked with pigments. She’d been painting with egg tempera. “I’m slowly being smothered, by the guild, by Mamma…”

She nodded. “I’d heard from my mother that guild members condemned your use of certain herbs when the men were in my father’s shop. These rumors stew when you have a gaggle of doctors waiting for their remedies to be measured by my father’s fumbling apprentice.”

“Why didn’t you tell me?”

“I wanted to protect you. And I thought it idle complaint. After all this time, why would they sever your membership?”

“The reason given was that I lack a mentor.”

“That’s nonsense. There must be a dearth of new patients, so they plucked a reason out of the ether that fills their poor brainpans.”

I laughed and said, “Well, now I can seek my way in the larger world. I’ll visit those cities renowned for their universities of medicine and garner letters of recommendation—how will the guild refuse me then?”

“Yes, Gabriella. You’ll practice your art.” She set a brave face. “Just as I will practice mine. But what about other languages—how will you speak?”

“It will be small worry. Many speak our melodious tongue. And my French and English are fair, since I’ve had occasion over the years to practice with foreign physicians at our table.”

“Where will you go?”

“Come, I’ll show you.” I led her to my desk. “There, and there.” I moved my finger tentatively along one of many possible routes I planned on my Mercator map. The candle flame stood absolutely still in the evening torpor. She bent to watch me.

“See? Beyond Padua the great centers of medicine in Europe beckon: Leiden, Edenburg, Montpellier. And Tübingen, where my father’s last letter was recently marked.”

“But why not stay with Dr. Cardano and write to these other universities for news of your father? Otherwise aren’t you striking out at great risk, into the unknown?”

I barely heard her and instead spoke the names of the cities again in a low voice. My breath quickened, my heart and mind leapt far ahead of me. I glanced toward the open door to the corridor and quickly stepped across my room to shut it. “Lavinia, I want the unknown.” I touched the map, its paper softening to a kind of flesh in the hot, damp air.

She stared at me in astonishment and then flushed with the pleasure of understanding. “I almost wish that I could go with you.”

“Come, then!”

“No, I could never leave Venetia. I don’t hunger for the journey as you do.”

She hugged me impulsively and rushed from the room, her black hair loosening from her snood as it fell on the stairs, her coarse linen work dress rustling stiffly.

“Lavinia!” I cried, picking up the ecru snood. I ran to my window but barely glimpsed her form as she turned the corner near Campo Sant’Agnese. I held the snood for a moment with affection, then pressed it down among my things in the satchel.

The following morning I listened to Olmina knock her wooden clogs about the stones of the Zattere as she paced in irritation. Her singsong voice called up to my window from the narrow wharf. “How long must we wait, signorina?”

And then: “Dottoressa Gabriella, the gondolas are ready!”

Her impatience was born of reluctance. When I asked her and Lorenzo to accompany me on the journey, she’d pleaded, “Let us stay, Gabriella. The journey does not bode well. I smell a corpse in the future.” But she was always casting tarocchi cards and predicting ruin, so I paid her no mind. She continued, “We should be patient and await your father’s return. For sooner or later the city will pull him back to her embrace, no?” She didn’t want to leave her city—the city that rose from the silt of salt marsh, the city that rocked upon the tides like a marvel run aground.

Olmina had ordered my life since birth. A few months before my arrival, her own child had been stillborn, its head wrapped with the caul (a sign of second sight, a talent never to be realized), and so she took me to her breast as a babe; I suckled both salt and sweet, tears and milk. Over the years, she’d protected me from my mother, who’d refused to nurse me, for as a young maiden of only fifteen, she was frightened, I suppose, of what had happened to her body. She didn’t take to mothering easily. And her own mother, a lay healer falsely imprisoned on charges of witchcraft, wasn’t there to tend her. Even now Mamma would tell me, “Oh, Gabriella, I wept when you were born! Your head emerged so misshapen, I thought I’d brought forth a changeling!”

There were a few early years when Mamma amused herself with me as one would with a doll. She dressed me up in uncomfortable frocks. She twisted my damp red hair into ringlets around her finger. She placed me on a cushion before one of the windows so that I could watch the ships on the canal, dusted my face with white powder, and told me not to move when her friends came over to talk and preen. But I remember a day shortly after my third birthday when I didn’t listen. It had drizzled for weeks. Olmina gave me my own bowl of chestnut dough to form dumplings. I squatted on a rug on the kitchen floor (though mostly I just clenched the dough in my little fists with delight and squeezed out bits and pieces). My mother bent over me, firmly holding my arms as if she could fix me to the floor, and said, “Stay here, do you understand? Do not leave this rug, or monsters will come out of the cellar!” But if there were monsters in the cellar, I wasn’t sure I wanted to stay in our house.

While Olmina rolled the dumplings on the thick table with her back to me, and my mother pulled up a chair and dozed before the cooking hearth, I slipped away, determined to explore the wharf before our house. I hastily put on my child’s cape and woolen cap, and pushing open the door Lorenzo had left ajar when he went out that morning, I tumbled out into the day. The rain had paused, the ships rocked like houses afloat, and I squealed with joy at my freedom, running along the stones to the edge of the water. Merchants stared at me, two nuns asked me where my mother was, sailors sang loudly and waved, and a lady with her servingwoman reprimanded me harshly when I bumped into them. I found a cat with three legs under a bench. I tasted a bit of bread that had fallen on the stones, then spit it out again. I clutched the beautiful damask skirts of a woman in purple who laughed at me and asked me my name. The wind hurt my ears. All at once the dark cloud of my mother descended. “Don’t you ever do this to me again!” she shouted as she yanked me along the stones, my feet flying off the Zattere at intervals. She locked me in her closet. “I’ll confine you to this place from now on, do you hear?”

After sobbing quietly for a while, I fell asleep. Sometime later in the uncertain dusk of that place I awoke beneath a boned farthingale, as if within the rib cage of a great sea creature. In my dense imagining, my mother became a leviathan. I rocked back and forth beneath the ribs of the beast. She couldn’t harm me there, because I was hiding within her. Or so I imagined when Olmina came jangling her ring of skeleton keys to fetch me for supper.

Olmina knew all the secrets of our household, which is why my mother refrained from throwing her out, lest she directly feed the ravenous ear of Venetia, which thrived upon the misfortunes of others. It was Olmina who later, when I attended university, urged me to hide my medical writings, which I promptly did, behind the lesser medical texts that my father rarely consulted. My mother seldom entered his study and had to ask for the key, as my father knew full well her jealous habit of stealing into his papers and shuffling the pages. “Materia medica is your mistress,” she’d say when she was upset. He took the keys with him when he left, citing fears that his rivals might try to steal his writings or his books, though perhaps he was truly wrestling with the rivals within.

For months I suffered my father’s absence twice over: the lack of his presence and the dearth of his written words. I became so disturbed by the locked room that I considered ways to break and enter, with the clandestine help of a locksmith (though I knew it wouldn’t remain secret for long) or by breaking a window with a stone and enlisting the help of a glassmaker as an excuse to go inside using a ladder (though that would be very suspicious, and ridiculous too—bedecked woman doctor swaying upon ladder). Of course these schemes were only a distraction. Some essential part had been stricken from me. But in one of his early letters to me from Padua in the fall of 1580, he had a change of heart.

And in the hub of the reading wheel that we removed to your room before I left, you’ll find a central round peg that, unlike its fellow on the other side, may easily be pulled out. In the small hollow there, you’ll find an extra key to the study. Keep this key, then, for it was yours originally anyway, dear Gabriella. Under no circumstances lend it to anyone. Lock yourself in when you visit the study, so that no one may guess the room has been opened, and enter only with caution, when no one is at home. I trust you’ll continue your studies and writings on diseases, which I may join to my own when I return. Who knows but one day you will outstrip my own research and inquiries into the vast nature of the maladies that beset us. This is the duty you have to your elders, to complete what they cannot…even perhaps to complete the healing that they cannot or choose not to pursue.

I was glad to have access to the study, though after a while my joy carried a bitter aftertaste. As the years passed, my father’s study stood in our home like a strange mausoleum to his absence. I entered from time to time to read and to wipe the shelves and tables, which accumulated dust that fell from I know not where (since the windows and doors were always closed), unless it was the brief dust of the world I brought in with me. I also spoke with his ghost—a peculiar thing to say, I know, when a man is still alive. But that is how it was. Papà, where are you now? What cures are you working? I have a patient suffering languishment, and all the usual simples have failed to quicken her. What must I do?

I never wrote there at his desk, though, because I didn’t want to disturb his things. If I left everything as it had been when he went away, perhaps that unchanging order would hasten his return. But of course nothing was changeless. The ink curled and dried in its pot. Minuscule insects consumed the quills. Webs shrouded the books.

By contrast, I kept the windows of my own room open in nearly every weather. On this day of departure, I gazed across the small side canal at a winged lion of mottled stone with a lifted paw, dispassionate as a saint. He’d inhabited that outlook for my entire life. Sometimes cats slept beneath his mossy stone chest, multiplying his remote expression while the dim mirror of water below overturned him. In the Rialto Market they sold palm-size lions carved in jasper alleged to cure fever and dispel poison, and some carved in garnet, cure-alls and amulets against the dangers of travel. Though I barely believed in such things, I’d purchased one.

The narrow corridor below my third-story room was still pooled in shadow despite the advance of morning. I could see a thin ribbon of sea, the San Vio surging into the swash of the Canale della Giudecca, which joined in turn the Canal Grande di San Marco, then the tides of the lagoon, and finally the open Adriatic. When I breathed in the smell of sea from below my window, I could also detect the metallic scent of ice, the source. Rivers and mountains.

A muffled knock at my door.

I opened it to see Lorenzo, Olmina’s short, wiry husband, who brought me back to matters at hand.

“Dottoressa, please, Olmina is pulling my beard! We must reach Padua by evening. All the leather bags and provisions are loaded, everything except your medicine chest.”

Lorenzo had also joined our household when I was born, his eyes and skin the color of dark shellac, as if he were a man made of wood. He was born in Pinoa, and his mountain dialect gave him a halting speech and manner, like one of those exotic creatures merchants bring back from their travels: Numidians and their dromedaries, or listless Barbary apes. Lorenzo often complained about the moods of the Adriatic. “Just give me terra firma, Tirolia, instead of this city ruled by moon and mud, where our lives are as sloppy as the sea!”

Olmina always defended Venetia (this was the fray and habit of their marriage): “If it weren’t for this city, La Serenissima, we would be griming about in some frozen hut, our feet wrapped in last year’s straw, staring out at your beautiful mountains. That’s firm land for you. Have you forgotten your toes?”

Three of Lorenzo’s toes had gone char black from frostbite and had to be severed when he was a child. He always stuffed the right foot of his brown stockings with wads of wool to compensate for the gap, after plucking burrs from the rough fleece. “La Serenissima!” Lorenzo would repeat sulkily and spit into the sea. He was phlegmy and possessed of a cold, overmoist nature.

Now I closed and firmly latched the dark green shutters on my window for the last time. “Thank you, Lorenzo,” I told him. “I’m coming. I was just leaving my devotions.” Even as I excused myself in this way, I thought of the old proverb: Where there are three physicians, there are two atheists.

Lorenzo grinned, as if he’d overheard my thoughts.

I clasped the twin dolphin handles of my oak medicine chest, and refusing Lorenzo’s help (I always carry it myself, wary of the influence of others upon the medicaments), I descended the cramped stairs.

“Mamma?” I called out.

I was greeted with silence. Lorenzo stepped back as I called out her name again, this time adding a farewell.

From the cool recesses of the house, her voice shot out through the corridors. “Now I will be free to enjoy my life!” Her bluster didn’t fool me.

Again, I said, “Farewell!” I wanted to say, Be well, Mamma. Be content, but my throat closed and my mouth tasted brackish. The old salt of grief was in it.

There was no reply. Silence dropped like a heavy plumb in my belly, which tightened against it. Against weeping. Despite having endured her swerves of mind and heart for years, I still wanted my mother’s blessing.

Once I was outside, the sun’s glare, multiplied by the water, struck me full on.

“Finalmente!” Olmina glowered in the bow of the pitching gondola.

I stepped into the stern, followed by Lorenzo, and was thrown unceremoniously forward as I flung the chest down with a thud in the center. I chose the seat facing backward, to see the house I was leaving. The faded ocher walls stood discolored by the sea, gray and green at the foundations as if the building itself were a decaying body. Bricks the hue of dried blood were exposed near the water where the plaster had fallen away. The weathered doors, toothed from rot at the bottom, remained closed. Was it possible that I hadn’t noticed the decline of my family’s home until just now?

Yet other houses were in decline too or crutched with scaffolding in restoration. As we slid through the calm water to the steady dip, pull, lift, drip of the oar, I watched the Zattere retreat, then San Marco appear beyond the other bell towers, steeples, canted roofs, the other quarters shabby, mossy, glorious, gleaming, prayerful, lively, sorrowful, muted, exuberant, fleshy, fabulous, then diminished—made one by distance, faint, flat, bluish white, thin as gauze I might use to wrap a wound.

The gondola swayed, and I lifted the satchel of my father’s letters to my lap. Though I knew I’d packed them earlier, I checked again—they were all inside, tied neatly in bundles.

I watched my home recede for the last time. Every faraway window was shuttered against the heat but one. No hand parted a curtain there. No visible face watched us go.

Chapter 3

Dr. Cardano’s House

The fields on the road to Padua shimmered with ripening millet, and an army of cicadas steadily drilled the air. As a curious little girl I’d once brought my father a handful of perfectly split cicada husks and asked what happened to their bodies rent asunder at the highest pitch of summer. Did they turn into small scorched spirits? Did the spirits then chafe the air in heaven? My father had smiled at these questions. Gabriella, he teased, they sing until they burst!

We approached Margera in the gondola after little more than an hour, just as the midday bells began to ring out. My uncle Ubaldo awaited us on the small wooden dock and led us to the animals: five mules and his own horse, Orfeo, a fine black Murgese. Orfeo gleamed darkly in the noonday sun and jostled the mules, which stood nearly as high as he did.

“Gabriella!” My uncle clasped my arm, and through my sleeve I could feel the calluses from ironmongery on his hand. “Aunt Cecilia is very disappointed that you’re not stopping at our home. What’s the hurry after all these years?”

“It’s restlessness unbottled at last, dear Uncle. I don’t want to linger at the outset of the journey, and I’m anxious to cross the mountains.”

I leaned forward for a hasty farewell kiss, first on one cheek and then the other, as Lorenzo finished outfitting the mules with our supplies. How odd it was to say good-bye to the near image of the man for whom I was searching!

After riding sidesaddle for a short distance, I grew uncomfortable, and against Olmina’s protests I unfurled my linen skirts and rode astride my horse (the way my uncle had taught me many summers before). What a relief! In future I vowed to wear breeches beneath my skirts in the style of Venetian courtesans. I’d packed just such a pair of fine women’s breeches for relaxing when skirts felt too oppressive, and now I had another purpose for them. The luxury of damask would serve as riding garment.

Behind me the walls of Venetia—her palazzi, scuole, churches, and convents, her infinite exquisite and horrific prisons—blurred with the swampy sea. She was truly a strange theater. For as much as travelers glorified her beauty and wealth, the delicious, insubstantial semblances she put on, I knew her as substantial, weighted, and hard. Stones, bricks, pilings driven into the clay. She stood against the vaporous and mutable sea that was always trying to claim her, and the best she could do was to withstand it, to toy with it for a while. Venetia, a dense accretion of lives, announced the solidity of those lives in a broad villa or narrowing passageway. In stone lions, parapets, and empire. But the water was always there. Much has been made of the city and her looking glass. But sometimes I thought she was a flawed and dull glass (what is glass after all, but sand?) trying to reflect the water without much success. How could our edifices, how could we, in these poor, troubled bodies, cast light?

As we traveled farther away, the city dimmed even more. The men of the Physicians’ Guild and their jealousies lost their edge. The tightening noose of their injunctions against my practice lost its threat. I began to feel free of them, able to work my skills upon whoever was in need of my help along our journey.

I’d already resolved to pursue notes on diseases completely unknown to those most esteemed doctors of the guild. My father would be glad of that. In a letter from Leiden in the spring of 1581, he wrote:

I grow frustrated with my notes at times and have failed to appreciate, perhaps, the good degree of your help in these matters. However did you unravel my thoughts, my girl? I think that maybe your unusual position as a woman in this profession allowed you a certain winding approach that, while appearing childish at the outset, proved more effective than my sharpened intelligence at times. I recall when you brushed the hair of the furry girl, drawing her out of her closet, rather than directly assessing the amount of hair on her body and its obstruction of her life. We were better able to suggest a situation for her, though her parents wouldn’t hear of it. In short, I miss your sinuous logic. Together we make the finer doctor. But alas, the world does not welcome women to this role. Yet I keep you as muse, though you are distant, as you must be.

How many hundreds of miles would we have to travel? Every mile was a thousand steps, mille, according to the ancient Romans. Olmina sniffled softly as we rode, but Lorenzo was gleeful. “Stop that noise, woman, we are going to see the world!”

“There is no world outside of Venetia,” she said.

“We will carry our world with us, dear Olmina,” I reassured her.

“It seems that we are,” complained Lorenzo under his breath, annoyed at the necessity of three pack mules for our leather bags and provisions.

“Lontan da casa sua, vicino a qualche disgrazia,” Olmina warned. Far from home, closer to misfortune.

“O Dio mio, we cannot live by fear alone!” Lorenzo said, and then he slapped the rump of his mule to escape us.

We both began to laugh at the odd sight of his ruffled thatch of gray hair and short, bony limbs and body jouncing down the dry road.

Later we were no longer amused when the dust settled upon us like grimy flour. You’re going to regret this journey, Gabriella, for it will only bring hardship! my mother had warned. We’d only begun, and already my ungloved hands were swollen in the heat as I wiped the grit from my face with a small lace-fringed handkerchief and drew the veil down from my broad straw hat.

We were silent as we passed through the small village of Luciafuccina. No one was about. Undoubtedly they were eating the midday meal in the fields or within the cool of their houses, shuttered tightly against the heat and mosquitoes, which coagulated from the very air and attached themselves to us like floating headpieces.

Lorenzo stood up ahead, swatting at the cloud that hung in a dark halo about his head as he watered his wayward mule at the edge of a line of poplars. Their branches teased us with silvery pieces of light, a treasure that never reached the earth.

Two more hours to Padua.

As we rode on, the flatlands gave way to lazy slopes where villas with ramshackle dovecotes clustered under the cool limbs of great oaks and chestnuts, overlooking orchards strung with grapevines. Stone-terraced or walled gardens of lettuces, radicchio, melons, and herbs checkered the land with an even geometry, as if a giant with a tremendous rake had grooved the curved earth into squares, lines running first one way and then perpendicular, so that the plots would surely appear woven if one were a hawk wheeling above them.

I was lulled by their pleasant aspect; when I felt I might fall asleep on Orfeo’s back, I caught the refreshing smell of wet sand from the Brenta River. The grand gateway into the city of Padua—the pale stone Porta del Portello—was flanked by rows of gondolas and boats knocking against the stone steps. Boatmen loaded all manner of things for market or transport, from caskets of wine, baskets of fruits and vegetables, and lengths of wood to portly dignitaries. Some empty boats thudded with deep, hollow sounds against the stones of the city’s thick bulwarks. The raucous boatmen were a spectacle, emboldened to comment on every passerby, taunting students, singing to women, and hooting even at nobility!

Of course I kept my gaze straight ahead as I rode out in front, though I was tempted to smile at the foolish lyrics they sang to my horse:

Oh handsome black mount,

bearing delight!

I’d gladly swap burdens to give

her the gallop all night!

Lorenzo, who rode at the end of our string of animals, raised his fist. Beside me, Olmina sat upright and impassive as an oar as her mule steadily plodded forward.

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Excerpted from The Book of Madness and Cures by O'Melveny, Regina Copyright © 2012 by O'Melveny, Regina. Excerpted by permission.
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