The Price Of A Soul

The old woman limped along, hunched over a wooden stick. She wore a particularly hideous, shapeless grey cloak with the hood pulled over her head, with wisps of white, stringy hair sticking out. She was ignored as she shuffled by; men and women avoided her gaze. It was hard to say what repelled people more – the stench emanating from her person or the air of desperation that surrounded her. Or perhaps it was her age. No one noticed old people. Even in plain sight, in a crowded marketplace, she was nobody.

This fact might have disheartened most people, but Cornelia Sabina was delighted. As a respectable Roman matron, it was impossible for her to set foot in the Suburra, but with a little planning and preparation, she was now entirely someone else. What an exhilarating feeling! Her giddy thoughts were abruptly cut off as a rowdy youth slammed into her, too preoccupied yelling at someone to notice her presence.

“Watch where you’re going, you old hag,” he spat out. Cornelia bit back a retort and forced herself to shuffle away. The denizens of the Suburra were not known for their manners. Just a little further to go. She continued until she reached a woman selling juicy, ripe olives. Her mouth watered as she darted past the taberna and headed to her destination. A plain, unassuming door on the side of the insula. There, the stairs! She headed to the third level and ducked her head as she hurried to the apartment at the end of the corridor.

Apartment was a generous description for the squalid, windowless room. There was a rickety table and chair in one corner and a narrow, low bed. Today, it would serve as a makeshift clinic. Her appearance startled the woman in the far corner of the room. She let out a tiny gasp. “Domina?”

Cornelia grinned. “Salve, Meda.”

Meda’s eyes widened as Cornelia cast off the disgusting cloak and smelly wig to reveal her youthful face and dark hair. “This is…new.”

“I had to get creative. The elections for the Tribune of the Plebs are in a few days. Gemellus is in the running this year, which means there are more eyes on me than usual.” Her mouth twisted when she spoke of her husband. His work as a senator kept him too busy to notice his wife’s comings and goings, or even her very presence at times.

Meda nodded knowingly. Cornelia knew she could rely on her discretion. They knew each other from a different world. A lifetime ago, in a faraway province of Rome. A physician’s daughter and a slave girl. Now, a senator’s wife and an obstetrix – a midwife. More importantly, she was also a freedwoman who had good reason to be loyal to Cornelia, for it was Cornelia who had freed her in the first place.

Her mind took a wistful turn as she thought of her happy childhood in Ephesus as the only daughter of one of the city’s most prominent physicians. All those who knew Publius Cornelius Sabinus had known him not just as a competent physician but as an indulgent father. He trained her in the art of medicine and ensured that she received an extensive education on the various conditions of human health. If she had her way, she might have even begun practice as a medica in her own name; she would have hardly been the first to do so. But fate had intervened, her father had died, and her uncle had arranged her marriage to Gaius Gemellus Rufus of Rome. For a girl from a patrician family, she couldn’t really wish for more, could she?

She shook her head. No point dragging those memories around. She had a comfortable life, and she was a practicing medica, even if it was in secret. And unlike her male counterparts, she did not believe that childbirth was merely “women’s business”. As if it were not a vital part of caring for the health of women and children! She turned towards the figure writhing on the bed.

Meda followed her gaze. “A Briton or a Gaul, by her looks, and more likely than not, a runaway slave. The woman who owns the fish stall down the road found her in labor near the Clivus Suburanus early this morning. She sent her to me. She arrived barely moments before you did. I have not examined her yet.”

The girl – the woman – let out a groan, clutching her hands to her disproportionately large belly. She seemed of Cornelia’s age, yet the lines on her face and dark smudges under her eyes made her look older. Her fair hair was lank and lifeless. She opened her eyes, which were a pale gray. Cornelia suddenly felt cold.

“Do I know you?” she blurted before she could stop herself.

“I… no... understand,” the girl stuttered in broken Latin. But her eyes were fixed on Cornelia, brows furrowed.

Meda frowned. “Likely not. She came from the marble quarries in Aphrodisias, from what I can tell. A runaway, most likely. She has barely any Latin. Certainly not from around these parts. She said her name was... Ceara?”

Cornelia forced a smile, desperately trying to quell the sense of dread twisting in her gut. That was not her name. Her name was Aoife. She looked like her sister. And she was staring at Cornelia as if she were seeing a ghost.

The moment was broken as Aoife – Ceara – moaned as another contraction began.

“Well, let us begin then.” Meda moved to her side to palpate her abdomen. Her instrumentarium lay on the table – a toolkit for birth that every obstetrix possessed. Olive oil, sponges, clean cloths, quince and lemons for smelling purposes, a forceps to pull the child out if they did not slide out, and a pillow to lay the baby on. Meda had also brought the birthing chair.

“Sideways,” she whispered, referring to the lie of the babe in the womb. Meda muttered under her breath, closing her eyes. Cornelia sucked in a breath. Ceara rolled to her side, moaning, and she spotted blood staining the mattress under her. That was not a good sign either.

“We must try to turn the babe,” Meda said, urgently.

Cornelia’s mind worked furiously. With how close together her pains seemed to be coming, it could already be too late. She opened her mouth but hesitated, looking at Meda’s pinched face.

Meda was already in motion, positioning the girl’s legs. “You will push on her belly while I try to grasp the head from underneath,” she ordered. Cornelia bristled slightly at the command but obeyed. The girl stared uncomprehendingly and began to struggle when Cornelia approached her belly. The girl flinched away when Cornelia laid her hands on her abdomen. She spat something out in her harsh language. It sounded accusatory. She tried to slap Cornelia’s hand away. Meda tried to explain what was happening by miming what they were trying to do, but the words didn’t get through to the panicked girl.

How was she even alive? She had never heard of slaves escaping from the mines successfully. And how on earth did she end up in Rome? She did not know. Yet one thing was undeniable – she was the reason Ceara had ended up in the mines in the first place. And the hostility was any indication, Ceara – Aoife – knew it.

Meda let out a frustrated snarl. “It is of no use. We must restrain her. She doesn’t understand that we are trying to help her. Domina, if you will.”

Cornelia’s vision went blurry for a moment. She blinked, finding her eyes wet. She quickly turned away and took out a small vial with a dark, murky liquid from her own satchel. Tincture of mandrake. She carefully poured a few measured drops onto a sponge and held it to Ceara’s nose. The girl recoiled. Her condemning gaze did not leave Cornelia even as her despair took over and she began to thrash. She couldn’t fight the powerful drug for long. Her eyes began to droop.

Meda grabbed a length of cloth from her kit and ripped it into several pieces, using them to tie Ceara’s hands and legs to the bed.

“Now, we must move quickly. The tincture only puts her to sleep but doesn’t halt her labor.”

Cornelia laid her hands on the unconscious girl’s abdomen, feeling for the fetal body. Finding the head, she pushed, praying for the baby to flip. As she worked, Meda inserted her hand into her birth canal, trying to grab the leg of the fetus to pull it downwards. If this worked, the babe would still be breech, but that was still infinitely better than a transverse lie. Ceara’s eyes fluttered as she let out a pained moan, dilated pupils visible underneath.

Several minutes later, the fetus refused to budge and remained stubbornly sideways. Cornelia felt the womb stiffen under her hands as another contraction came. The girl thrashed against the restraints. She and Meda stared at each other. Ceara’s labor was going to kill both mother and child. The law also dictated that the fetus had to be extracted from the mother so that they could be buried separately.

“We must extract the fetus. It is the only way to save her life,” Meda’s mouth was a thin line.

Cornelia knew what she meant. It was a barbaric procedure. The fetus had to be cut – no, dismembered – to extract it piece-by-piece from the birth canal. Bile rose to the back of her throat, and she pressed her hands together to stop the trembling. No. This was all wrong. She shouldn’t be here. She breathed in deeply, trying to gather herself. “The trauma of that could still kill them both. It would also take hours, which she may not have. A clean incision on the abdomen could let us cut the babe out. We could save its life. And she may yet survive.”

Meda looked horrified. “That is a death sentence for both mother and babe. No one survives that.”

“That may not be so,” Cornelia argued. “I have seen gladiators survive far worse abdominal wounds. There was one who was gored in the belly by a mad bull, and he went on to survive. This would be a controlled incision.” She took a deep breath. “I believe the trick is to place sutures on the womb itself, not just the skin. That would stop any bleeding that occurs and allow the wound to heal.”

The more she spoke, the more confident she felt. She could do this. She must try.

Meda locked her arms stubbornly. “Cutting the babe out is the way, domina. That is the only resort when the babe lies sideways. Any good obstetrix knows this.”

“I am not a mere obstetrix,” Cornelia snapped. “And I will not take orders from a mere freedwoman. You are still my client.”

Meda stiffened like she had been slapped. “As you wish,” she said, coldly.

Cornelia did not meet her eyes as she prepared the sponge with more mandrake. She knew what she was doing. She added five drops, then, after a brief pause, added five more. The girl’s eyelids were already fluttering, and the surgery would be painful beyond comprehension. She held the sponge over her nose and mouth for several seconds, followed by two more drops under her tongue.

Next, she took out a small wooden box filled with a grayish powder. Crushed memphitic stone. She carefully scooped up some with a spatula and spread it over Ceara’s abdomen. It would numb the area.

She laid out her instruments – her father’s set of surgical instruments, made from the finest Noricum steel. A veritable collection of scalpels, hooks, forceps, specula, and cupping devices. She chose a sharp-looking scalpel with a tapered blade.

She felt a pang of uncertainty. What was she doing? She had never done this before. She had studied it in textbooks, certainly, and dissected animals, but to cut open a living human being…

“Meda, I need you to assist,” she said sharply, without looking at her. She did not wait for her to obey before positioning herself to the right side of the unconscious girl. If she waited any longer, she might change her mind.

She hastily splashed the abdomen with strong vinegar to purify the site, then proceeded to position the blade with her index finger and pressed down into the flesh, dragging it downward in a straight line across the middle of the belly along the linea alba. The skin parted, and rivulets of blood trickled down along the sides of the incision. She dabbed at it with a clean cloth and repositioned her blade. Fat, fascia, and muscles came apart beneath her fingers. It would feel powerful if it weren’t so terrifying.

The world faded away as she worked. She carefully dissected with the blunt end of her scalpel until she reached muscle. She used her fingers to pull apart the fibers as best she could, then cut through the rest. After several painstaking minutes, she saw a glistening pink organ. The womb.

She pulled out a pair of blunt hooks from her satchel and thrust them towards Meda. “Hold them like so to keep the flesh away from the womb.”

Meda mercifully obeyed without argument.

This was it. She swallowed loudly and darted a brief glance towards the girl’s face. She was still unconscious. In fact, she hadn’t stirred this entire time. A brief ripple of unease went through her. Was this the usual course? She did not know. She had never done this before. She lifted her head to look at Meda. Her face was turned away. Tears were streaming down her face.

Cornelia’s lip curled. She made a rapid incision across the middle of the womb. It was thick and harder than she expected. She jumped as fluid gushed out, spraying her dress. The coppery tang of blood filled the room. She reached inside the womb and dug around until she felt a foot. Grasping it, she pulled – hard – until the entire babe was out. It was a tiny thing – limp and lifeless. Covered in blood as it was, she could barely make out the dark hair – but there, on its back – Cornelia’s heart stopped. She stared at its back. The flesh of the back gaped open, and she could see the spine underneath. A monstrous deformity. The child was not whole. It could not survive.

Her own horror was echoed in Meda’s eyes. Along with judgment.

Blindly, she thrust the dead child towards Meda. “I must close the abdomen.”

Blood. So much blood. The fluid had drained out of Ceara’s body, but blood continued to spurt. Where was it coming from? She couldn’t tell. Sutures. She had to start suturing immediately. That would control the bleeding. She racked her brain trying to remember what she had read. Silk sutures – that was right. That was what Galen recommended.

“Meda… the silk sutures… get them,” she rasped.

Meda did no such thing. She laid the babe – the corpse – on the pillow and walked out without a word.

Cornelia felt lightheaded. She knew she was hyperventilating. She desperately fumbled through her satchel, scattering instruments around her. Silk, silk. She must find the sutures. Finally, she pulled out the needle and silk. There! Now all she had to do was stitch.

It was so wet. The needle kept slipping out of her hand. The muscle was thicker, and she could barely get the needle through. She lost count of how many times she pricked herself. The silk kept getting caught in the ragged edges of the torn muscle. Damn it all. She continued to frantically yank at it until it abruptly snapped.

Cornelia lost her balance and fell backward, landing on the floor. The room looked darker. How long had it been? Where was Meda? She grabbed Aoife’s hand.

“No, no, no,” her voice broke. “I-I’m so sorry… it was a mistake. I was young and foolish, and I-I was so jealous that Lucius smiled at you. I was j—just so angry…it seemed harmless to say that you stole that hairpin... I-I thought a whipping would teach you a lesson… I didn’t know… I didn’t think my uncle would send you to the m-m-mines… punish you like that.”

Aoife did not reply. Her eyes were closed, and her arm hung limply in Cornelia’s hand. It was cold. She desperately felt for a pulse. There was none.

There was a sudden rustle of movement behind her. Cornelia flinched. She hadn’t heard Meda come in.

“I sent word to the libitinarii. They will come to collect the bodies and… to clean up. Have you coin for them?” Meda’s voice was neutral, but she did not meet Cornelia’s gaze. How much had she heard? And what was she thinking? Cornelia felt a chill pass through her.

It didn’t matter. Aoife was a slave. Meda was only a freedwoman. She was a senator’s wife. This whole episode was unfortunate, but it didn’t affect her. Cornelia looked down at her bloody hands. It doesn’t matter, she repeated to herself.