David Mitchell - The Thousand Autumns of Jacob de Zoet

In all his life, Jacob has never heard this word spoken aloud.

She senses his shock and looks up, half alarmed. ‘I mistake?’

Dr Lucas Marinus, Jacob thinks, you sadistic monster. ‘No,’ he says.

Frowning, she finds her place again: ‘ ”… to feel if the placenta is at the os uteri… and if this is the case… I am sure it will come down of itself in any rate… I wait for some time, and commonly in ten, fifteen or twenty minutes… the woman begins to be seized with some after-pains… which gradually separate and force it along… but pulling gently at the funis, it descends into the -” ’ she glances up at Jacob ‘ “- vagina. Then, taking hold of it, I bring it through the… the os externum.” There.’ She looks up. ‘I finish sentences. Liver is making much pain?’

‘Dr Smellie’s language,’ Jacob swallows, ‘is rather… direct.’

She frowns. ‘Dutch is foreign language. Words do not have same… power, smell, blood. Midwife is my…’ she frowns ‘… “vacation” or “vocation” – which?’

‘ “Vocation”, I hazard, Miss Aibagawa.’

‘Midwife is my vocation. Midwife who fear blood is not helpful.’

‘Distal phalanx,’ comes Marinus’s voice, ‘middle and proximal phalanxes…’

‘Twenty years ago,’ Jacob decides to tell her, ‘when my sister was born, the midwife couldn’t stop my mother bleeding. My job was to heat water in the kitchen.’ He is afraid he is boring her, but Miss Aibagawa watches him with calm attention. ‘If only I can heat enough water, I thought, my mother will live. I was wrong, I’m sorry to say.’ Now Jacob frowns, uncertain why he raised this personal matter.

A large wasp settles on the broad foot of the bed.

Miss Aibagawa produces a square of paper from her kimono’s sleeve. Jacob, aware of Oriental beliefs in the ascent of the soul from bedbug to saint, waits for her to guide the wasp out through the high window. Instead, she crushes it in the paper, scrunches it into a little ball and, with perfect aim, tosses it through the window. ‘Your sister, too, have red hair and green eyes?’

‘Her hair is redder than mine, to our uncle’s embarrassment.’

This is another new word for her. ‘ “Am-bass-a-ment”?’

Remember to ask Ogawa for the Japanese word later, he thinks. ‘ “Embarrassment”, or shame.’

‘Why uncle feel shame because sister has red hair?’

‘According to common people’s belief – or superstition – you understand?’

‘Meishin in Japanese. Doctor call it, “Enemy of Reason”.’

‘According to superstition, then, Jezebels – that is, women of loose virtue – that is, prostitutes – are thought to have, and are depicted as having, red hair.’

‘ “Loose virtue”? “Prostitutes”? Like “courtesan” and “whore’s helper”?’

‘Forgive me for that.’ Jacob’s ears roar. ‘Now the embarrassment is mine.’

Her smile is both nettle and dock leaf. ‘Mr de Zoet’s sister is honourable girl?’

‘Geertje is a… very dear sister; she is kind, patient and clever.’

‘Metacarpals,’ the doctor is demonstrating, ‘and here, the cunning carpals…’

‘Miss Aibagawa,’ Jacob dares to ask, ‘belongs to a large family?’

‘Family was large, is small now. Father, father’s new wife, father’s new wife’s son.’ She hesitates. ‘Mother, brothers and sisters died, of cholera. Much years ago. Much die that time. Not just my family. Much, much suffer.’

‘Yet your vocation – midwifery, I mean – is… an art of life.’

A wisp of black hair is escaped from her headscarf: Jacob wants it.

‘At old days,’ says Miss Aibagawa, ‘long ago, before great bridges built over wide rivers, travellers often drowned. People said, “Die because river god angry.” People not said, “Die because big bridges not yet invented.” People not say, “People die because we have ignoration too much.” But one day, clever ancestors observe spiders’ webs, weave bridges of vines. Or see trees, fallen over fast rivers, and make stones islands in wide rivers, and lay from islands to islands. They build such bridges. People no longer drown in same dangerous river, or many less people. So far, my poor Dutch is understand?’

‘Perfectly,’ Jacob assures her. ‘Every word.’

‘Nowdays, in Japan, when mother, or baby, or mother and baby die in childbirth, people say, “Ah… they die because gods decide so.” Or, “They die because bad karma.” Or, “They die because o-mamori – magic from temple – too cheap.” Mr de Zoet understand, it is same as bridge. True reason of many, many death of ignoration. I wish to build bridge from ignoration,’ her tapering hands form the bridge, ‘to knowledge. This,’ she lifts, with reverence, Dr Smellie’s text, ‘is piece of bridge. One day, I teach this knowledge… make school… students who teach other students… and in future, in Japan, many less mothers die of ignoration.’ She surveys her daydream for just a moment before lowering her eyes. ‘A foolish plan.’

‘No, no, no. I cannot imagine a nobler aspiration.’

‘Sorry…’ she frowns ‘… what is “noble respiration”?’

‘Aspiration, miss: a plan, I mean to say. A goal in life.’

‘Ah…’ a white butterfly lands on her hand ‘… a goal in life.’

She puffs it away; it flies up to a bronze candle on a shelf.

The butterfly closes and opens and closes and opens its wings.

‘Name is monshiro,’ she says, ‘in Japanese.’

‘In Zeeland, we call the same butterfly Cabbage-white. My uncle-’

‘ “Life is short; the art, long.” ’ Dr Marinus enters the Sick Room like a limping, grey-haired comet. ‘ “Opportunity is fleeting; experience-” and, Miss Aibagawa? To conclude our first Hippocratic Aphorism?’

‘ “Experience is fallacious,” ’ she stands and bows, ‘ “judgement difficult.” ’

‘All too true.’ He beckons in his other students, whom Jacob half recognises from Warehouse Doorn. ‘Domburger, behold my seminarians: Mr Muramoto of Edo…’ the eldest and dourest, bows ‘… Mr Kajiwaki, sent by the Chôshu Court of Hagi…’ A smiling youth not yet grown into his ropy body bows. ‘Next is Mr Yano of Osaka…’ Yano peers at Jacob’s green eyes ‘… and, lastly, Mr Ikematsu, native son of Satsuma.’ Ikematsu, pocked by childhood scrofula, gives a cheerful bow. ‘Seminarians: Domburger is our brave volunteer today; please greet him.’

A chorus of ‘Good day, Domburger’ fills the whitewashed Sick Room.

Jacob cannot believe his allotted minutes have passed so soon.

Marinus produces a metal cylinder about eight inches in length.

It has a plunger at one end and a nozzle at the other. ‘This is, Mr Muramoto?’

The elderly-looking youth replies, ‘It is call glister, Doctor.’

‘A glister.’ Marinus grips Jacob’s shoulder. ‘Mr Kajiwaki: to apply our glister?’

‘Insert to rectum, and in-jure… no, in-pact… no, aaa nan’dattaka? In-…’

‘-ject,’ prompts Ikematsu, in a comic stage-whisper.

‘- inject medicine for constipation, or pain of gut, or many other ailment.’

‘So we do, so we do; and, Mr Yano, where lies the advantage in anally ministered medicines over their orally ministered counterparts?’

After the male students have distinguished ‘anal’ from ‘oral’, Yano responds, ‘Body more quick absorb medicine.’

‘Good.’ Marinus’s slight smile is menacing. ‘Now. Who knows the smoke glister?’

The male seminarians confer without including Miss Aibagawa. At length, Muramoto says, ‘We do not know, Doctor.’

‘Nor could you, gentlemen: the smoke glister has never been seen in Japan until this hour. Eelattu, if you please!’ Marinus’s assistant enters, carrying a leather tube as long as a forearm and a deep-bellied, lit pipe. The tube he hands to his master, who flourishes it like a wayside performer. ‘Our smoke glister, gentlemen, possesses a valve in its midriff, here, into which the leather tube is inserted, here, via which the cylinder can be filled with smoke. Please, Eelattu…’ The Ceylonese inhales smoke from the pipe and exhales it into the leather tube. ‘ “Intussusception” is the ailment for which this instrument is the cure. Let us speak its name together, seminarians, for who can cure what he cannot pronounce? “In-tus-sus-cep-tion!” ’ He waves one finger like a conductor’s baton. ‘A-one, a-two, a-three…’