It was mid-morning by the time that Felicia was ready to remove the arrow from the wounded cavalry officer. She stood over her patient, his eyes slitted in a deathly pale face as he clung to consciousness with a tenacity that gave her hope for his survival, despite the blood-crusted arrow protruding from his armpit.
‘Decurion? Decurion, can you hear me?’
The exhausted officer’s eyes flickered in her direction, his mouth opening fractionally in a hoarse whisper.
‘I hear you.’ He swallowed painfully, licking his lips.
Felicia knelt by the bed, taking one ice-cold hand in both of her own.
‘My horse…?’
She smiled despite her concern.
‘Your horse, Cornelius Felix, bit two men and kicked several more black and blue while they were getting the arrow out of him, but I’m told he’s happily chewing his way through the fort’s stock of barley even as we speak. And as for you, Decurion, you have a barbarian arrow deep in your left armpit. It seems to have missed your lung, and more importantly the artery that runs through your shoulder down your arm, but it must come out immediately. I need to clean out your wound and prevent the onset of sepsis. You’ve lost too much blood already, and you’ll lose more while I remove the arrow, but to leave it there will probably kill you anyway…’
His lips moved again, the smile touching his eyes this time.
‘Get the blasted thing out now, eh?’
She nodded mutely.
‘Do it, but promise me…’
‘Yes?’
‘If the arm has to come off…?’
‘Yes?’
‘Just kill me. I can’t ride that monster Hades one-handed…’
Shaking her head sadly, she gently squeezed the cavalryman’s right hand.
‘My oath forbids me any such act. We’ll just have to make sure this stays attached to you. Now drink this…’
She put a beaker to his lips and patiently tipped the drink into his mouth in small sips.
‘What is it…?’
‘A mixture of wine, honey and the dried and powdered sap of the poppy flower. It will make you drowsy, or possibly even put you to sleep given the amount of blood you’ve lost. What I have to do to you now is going to hurt considerably more than the pain you’re in at the moment.’
The doctor waited for a few minutes, noting the soldier’s gradually slower breathing as the drug took effect.
‘He’s asleep. Let’s move him to the table. You have to keep his arm absolutely as it is now, straight out from his body. We have no idea what the arrowhead might be touching in there…’
She supervised the orderlies as they carried the decurion from his bloodstained bed to the operating table, where so many men had laid in recent months, their wounds open to her gentle, skilful fingers. The table’s surface was criss-crossed with the scars inflicted by her knives and saws, marks left from those occasions when she had decided that the removal of a limb was a safer alternative than risking the onset of gangrene in a shattered arm or leg. The wood’s grain was rubbed smooth by the incessant scrubbing she insisted on to remove each successive man’s blood from the surface before the next soldier was laid out for her attention.
‘Keep his arm steady… that’s it. Now get him on to the table.’
With the unconscious man’s body arranged to her satisfaction, his arm held firmly at right angles from his body by one of the orderlies, she surveyed the wound carefully, noting the blood still leaking from the arrow’s wicked puncture. Stepping away from the table, she studied her instruments for a moment before selecting a pair of polished concave bronze blades, one with a blunt curved end, the other with small hooks at its end. Turning to her helpers, she addressed the man standing ready to help her by the unconscious patient’s head.
‘So, what do we know about arrow wounds, Orderly Julius?’
‘Doctor, the arrow is often barbed and will cause more damage during removal due to further tearing of the flesh inside the wound.’
‘And so the usual method for the removal of such an arrow is…?’
To push the arrow’s head out of the body through a second wound opened for the purpose, when this can be achieved without risk. This allows the arrow to be broken in half and safely removed.’
‘And given this arrow’s location?’
‘It would be impossible to make a second opening. The arrow must be withdrawn through the original wound.’
She smiled encouragement.
‘Good. Have you carried out this procedure before?’
‘No, Doctor, I have not.’
‘Very well, you shall have your first opportunity shortly. From the look of the wound this is a broad-headed arrow, with only two barbs, and not one of ours. We can be thankful for that small mercy, can we not, Julius?’
The orderly responded dutifully.
‘Certainly, Doctor. A flat-bladed arrow opens a pocket-shaped wound, which will close itself well enough as a result of the flesh swelling in response to the arrow’s intrusion. A wound made by the three-bladed arrowheads used by our archers will not close, however, and requires much more attention during recovery.’
‘And…?’
‘And… it has three barbs…?’
‘Rather than two. Exactly. So, back to this particular patient. Our decurion’s arrow’s upper blade and barb may be close to the large blood vessel that runs along the shoulder and down into the arm, and if we snag that vessel with the uppermost barb we will have a dead man on this table inside a minute or so. I’m going to use these…’ She lifted the bronze blades to display them to the two men. ‘… to prevent that from happening. These two items are called a dioclean cyathiscus, because their use was invented by the Greek Diocles.’
She bent over the patient, sliding the first blade into the wound, probing gently for the arrowhead.
‘There it is. Now I’m pushing the blade up and over the barb. It’s smooth and blunt, so there shouldn’t be a risk to the blood vessel. That’s it… now there’s a tiny hole in the top of the blade, which I’m going to engage with the point of the barb… got it. That barb is now harmless to the patient. Now the other blade goes in… see? I engage the tiny hooks over the first blade, like so… and I can now pull the arrow from the wound, with the second blade both providing the traction and keeping the first blade in place over the barb. That’s the worst part over with, and not too much more blood spilt either.’
She looked at Julius.
‘There’s another set of blades over there, go and get them. We’ve managed to protect the blood vessel, so now it’s your turn to make the other barb safe.’
The arrow was out of the wound a minute later, the orderly having made a decent fist of engaging its other barb before ceding control of the extraction to Felicia. She drew the vicious iron blade smoothly and slowly from its incision, looking critically at the missile before putting it to one side.
‘There’s a memento for our cavalryman when he wakes up. Now for this wound.’
She explored the wound carefully with blunt-nosed forceps, pulling out a scrap of cloth from deep inside the decurion’s armpit and holding it up for the orderlies to see.
‘See, a fragment of his tunic, punched into the wound by the force of the arrow’s impact. We must never leave such an object inside a wound, it will cause sepsis, possibly gross infection, and frequently end in the death of our patient. Especially a man as weak as this from loss of blood. So, Orderly Julius, what does Celsus advise us to do now?’
The orderly looked up for a second, remembering his long hours of reading the textbooks that Felicia had lent to him.
‘Doctor, we must pack the wound with lint soaked in vinegar to stop the bleeding, and pure honeycomb to assist the healing.’
‘Correct. And the vinegar will also help to prevent infection of the wound. How long do you think we should
