The Apothecary Diaries - Volume 15 - Chapter 12

Chapter 12: Explanation and Agreement

They didn't know where the word of the surgery had leaked from.

Actually ...

In Maomao's opinion, it was a miracle that the Emperor's condition had stayed hidden for so long. He'd been suppressing chronic pain, not taking proper meals, and yet supposedly doing his work as if everything was normal. He even occasionally went to the rear palace to spend nights with his consorts.

It was very frustrating for the physicians, then, to face interference when the discussions had all been had and essentially all that was left was to pick up the knife.

I guess we shouldn't be surprised.

The relatives of a patient always seemed to want a say in their care. At the apothecary shop in the city, it had even happened that one regular customer's relatives had shown up to complain that the medicine was too expensive and not doing anything, to the point that they were sent away with orders to find their own treatment, then. They hadn't seen that customer since.

I sure hope they're still alive, Maomao thought.

When they were dealing with the man who stood at the apex of his country's entire political hierarchy, then, they probably should have expected that people would stick their noses in about the treatment plan.

They would never do surgery unless it were absolutely necessary. Sometimes, when someone had a grievous external injury, emergency demanded surgical treatment, but when it came to illness, treatment with drugs was the typical course.

But this isn't responding to drugs, which is why we're doing this! Maomao ground the herbs in her mortar with more vigor than usual.

"You'll just tire yourself out doing that," came the voice of a somewhat elderly woman from beside her. If one wondered why Maomao didn't look entirely thrilled despite the fact that she had been included among the physicians, this woman's presence probably explained it. "Your old auntie has to shepherd her strength in these latter years of her life," the woman went on. "Now, just because you're young doesn't mean you should waste your energy. You'll only end up exhausted."

The woman described herself as an "auntie," and indeed, she looked like one. She was evasive about her exact age, saying only that she was somewhere in her fifties, but she had the wrinkles to match. A certain plumpness showed that she led a rich dietary life, but her fingers had dark stains that never seemed to wash away-evidence, Maomao knew, of someone who had been compounding medicines for many, many years.

People called her Auntie Liu. It was a perfectly ordinary family name, but among the physicians it referred to one man, Dr. Liu-and Auntie Liu, as it happened, was his younger sister.

"I realize it looks like there's a lot of nepotism going on, but please don't hold it against us," Dr. Liu had said. If anything went wrong with the Emperor's treatment, all the physicians involved as well as their families would be summarily executed. In order to minimize the number of people caught in the purge, Dr. Liu had decided to hire family members of the physicians already involved. And of course, although he might talk about nepotism, Dr. Liu would never bring in mere amateurs. Auntie Liu had passed the selection examination, which implied that she knew at least as much if not more than the actual doctors here.

"Hee hee hee! This is my first time doing work outside the home, and I must say I'm nervous. Do take it easy on me, Senior."

Auntie Liu had spent many years in Dr. Liu's family home being involved with the practice of medicine; her medical knowledge was extensive and she was accustomed to the work.

However, she was evidently unmarried and had no children. The smudges on her fingers told the story: There were many who viewed medicine as low-class work. Maomao could only guess how many people had seen those darkened fingers and immediately decided this woman was unfit to be their bride.

In a way, Auntie Liu represented one possible life that might await Maomao.

If Maomao was annoyed, so were the other physicians.

"And here we've got everything ready!" one complained.

"His condition will only get worse if we hold off," said another.

If Dr. Liu was right that this was appendicitis, then they were in a battle with time. If the appendix burst and sent filth all over the Emperor's abdomen, the chances of his demise skyrocketed.

"All right, all right, getting upset won't solve anything. We just have to do whatever we can," Auntie Liu said, defusing the charged atmosphere. In terms of age, she reminded Maomao of Jinshi's elderly assistant Suiren, but less calculating.

She doesn't seem like Dr. Liu at all.

Then again, maybe it was exactly because they were so different that they worked well together. And they must work well together, or Dr. Liu would never have called her here. She was certainly a boon to the general atmosphere; if that was why Dr. Liu had involved her, it was a brilliant stroke.

The upper physician who had been leading the surgical team had been reassigned to anesthetic needling, and Auntie Liu had effectively taken charge. The fact that no one complained was probably down to her personality.

As such, she promptly became the subject of discussion at break time.

"An auntie like her? I don't know ... "

"I hear you. I mean, we're risking our lives too, sure, but ... "

At mealtimes, even the physicians, who normally spoke with careful formality to each other, could be heard to relax a bit.

Maomao was preparing tea, and, along with the auntie, was among the listeners. From what she gathered, there was more than one person raising objections to the surgery. Moreover, they were coming from both the Empress Dowager's family and from voices within Gyokuen's faction. In other words, both of the major powers at court were opposed.

"Not like I can't understand what they're saying," one of the physicians said.

If the surgery were to fail, the Crown Prince would become emperor at not even five years old. In that case, the Empress's father, Gyokuen, would likely become regent. The Empress Dowager's people would not be amused by the possibility.

By the same token, it had to be obvious to the Empress's partisans that having such a young ruler take the throne when their own power base was not yet firmly established would open them up to a counterattack. One major factor was that they had Jinshi, the Emperor's younger brother and a man of just the right age for the job. Should the Emperor not survive, there would no doubt be loud voices calling for Jinshi's appointment.

There's a lot of downsides to that scenario for both of them.

They wanted the current Emperor rather than a young sovereign precisely because this was an era with no significant upheaval. If this had been a world at war, the bloodlines of the earlier era would no doubt have come crying, and the throne would be soaked in blood.

I guess what we have is better than that ...

The question was how to explain to people that doing nothing was the surest way to make the illness worse.

Maomao sipped her tea and listened to the doctors do what amounted to griping.

That day, there were men Maomao didn't recognize at her dormitory. They rode in a magnificent carriage, and the dormitory chief was giving them a baleful look.

"What do you suppose this is about?" Maomao's junior, Changsha, asked with a mystified look. They no longer saw each other at work, but at the dorm they took turns making dinner. Today it had been Maomao's turn to buy ingredients on the way home.

It's definitely not Miss Chue.

When Chue came to summon Maomao on Jinshi-related business, she was more discreet. She would bring a less flashy carriage, or park somewhere a bit farther away.

"We'd like to ask you to come with us," one of the men said, showing her a peony crest. It was the very same one that was burned into Jinshi's flank.

Empress Gyokuyou's symbol ...

Maomao studied the men's faces. It would have been reassuring to recognize at least one of them, but unfortunately there was no one she knew. Considering Maomao's singular inability to remember even those people she had actually met, maybe she couldn't complain.

If these were messengers from Empress Gyokuyou, then she had no choice but to go with them. If they were simply posing as Gyokuyou's men, however, she would prefer to refuse.

As she dithered, someone she did recognize finally emerged from the carriage.

"Maomao," the woman said.

"Lady Hongniang," Maomao answered.

It was Empress Gyokuyou's chief lady-in-waiting.

"You will come with us, won't you?" Hongniang asked.

"Yes, ma'am."

If the chief lady-in-waiting had come in person, then Maomao definitely couldn't say no.

"Changsha," Maomao said, turning to her junior, "would you be so kind as to eat dinner by yourself tonight?"

"Of course."

Maomao gave Changsha the ingredients she'd purchased and then got into the carriage.

The carriage rolled into the Empress's pavilion. As it went, Hongniang peppered Maomao with questions.

"Do you know why we've summoned you?" she asked.

"Does it have something to do with the Emperor?" The high officials wouldn't quit jabbering about the surgery. There was no way Empress Gyokuyou didn't know about it.

"That's right. I suppose, then, you have a sense of what you're going to be asked."

Maomao thought about what a patient's family would most want to know. "I'm guessing you want to find out from me whether what the doctors have said is true."

"Exactly," Hongniang replied.

"Of course, you couldn't have asked my superiors for permission before you brought me here."

From Maomao's perspective, talking too openly about her work could lead to disciplinary measures.

"Of course. We couldn't have you coordinating your stories."

I have my own position to think of, you know ...

Maomao might not like it, but here and now there was no way she could refuse. There was simply too vast a gulf between an ordinary palace lady and the Empress.

Hongniang led Maomao out of the carriage.

The leaves are red, she noted, realizing how deep in the autumn they now were. She'd been so busy recently that she had hardly noticed the changes in the season.

Hongniang took her to a room with a guard standing outside. She motioned to him, and he opened the door.

Empress Gyokuyou was within, reclining on a couch. In addition to her ladies-in-waiting, whom Maomao recognized, there was another young woman with red hair much like the Empress's. The young lady sent by Gyoku-ou, perhaps. Publicly, she was described as Gyokuyou's niece.

That's the girl Tall Senior was talking about.

Maomao was no Tall Senior, but she could tell that all the ladies in this room, the Empress not least of all, were beautiful. It wasn't just their looks-the way they did their makeup and the way they comported themselves was ineffably refined. It struck Maomao all the more because she'd spent all her time of late in workplaces full of unwashed guys.

There was one other young lady there, with braids and narrow eyes. She was plain-faced and tall, and looked to be in her mid-thirties, like Hongniang.

Is she from the west?

With her suntanned skin and slightly unusual clothing, she looked to Maomao like someone from I-sei Province.

Who's that?

Even as she pondered the question, Maomao bowed deeply.

"It's been such a long time. How are you doing?" Gyokuyou asked, and only when the Empress had spoken did Maomao raise her head.

"Yes, far too long, milady. I'm doing much the same as always."

"So I see. Have a seat."

"Yes, ma'am. Thank you." Maomao sat in a chair.

Yinghua and the other two girls were looking at Maomao fondly. They gave her little waves; she wanted to wave back, but since Hongniang was there, she thought better of it.

Hongniang noticed what the girls were up to. "All right, surely you have something else to keep you busy. These two have something very important to talk about, so if you would kindly leave?"

"Awww," Yinghua said.

"Don't awww me!" snapped Hongniang.

"Yes, ma'am!" all three replied in unison.

The rapport between Hongniang and the three of them seemed alive and well. Empress Gyokuyou watched the exchange with evident amusement.

Then the three young ladies and Gyokuyou's niece left the room. The unfamiliar girl with the braids stayed. Hongniang locked the door, while the guard remained outside to make sure no one listened in.

Empress Gyokuyou was the first to speak. "I assume Hongniang has filled you in. My apologies for dispensing with the pleasantries, but could you tell me what his condition is?"

"It's the doctors' opinion that he is already beyond treatment with medicine. His symptoms suggest a high probability of appendicitis, which is when the organ called the appendix becomes inflamed. If it gets worse, the appendix could rupture, scattering the filth inside it all over his body. That would invite further illnesses and drastically increase the likelihood of his death. As such, they believe it's necessary to do surgery and remove the appendix before the situation gets any worse."

Maomao thought fast as she spoke, but she answered honestly-she decided that there was no way that Dr. Liu or Luomen had given the Empress a false diagnosis; they had no reason to do so.

Everyone had grown skeptical toward the doctors, even Gaoshun. From the looks on the faces of Gyokuyou and the others in the room, Maomao suspected she was right: They had heard this before.

"And removing the appendix ... That involves cutting into his stomach, doesn't it?" Gyokuyou asked.

"Yes, ma'am."

"Will the surgery succeed?" She sounded worried. Maomao could tell she wasn't just thinking about her son's future, but was genuinely concerned for the Emperor.

The relationship between the Emperor and his Empress was not one that could be described as love or romance. Yet nonetheless, it was not as if Empress Gyokuyou felt nothing for His Majesty at all.

If only that had been anything like enough to make him better.

"The physicians are doing everything they can to make sure it will," Maomao answered.

"But it could fail, couldn't it?"

Maomao stopped and thought for a moment. It was hard to say what would be the best way of explaining this. Finally she said, "In his current condition, the success rate is likely better than ninety percent. However, it will decline as time goes on."
"Why?"

Maomao tried to put the matter as simply as she could. "As I said, if the appendix bursts and sends filth everywhere, it can cause other illnesses. Meaning that the longer we wait, the more this becomes a matter of life and death."

"All right. And what other causes of failure might there be?"

"It's possible that toxins could enter the surgical site after the procedure and cause it to become infected."

"Toxins? You mean he might be poisoned?"

"No, ma'am. It's like ... Suppose you scraped your knee and didn't wash it off. Toxins could enter your body through the wound and cause it to become infected. It's the same principle. One shouldn't touch a wound with dirty hands, for example-but patients often inadvertently touch the surgical site and introduce toxins that way."

Maomao was as honest about the possible failures as she was about everything else. Trying to hide anything would only make her seem suspicious.

"One last question, then," said Gyokuyou. "If the physicians are wrong and it isn't appendicitis, what will you do then?"

"We'll just have to cross that bridge when we come to it. However, I don't think it would mean that the surgery was in vain."

If they could physically see where the illness was, that would be worth a lot. Moreover, if they could even just remove the filth from his belly, it would almost certainly contribute toward the lessening of his symptoms. They might or might not be able to treat the fundamental problem then and there, but it would be better than waiting around.

Empress Gyokuyou, Hongniang, and the woman with the braids looked at each other.

"Did I say anything that contradicted the other medical staff?" Maomao asked.

"No," Gyokuyou responded, a troubled smile on her face. "I don't suppose you've all agreed on a story, have you?"

"If we had, I might be better able to dissemble about the rate of failure for the surgery."

"True enough." Gyokuyou sighed and looked at the braided girl. "You heard her. Would you be so kind as to explain to Father, Honored Elder Sister?"

Elder sister ...

So she finally knew who the woman with braids was-one of Gyokuyou's many half-siblings.

"I will," the woman replied. "However, I take no responsibility for how those around him may receive this."

"Meaning you think Father will understand."

The other woman nodded silently. It was obvious from the conversation how intelligent she was.

"Sigh ... I'm sorry to have called you so suddenly, Maomao," said Gyokuyou.

"Not at all, ma'am," Maomao replied, relieved to find that she hadn't offered anything mistaken.

"You haven't had dinner yet, have you? Since you're here, why not eat before you go?"

Maomao reflexively put a hand to her tummy.

I want to! Oh, how I want to ...

But if she ate here, her careful, correct explanation would be in vain.

The meal might look like a bribe.

Maomao bit her lip hard and bowed her head. "I'm terribly sorry, milady. In fact, I've had my meal already."

Then she left the room, trying to keep her stomach from growling.