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Do No Harm by Stephen Hamilton

© 2015 Stephen Hamilton, "Do No Harm"

For twenty-seven thousand years—through kingdoms and republics, through prophets and messiahs, through decay and collapse and rebirth—the city and the medical school had grown around each other. The campus stretched across districts and neighborhoods, spanning parks and rivers, but few buildings belonged to it alone: an operating theater might once have been a workshop, a classroom a factory floor. The basement room where Mutende sat in a circle of his fellow basambilila was an ancient one and had been many things: office, boiler room, refrigerator, storage for diagnostic equipment. Remnants of all its uses were in the walls, the fixtures, and most of all, in memory.

The mukalamba—the professor—stood in the center of the room, on a platform that may once have held an operating table or a cutting-board for meat, and his projectors and anatomical models were arranged amid pipes and hooks. His robe was deep black, without the patterns that another man might wear; his face was a softer black and lined with age; his gray hair just visible under a flat cap. He waited for the circle of students to arrange itself, clapped his hands twice for silence, and made a brief invocation to the god of medicine.

"Today," he said as the prayer's echoes faded, "we will discuss the ichiyawafu-fever."

Mutende was amused to see how many other students, high-born though they were, made signs to ward off evil. Less amusing was that he had to stop himself from doing the same. The ichiyawafu was the non-space through which people traveled between stars, but it was also the ancient name for the land of the dead, and the sickness that bore its name was a killer. He knew that now better than he'd ever wanted to know.

"There are many maladies that have been brought to us from across the ichiyawafu, of course," the professor was saying, "but this one carries its name because it returns from the dead. Years may pass between exposure and the first attack, but after that, it will attack again and again, more and more often, until the victim is wasted away. If you will open your books and give your attention, we will discuss the signs."

Mutende's book was already open, and he followed as the professor explained how to recognize the fever and how to tell it from other diseases with similar symptoms. The book was still difficult to read even after nineteen months of study. Not only were medical terms a language in their own right, but like all medical texts, the Book of Maladies was written in the language that had been spoken before the Union fell fifteen hundred years before, and in some places the words and grammar were so archaic as to be foreign. It was easier for the other students—most were imwinamulende, minor aristocrats, and had learned the archaisms in school—but Mutende had gone to a mechanics' fostering at fifteen, and for him, medical study had meant learning two languages rather than one.

"You must always look for lesions here and here," the mukalamba said, pointing them out on his models and projecting a ghostly image of how they appeared in a long-ago case, "and for labored breathing, loss of weight, progressive wasting of muscles . . ." Mutende listened, but he knew them all. He saw them every time he visited his landlady, growing worse by the week and month.

"Your patients will ask you if there is a cure," said the professor suddenly. The lecture had moved from luwuko, the art of diagnosis, to uganga—treatment. "There was none known to our ancestors, and none known to us. But there are palliatives. Your book describes several kinds of pills, and other remedies that are inhaled, and you will learn to compound them and what to watch for . . ."

Mutende listened with the other basambilila and dutifully wrote down lists of ingredients, the places where they could be bought or ordered, the steps that must be taken to prepare them. He knew them too, all of them, and at that moment, the classroom carried the memory of a butcher's icebox much more than any of its other incarnations.

All the pills, all the rubs, all the vapors—they were the ones that did his landlady no good at all.


Mutende had an examination three hours after his class, and it was in another building across the Katwe near the old Mwata's Gardens. That was far from the port district and he couldn't afford a moto-taxi, so he had no time to go home between classes. He went anyway.

He lived on the edge of the port, in one of the three- and four-story houses that had been built in the interstices of ancient buildings. There were six of them in a row, with water-towers hanging precariously from the upper stories and clotheslines and crazy angles between them, and somehow they looked less solid than the remnants of steel girders that towered over them. There were market-stalls set up in the street, and men in sober agbadas and women in bright dresses and hair-ties swirled around them, but none tried to claim Mutende's attention: anyone who wore a gray student's robe and lived here was likely to be even poorer than his neighbors.

Mapalo, the landlady, lived in two rooms on the first floor. The outer one, where she slept, was decorated with masks and dolls from the north country where she came from; next to them, beside the sewing machine, was a picture of her husband who had traded between worlds. He was lost to pirates ten years past, but not before he'd picked up the ichiyawafu-fever from a prostitute in a distant port and brought it home to his wife.

She stirred when Mutende came in, and he helped her sit up and put a plate of lamb and a cup of shake-shake beer before her. The tip of his index finger touched her facial scars, shaped many years ago to suggest a bird's wing: the sign of the Hornbill clan, one of the old clans that traced its ancestry to before the Migrations. His own face bore the same scars, and that was why she'd agreed to rent a room to him when he finished his fostering, but in the time since, she had become not only a clanswoman but a friend.

"How is it with you, mbuya?" he asked. She wasn't his grandmother, but as an elder woman of his clan, she was entitled to the honorific, and now, as they said in the north, it was a heart-title as well.

"A little better," she answered. Mutende felt of her forehead and knew it was a lie. Her temperature was higher and her lesions hadn't improved. He wasn't sure if she'd lost more weight, but she certainly hadn't gained any back, and this latest attack was taking vitality from her practically by the day.

"I made you something to reduce the fever," he said. He held a cup to her mouth, watched her drink, and pressed a wet cloth to her brow. He put the bottle down next to the half-full container of pills, the kind that the mukalamba had talked about in class. Mapalo had taken them religiously, and she was still getting worse.

"Can you make me a blue-leaf tisane too?" she asked. "The umulaye told me it would help against witchcraft."

Mutende fought hard not to sigh. Mapalo had found a street-doctor, no doubt one who was from the Kabwe country like she was, and he'd given her a folk remedy. Out in the countryside, many people still believed that imfwiti—witches—caused all sickness and death, and his landlady evidently thought a specific against them would do her more good than a treatment for her illness.

Maybe, Mutende thought ruefully, she was right.

Do No Harm by Stephen Hamilton

He clapped once—it was a way of saying yes—and went to the kitchen. It was one of the hours when the power was on, so he could boil water in the hotpot, and he found some sprigs of blue-leaf in the herb cabinet. He made the infusion, and a smell like cinnamon and pepper filled the room. It would give Mapalo pleasure, if nothing else.

In a moment, she smelled it too. "Kaweme said that blue-leaf was one of the best cargoes he could carry. On one world, the awantu used it for money . . ."

She launched into a story of her husband's exploits among the stars. Mutende brought the tisane to her and listened for a while, but her stories could go on for hours, and that was time he didn't have.

"I'm sorry, mbuya," he said, "but I have to go to my test."

"Go! Go!" She waved a hand in dismissal. "You have to take your test. You can't let me keep you."

He bowed his head and left the room. Barely an hour remained before the exam: he would have to take a moto-taxi or else run the whole way. He felt in his pocket and found a two-indalama coin and three half-ndalama pieces: if he didn't eat lunch today, he had enough.

There were taxis by the market-stalls outside—there always were—and by instinct, the drivers knew when they were needed. Mutende bargained between two of them and, the contract made, sat behind the winning bidder and felt the wind in his face.


The examination room was in a very different part of the city: a place of gardens, public buildings, and stately homes, where the ancient structures had retained much of their glory. The people who lived here were imwinamulende or even imwinamishishi; there was power all the time and running water, as there had been in the days of the Union and as the government promised there would one day be again.

The moto-taxi stopped on one end of a plaza, near the House of Kingmakers and the Chamber of the Ifapemba. The building here had always been a hospital, and the testing room had always been an operating theater: inganga had labored to save Lukwesa the Great's life here after his defense of the system, and Chinkonkole the Navigator's crew had found treatment here for the maladies of a hundred distant worlds. This place was sacred to Eyinle, the orisha of medicine, and thus was it where oaths were made and tests were taken.

Mutende got to the testing ground barely five minutes before the appointed time. The preceptor was already waiting and registered him in the book: Mutende, second-year student, examination in surgery on the fourteenth day of the fifth month of the Year of Migration 31,779.

At the word "surgery," Mutende's foreboding suddenly turned to elation. He hadn't been told in advance of the subject in which he would be tested, but this one, of all of them, he knew he could pass. The surgeons of today were as good as any of their ancestors—not everything had been forgotten when the Union fell, and tools had survived much better than burned books or plague-ravaged computers—and Mutende, with mechanic-trained hands, counted himself as good as any of his teachers.

Beyond the door, sanitized and dressed in sterile clothing, he saw the patient on whom he would be tested: a child of eight years, already anesthetized with drugs and needles and connected to fluids and plasma. He read through the records and films that the preceptor proffered, and saw that she had a brain tumor: a dangerous one that would surely kill her in a few months if left untreated. His elation wavered slightly—this was beyond the tests normally given to a student in his second or even third year, and the others in the room would intervene only to save the child's life—but he found a calm place within and steeled himself to the work.

He checked his instruments, making sure each was sterile and sharp, and made the initial incision. He clamped down a flap of scalp and cut away a piece of the skull; he probed the membranes inside and opened them carefully. The brain was exposed, and behind him, the machine waited.

Mutende had used such machines before: he had trained with one until it was part of him. A movable arm protruding from the machine held tiny tools, and a light and camera so he could see what the tools saw; below was a seat and a sleeve with which he would manipulate the instruments. If he put his arm and hand in the sleeve and moved a centimeter, one of the tools could be set to move a hundredth or a thousandth of a centimeter or even less. A surgeon with a steel nerve could use the instruments with an almost incredibly fine touch: once, on a dare, Mutende had written his name on a single cell sampled from his skin without breaking the membrane.

He placed the end of the arm on the surface of the brain, took his seat, and put on the mask that connected him to the camera. He probed, looking for the tumor: time took on a dreamlike quality as he found it, excised it, and set his tools finer so that only the cancerous cells would be cut away. He probed again, looking for fragments that the imaging might have missed, keeping iron control of his movements lest he break a blood vessel. Finally—was it minutes later, or hours?—he was satisfied that the tumor was gone, and with a shock that was almost pain, he withdrew his instruments and returned to the real world.

The preceptor, and the other inganga who were watching, said nothing as he closed up the opening he had made. He would know whether he passed when they chose to tell him. But he trusted his eyes and his hands, and he knew the child would live.

He thought of his landlady, and wondered why fevers were so much more elusive.


In the morning, Mapalo was sweeping the downstairs hallway. She sang a north-country song as she worked, but her movements were slow and painful and her breathing labored.

"You should be in bed," Mutende said.

"Inchito talala tulo," she said—"the work doesn't sleep." They said that in the Kabwe country, and they also said that about Hornbill clanswomen. Hornbills were supposed to work hard: that was as true as any other saying, but Mapalo had always taken it to heart.

"The work might not. But you're sick. You should."

"What would I be if I did nothing but sleep? And I had another tisane this morning, and I felt better."

Mutende mentally cursed his landlady's umulaye again, but then he stopped short. The other day, he'd learned that a substance distilled from the blue-leaf plant was used in drugs that strengthened the immune system, and didn't they say that repeated attacks of ichiyawafu-fever eroded the victims' immunity? He'd been taught, long before medical school, that an umulaye was good only for stitching up cuts and easing women's pains, but there was long experience in the street-doctors' fostering lines, and sometimes experience was wisdom . . .

"You should rest even if you feel better," he said, taking a different tack. "Get your strength back if you want to fight this attack off." He took care not to mention the next one.

"Don't mind me, I can . . ." Mapalo's voice trailed off, and Mutende turned to see her leaning heavily against a wall. She'd dropped the broom and was breathing very hard, and he had to catch her to keep her from sliding to the floor.

He helped her back to her rooms and, seeing no water in the jar, went out to pump her some. He made her drink and eat some of the nshima porridge that was on the stove, and after a few minutes her heart stopped racing and her breath came more evenly. He picked up the pill bottle and shook it, but then put it down: what good would it do?

"I forgot—there's a message for you," she said suddenly. "You're to be at the second-year offices at three o'clock."

Now Mutende did curse. He had no classes today, and he'd hoped to find some casual labor in the port, but not if he had to be across the city by three. He wondered why the summons had come: surely something hadn't gone wrong after the examination . . .

He would worry about it, he knew. And he did worry, through five hours of fetching and carrying for the market-women, past the university and the derelict towers of the city center, all the way to the ancient factory of which the medical school now occupied two floors.

The professor was waiting by the door and conducted him to a back office. He took the chair that was offered and waited to hear why he had been summoned, but the professor seemed strangely diffident, in no hurry to speak. For a long moment, Mutende watched as the teacher busied himself around the office, straightening books and dusting sculptures.

Finally, the moment stretched on too long. "Mukalamba," he said, "have you called me here to talk about the test?"

The professor straightened, as if suddenly reminded that Mutende was there. "The test? Oh yes, you did well. The child will live long. But that isn't why I asked you to come here. The other bakalamba and I are concerned about you as a student."

Whatever Mutende had expected, it wasn't this. "Have I failed in anything?" he asked.

"No, there is no single thing. But we have noticed an . . . irreverence in you. Of late, you have seemed uninterested during lectures, and when the gods of healing were invoked, you have been detached, preoccupied with other things. This is not a correct attitude for a musambilila who wants to qualify as a doctor."

Mutende's first instinct was to be defensive, to say that the gods of medicine weren't his gods. The orishas weren't the original gods of Mutanda: they had come in the ancient days of the Association and the Accord, but there were still people in the far north and west who rejected them. But he swallowed the words. He wasn't a mountain man or an islander; his family had lived in Chambishi Port since the days of the Union rather than being among the latecomers who flocked to the city as it rebuilt its factories. He had been raised with the orishas, although he'd come to doubt them, and if he said otherwise, the mukalamba would know it was a lie.

"The orishas have not protected my landlady," he said instead.

The professor looked at him sharply. "How have they failed her?"

"All of us have failed her. She has the ichiyawafu-fever, and the pills and remedies in the Book of Maladies—none of them have worked."

"Ah," the mukalamba said. He was on familiar ground now. "I have seen many students with your doubt. You must understand that nothing ever works in all cases . . . your landlady's husband was a free trader, was he not?"

"Yes," Mutende answered, too surprised by the sudden shift in questioning to say anything more.

"You have learned that pathogens evolve . . . good, good. The remedies we have were created in the ancestors' days, the days of the Union, and some strains of the ichiyawafu-fever have evolved to resist them. Much was lost when the Union fell, and many worlds fell out of communication, and in centuries without contact, their illnesses changed."

Mutende felt a sudden epiphany: the professor had never examined his landlady, but he was sure that his luwuko was true, and he cursed himself for not thinking of it before. "Why don't we look for remedies that do work, then? Why don't we find out what might kill the new pathogens?"

"That would be foolish, wouldn't it?" The professor spoke as if his words should be self-evident even to a child. "We haven't yet learned everything the ancestors knew—it would be dangerous to try to go beyond them."

It seemed to Mutende that there was something wrong with the mukalamba's premise, but in his confusion, he couldn't put a finger on what it was. "What are we doing, then, to learn all that the Union knew?"

"We find fragments of new books every year, and we recover computer files—sometimes even from other worlds. Everything that comes to us, we add to our texts . . ."

"But we don't study cases?"

"Of course we do. We have the cases that the Union doctors treated, and even some of those from the Commonwealth and the Accord."

"New cases. Cases to recreate what was in their books rather than looking for them in holes in the ground." He trailed off, suddenly deflated. "Then Mapalo is in the care of Babalu, not Eyinle?"

"She must be. Where we have not the knowledge to follow the god of health, then only the god of sickness can help."

"Where we refuse to find the knowledge, you mean."

"Be careful, musambilila," the professor said, his voice calm but with an edge of iron. "I know your anger. Many students have it. But if you don't grow beyond it, then you will never be a nganga. You didn't come this far, sacrifice this much, to be an umulaye."

"No," Mutende said. "I will think about your words."

"See that you do."


Do No Harm by Stephen Hamilton

That night, Mutende didn't go home. His feet took him to the port district instead, and into a shebeen only blocks from the landing fields. He wanted to be among those who knew the ichiyawafu, those to whom it was a highway rather than a fearful mystery, and he wanted to grieve with those who had passed through the land of the dead and lived.

The shebeen was a free traders' bar: that was confirmed by the patrons' florid clothing, and also by the tapestries that hung between the tables so that merchants and sailors could keep their secrets. The hangings were in blue and white, the colors of Yemoja of the Waters and Stars, with scenes from foreign worlds or abstract patterns that recalled ichiyawafu-dreams.

He bought a cup of imbote and sat at one of the long tables outside the curtains, sipping the honey-beer in the candlelight and listening to the others' stories. A few looked at him sharply—a man with no ship-clan had no place here—but one of them was a Hornbill and he was quiet in the shadows, so they let him stay.

"Kaweme," one of them said when he spoke at last. "Yes, I remember him. He always wanted to find something—the world the orishas came from, the lost colonies of the Second Migration, the jewel of an awantu-king a million years dead. He was going to find the universe and bring it home to sell . . . you say his woman has the fever?"

"Yes. That's what he did bring home."

"I should see her. Kaweme was in my ship-clan, and we owe her something. A funeral, if nothing else."

"The pirates got him, didn't they?" asked another trader, leaning in.

"That was when he went looking for the lost colony. They'd found it first."

"No, it happened on Muya, where the pirates were paying tribute to the governor . . ."

Others around the table joined in with their stories until it was almost a wake for Kaweme. But it wasn't one for Mapalo, and after a few attempts to steer the conversation in that direction, Mutende realized that the sailors didn't know her. Ship-clans and ship-marriages were what mattered to them; their lives in port, and their husbands and wives there, were separate. Mapalo was as much a stranger to them as Kaweme was to Mutende.

He finished his fourth imbote and sank into a sodden despair; he had come to the wrong place for this particular grief. But he bought his neighbor a shake-shake beer and let the sailor buy him the next one, and watched the candles flicker and listened to stories.

There was noise by the bar and Mutende saw that a group of young men had come in; a second later, he saw that they were basambilila. The medical school had rooms near here, he remembered—a clinic, purchasing offices, a center for study of off-world diseases—and the students must have just come from class. They were high-born, too: if that wasn't clear from their clothing, it was made plain when they ordered liquors from distant worlds. If everyone at the long table emptied their pockets, they wouldn't have enough to buy even one of the cups the students held.

Mutende never remembered standing up. He stood at the table for a long moment, his eyes fixed on the students, oblivious to the looks of concern the sailors were giving him.

"You!" he said. "High-born fools! Are you tired yet of being dogs at the ancestors' feet?"

A musambilila turned to look at him, surprise and anger written on his face. "Who are you calling a dog, ifilolo?" he said.

"You scavenge for the Union's books but you don't care about the diseases that come on the ships every year. You learn the lessons your professors memorized but you don't want to learn the ones your patients teach you. Did I call you a dog? Dogs would know better than to do what you do."

One of the students seemed about to answer, but it wasn't debate that Mutende or most of the high-born ones wanted. "An umulaye would spit on you," said one of them, and he answered, "An umulaye is worth ten of you bush-pigs." The next part of the discussion wasn't with words.

Maybe Mutende charged first; maybe one of the basambilila did. His fist found someone's face, and he fought with hands and feet and knees, ignoring the blows that rained on him, wanting only to hurt or even kill. Blood ran into his eyes, forcing them closed; he lashed out unseeing, not caring about the pain he suffered as long as he could inflict some in return.

From somewhere, he heard the rasp of a knife being drawn. He couldn't see where it was. Others did, though, and the shebeen-owner's men stepped in: fights were one thing but blades were another, and no one wanted the attention of the bakulama. A dozen hands pulled the combatants apart, and two of them threw Mutende out the door.

It had begun to rain outside, and as the cool water washed over his face, Mutende realized how badly he had been beaten. He would have to find a nganga to put him back together—no, an umulaye. This was what they did well, and after he'd defended their honor, it would hardly be fair of one to refuse.


The predawn light was emerging in the east when Mutende made it home. He planned to collapse in his bed and find a doctor in a few hours, but when he passed Mapalo's apartment, he could hear conversation inside and the cinnamon-pepper smell of a blue-leaf tisane filled the hallway. Evidently her umulaye came early.

"I'll go to the ichiyawafu soon," she was saying. "They say it's everyplace at once, so Kaweme will be there even though he died on another world."

"Don't speak like that," said another woman's voice. "Drink your tea."

Mutende hesitated, but he knocked on the door.

"Come in . . . oh, you've been in a fight!"

"I'll live, mbuya."

"Lelato should look at you. Have you met her?"

He hadn't, and his eyes were drawn to the umulaye's appearance. She wasn't from the north country: no, she affected the dress of a free trader, with loose silk trousers and jacket in black and red geometric patterns and tight curls cropped close around her scalp. He wondered why, and then saw the tattoo of a ship-clan, weathered with age and just a shade darker brown than her face.

"I was a ship's doctor for twenty years," she said—she must have seen him looking. "Most of the traders like awamulaye better than inganga, and I had a year's training in surgery on Chama. They take women in the medical schools there."

"Did you know Mapalo's husband?"

"He was in my ship-clan. He made me promise to see her if anything happened to him. When I came back to the city and learned she had the fever, I came to her."

Do No Harm by Stephen Hamilton

There was a mystery here, Mutende thought. He'd expected a peasant healer from Kabwe province, full of remedies against witchcraft and half an infwiti herself, but here was a woman who'd traveled among the stars, and who might have seen medical books that even the bakalamba hadn't read.

"Did they teach you about the blue-leaf tisane on Chama?"

"No, that's a folk-remedy. I learned about those too, during my fostering. I did learn more about it on Chama and in other places . . . but let's take a look at you." She turned to Mapalo. "Can we go upstairs?"

"Yes, I'll be fine," Mapalo answered, and for all her earlier talk about death, she did seem to have rallied since the day before.

"I'll come later, mbuya," Mutende said, and followed the street-doctor to his room.

She examined him quickly and matter-of-factly, with an economy of movement that any nganga would envy. "I'll give you a lotion for the cuts and bruises," she said. "Most of them you'll just have to endure, but I'll need to stitch you up here and here. You'll have a scar or two . . . you're the one who's studying to be a nganga, aren't you?"

"Yes." Somehow, from Lelato, a change of subject seemed more natural than from the mukalamba.

"You should tell her not to take those pills."

"They don't do her any good, but they do no harm, and they at least give her comfort."

"Yes, they do harm her. I've seen it in other patients—the pills can make them weak. When the pills fight the fever, the weakness is worth it, but when they don't . . ."

"I'd thought that the weakness came from the attacks."

"The attacks can mask it, yes. I had my suspicions, though, so I took some patients off the pills and compared. I took them myself too, to make sure."

"Muyanda." Said one way, the word meant a drug; said another, it meant poison.

"The pills are both. Many medicines are—you've learned that."

"I'll take her off them, then," he said, and then he realized something else. "You've studied cases?"

"How else? Awamulaye are jealous of their cures, and all we know is what our fosterers tell us—for more than that, we have to learn the folk-wisdom and learn from what we see." She applied ointment to Mutende's fingers and opened his hand. "This isn't a nganga's hand," she said, surprised. "It's known work."

"I had a mechanic's fostering."

A sudden interest came into her eyes, as if she saw him for the first time as something other than a case. "You're a mechanic?"

"I learned the craft and I took the oath."

"You need to come with me, then," she said. "There's something I want you to see."


The umulaye's house was on the axial road that led along the lagoon and out of the city. Where she lived, the buildings were a single story, and the houses were surrounded by small gardens and guinea-fowl. It was still the city—buses floated past, taking people to work in the factories—but it was shading into farms, and from here, the ancient towers of the city center loomed like standing stones.

She shooed aside a couple of guinea-hens and led Mutende through the door. Like Mapalo, Lelato had two rooms, and she lived in one of them: in the other were shelves of instruments, compounds, books, an examination table, even an ancient computer that ran on a generator. Instinctively, he knew that this was not typical for an umulaye, most of whom carried their tools with them on the street, and when she pointed him to what lay on the table, he was certain.

It was the merest sliver of metal—no, of several metals. It was no more than a millimeter long and half as wide, but he could see that it had been finely machined: its surface was a maze of etched circuits, barely visible components and closely fitted parts. It was dizzyingly complex for an object of its size, and its complexity seemed to continue at a level below the visible.

"Have you seen one of these before?" Lelato asked.

"No. What is it—a machine?"

"It makes machines. It makes them smaller than we can see—smaller than a cell, smaller than a virus."

"Is this another thing you found on Chama?"

"I only learned of it here. They made these in the days of the Union, and we're only just learning how to make them again. We're starting to use them in industry—for very fine etching, to clean impurities, to increase surface strength. But in the Union, and in the Commonwealth and the Accord, they used them for medicine."

Mutende stared at the sliver for a long moment, trying to imagine how a long-ago nganga might have used it. "If it can clean impurities in metal," he said at last, "can it clean them in a human body?"

"The books don't say—certainly, there was nothing in the library on Chama. But I think they can. One of those can make millions of machines a ten-thousandth of a millimeter across, and release them into the blood to clean infections. More than that, it can send machines to all parts of the body to find out what's wrong. Machines for luwuko, machines for uganga—orishas in a bottle."

The possibilities seemed boundless, and Mutende's mind raced as he tried to imagine all the things such machines might do. "Have you tried it on Mapalo," he asked, "or on others with the fever? Have you tried to look in there to see how the pathogens have evolved, why the attacks keep returning?"

The umulaye laughed. "You're saying all the things I said when I first learned of these things. But that tool on the table—it's designed to make etching machines. I can't change it so it will make healing machines—I don't have the tools and I don't have the skill. But you, with a mechanic's fostering . . ."

"Do you know what I would have to do?"

"I think so. For something simple. But do you have the tools?"

That question was an easy one. "There is a machine the inganga use for fine surgery. Yes, it can do that work. We can go there today."

They did, and none challenged their right. As a musambilila, Mutende was entitled to use the school's facilities. If he brought someone with him, that was no business but his own, and if she were an umulaye, no one had to know.

They laid the sliver on the operating table, a speck in its vastness, and Mutende looked at the two images before him: the camera that showed how the machine looked now, and the schematic showing what it would have to become. It was a finer surgery than the one he'd done on the child, and would have been even if he hadn't still ached in the places where he'd taken blows last night. The surgery had only been a matter of cutting away: here, he had to cut and shape and replace. He replaced the tools on the machine-arm with successively smaller ones, and he set its movements finer and finer, rearranging circuits, resetting switches and machining parts that were too small to see. Day had turned to night, and night again almost to dawn, before he was finished.

"We'll take it home now," Lelato said, "and see if it accepts data."

"On the ichiyawafu-fever?"

"No, I'm afraid. It will have to be a blunt instrument: something that knows what healthy cells are made of and attacks everything else. I can't be certain of anything more—not with an etching-tool to start with, and not with computers and medical books in the state they are."

Mutende, halfway down a staircase, turned and looked back. "That's dangerous."

"Yes. If Mapalo wouldn't be dead in a week anyway, I'd never give this to her. Even so, the choice has to be hers."

Even the exhaustion of surgery was as nothing compared to hearing Mapalo's death sentence pronounced. "Then we will offer it to her," Mutende said. "It was made here, in a place sacred to Eyinle. Maybe it will bring her under his care."


"Will it protect me from the imfwiti?" asked Mapalo when Lelato was finished. The umulaye had carefully explained what she planned to do and what risk it carried, and Mapalo, nobody's fool, had understood, but she was from the Kabwe country and there was one more thing she wanted to know.

"It will help ward off the imfwiti within your body," Lelato answered. Mutende waited for his landlady to rebuke the street-doctor for saying such an absurd thing, but she nodded instead, and he remembered a north-country story she'd told him once. The peasants in her province told of witches who could make themselves any size, and who might lodge themselves in a victim's heart and use her very blood to make their magic. There were stories like that among the awantu as well—awantu who, it was rumored, had once been human—and she'd no doubt heard them from Kaweme. She nodded again, satisfied.

"But if it goes wrong, it might also attack that which gives life," Mutende warned—always one more warning.

"If it takes my life, it will do no more than the fever."

"Then sit back, mbuya." Mutende held Mapalo's arm while the umulaye held the needle. It was full of sterile fluid with the sliver inside, and when Lelato pushed it in, the machine went with it. The tool Mutende had remade was in Mapalo's veins, to make medicine from her very blood.

He had class that day in the room that had once been refrigerator and storage-closet: another session with the Book of Maladies, another lesson in diagnosis and remedy. He half-expected that the mukalamba would call him out in front of the class and expel him for fighting or sacrilege, but that didn't happen. Lesson followed lesson—biology, surgery, study of the body systems, hours in the clinics assisting the inganga with their work—and if anyone thought that Mutende's conduct was unbecoming a musambilila, they didn't say.

On the fourth day, he noticed that his landlady's condition had begun to improve. Her lesions were clearing and she breathed easier, and she could sit and then stand without discomfort. On the ninth day, he heard her singing Kabwe-country songs while she fixed a drain, and that night, she sat outside with two of the market-women and shared an earthen pitcher of imbote.

In his hours at the clinics and the luwuko-rooms, he took notes, comparing Mapalo's improvement to that of others who responded to treatment for ichiyawafu-fever. It seemed, day by day, that the sickness was leaving her body. On the eighteenth day, he and Lelato took her to the Mwata's Gardens for the first time since she was a child, and almost every evening now, she dragged a chair out to the street and talked and sang.

On the thirty-second day, she died.

It was a fever—not the ichiyawafu-fever, but the Orange Sickness that had been brought to Chambishi Port from the far western islands. Mapalo fell ill from it in the morning, and she seemed to have no resistance: it burned through her, growing worse by the hour, and all his remedies and Lelato's only slowed it down.

"It doesn't do this to other people," he said as he and the umulaye kept watch at Mapalo's bedside. She had passed from delirium into sleep; her breathing was shallow and her appearance deceptively peaceful. "It doesn't go this fast. In the Book of Maladies . . . there's time for the body to fight, for medicines to work."

Lelato was silent for a long time, and Mutende wondered if she'd heard. "I took samples of her urine and stool," she said finally. "I wanted to know which cells our nanomachines were cleaning from her body. And the cells she was passing—they're the ones that make her immune. That's where the infection was, and when the sick cells were cleaned, they left her with nothing to fight new fevers. I thought her body would make new ones, and maybe in time it would have, but . . ." She seemed on the verge of tears, and it took her four tries before she could say another word. "There's so much we don't know."

Neither she nor Mutende said another word that night: they watched Mapalo in silence, and three hours later, death claimed her. Lelato rose from her chair and Mutende heard a door open and close: soon after, the death-drums started beating.


The nyinachimbela came at dawn, the old woman who was queen of the women's burial society. She and Lelato and three of the market-women washed Mapalo's body, put strings of beads around her waist and neck and arms, folded her so that her hands were on her shoulders and her knees against her chest, and shrouded her in white imbafuta-cloth. Mutende did none of this: preparing a woman to be buried was women's work. But he was one of those who carried her to the burial ground, and he joined the awenamilenda, the men's burial society, in digging the grave and laying her down with her face to the east. And he was one of those who knelt, his hands in the cool earth, and pushed the dirt back into the grave to cover her.

That evening, after everyone had bathed in the lagoon, there was the wake: the ritual of singing and drinking and dancing. The market-women of Mapalo's street were there; her tenants and neighbors came as well, and an elder of the Hornbill clan. And there was one other: when Mutende dipped his cup into the keg of shake-shake beer, he looked up to see his mukalamba.

"Do you see now," said the professor, "how foolish it is to seek new knowledge without a foundation?"

"You watched," Mutende said.

"We watched, as we watched others before you. Your uganga failed."

Mutende, suddenly combative, looked the teacher in the eye. "She lived longer than she would have done without our uganga, and she had a better death."

"But still it failed." The mukalamba held Mutende's gaze with his own until, slowly, the younger man agreed.

"Learning needs a foundation," he conceded. "But trying and failing is the only way to build one." He realized suddenly what he'd wanted to say the month before when the professor had warned him against trying to surpass the ancestors. "We can't wait until we know everything the Union knew before we learn more. We must build our own foundation even if it's a different one from what they had."

The mukambala held his gaze steady again. "Even after your patient died, you say this?"

"How many patients have died because we didn't dare?"

The teacher clapped once, but it was only an acknowledgment, not an affirmation. "If that is your decision, you must make it as an umulaye, because you will never be a nganga."

He was silent, and Mutende realized he was being allowed a final chance. But if the mukalamba was expecting a recantation or a plea, one did not come.

"My choice is made," Mutende said.

He took his cup and wandered past one of the upstairs families singing a funeral song—wulukoshi wakawalila mwana, the eagle has carried off my child. Lelato was there, listening, and he told her.

"You want an umulaye's fostering, at your age?" she asked.

"I've had a fostering already. I am what I am—a sworn mechanic and a forsworn musambilila."

"I told you that awamulaye are jealous of our cures—what makes you think I'd want to share with you?"

"You already have. And if we're jealous of what we know, we'll never build the foundation."

"Yes," she said. They were silent, listening to the funeral chants and watching the dancing begin. "You know that Mapalo left her house to you and me . . ."

"No, I didn't know," he said, surprised.

"We cared for her, and her children have gone to the ship-clans. The Hornbills will have a claim, but we can pay them some of the rents."

He thought about it for a moment. "And she thought that if she showed us favor, the neighbors wouldn't think that we were the imfwiti who killed her?"

"Some of them may suspect that anyway. That's one thing you need to get used to if you follow the umulaye's path—a street-doctor who fails can be taken for a witch. But I was thinking that if you don't want her rooms, we can turn them into a school."

"A school for awamulaye?" The idea was startling, but it took only a second to seem natural. "Her rooms are small . . ."

Lelato spread her hands wide to take in the city, and said, "There will be time to grow."

Do No Harm by Stephen Hamilton




Jonathan Edelstein is 44, married with cat, and living in New York City. When he's not writing stories, he practices law, and hopes someday to get it right.

Stephen Hamilton is a Boston-based painter, illustrator, and art educator. His work focuses on the aesthetics and philosophies inherent throughout Africa and the Diaspora, and he strives to create a dialogue between contemporary black cultures and the ancient African world. More of his art and mission can be found on his Tumblr.
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