“Vittoria! Vittoria!” The woman shakes free of Nico’s arm and hurls herself at the window. She pounds on the glass until two nurses have to forcibly peel her away.

The patient’s back arches, lifting her whole body off the stretcher except her head and her heels, as if she is trying to levitate. She holds the unnatural pose for what seems like ages but then collapses, motionless.

But it’s not a good kind of still. Alana knows that even before the blood begins to seep from Vittoria’s nose and eyes.

Chapter

Four

Today marks the twenty-third day of January, in the year of our Lord thirteen hundred and forty-eight.

I, Rafael Pasqua, son of Domenico, was born here in Genova in the year thirteen hundred and eleven. I will most assuredly die here.

Never before have I committed my memories to parchment, but I am compelled to do so now. Forgive me, I am not a man of letters. I am a barber-surgeon, not one of the learned physicians educated at university. However, I was most fortunate to apprentice under the great Antonio Calvi, who practiced our craft in a way few will match and fewer still will ever surpass.

Today, I buried my beloved wife, Camilla. How my hand trembles as I write her name. She was twenty-nine years old, and as beautiful as a spring lilac. I can yet hear her voice. I could fill her grave with my tears.

In this terrible void, I am comforted, however, by one thought. What Camilla and I once viewed a curse, that she could never bear us a child, has amounted to a small blessing. She died, as I will, without ever knowing the pain of having to bury one’s own child. Would that I could say the same for so many others in Genova. Oberto, the keeper of the local tavern, has already buried two sons and four daughters. I tended Oberto’s wife in her final hours, and I am of the belief that she died not of the pestilence, but of a broken heart.

Such was not the case for Camilla. She went to bed in vigorous health and woke up suffocating in her own phlegm. Another among countless victims of the chest plague.

I dug Camilla’s grave today with the aid of my colleague, Jacob ben Moses. Unlike so many other physicians, Jacob has never looked down his nose at my craft. Together we have formed a partnership of sorts. By law, he is only allowed to tend to fellow Jews, but I turn to him for his advice in circumstances when I am most perplexed. In return, I perform surgery on his patients when they require it. Jacob is well past sixty years but he continues to work as hard as any man in Genova. And today I learned that the old Jew has a remarkably strong back for a man of such advanced years.

Why, you may wonder, would two men who have dedicated their lives to the study of medicine be digging a grave with their own hands? Absurd as it may seem, I cannot afford the price of a gravedigger. Besides, blessed is the man who could find a gravedigger still alive and not frightened to take on the work.