First Do No Harm, by Jonathan Edelstein

(c) 2015 Stephen Hamilton "Do No Harm"

Strange Horizons, November 2015

In a far-future world, where there is interstellar travel and trade, but much knowledge has been lost, Mutende is a medical student. He's not of the usual background for a medical student; he did his fosterage as a mechanic--which however refers to a much techie field than what we would today call a "mechanic." He's poor compared to his fellow students, who are mostly minor aristocrats. Mutende rents rooms from an older woman who is a distant member of his own Hornbill clan, and he's also using his growing medical knowledge to treat her in her terminal illness. She has a slow but ultimately fatal disease, ichiawafu fever, that her late husband brought back from the stars. He passed it on to her before dying of it himself.

The problem is that the known treatments have never been a cure, and now are getting less and less effective even in relieving the symptoms.

And Mutende is being a difficult student. He's asking questions, asking if it really makes sense to do no original research while they are working to recover all the lost and buried knowledge from the more advanced civilization that fell many thousands of years ago.

Mutende works to learn all his teachers have to teach, though, and is frustrated to realize that his landlady is also seeing and getting treatment from an umulaye, a street doctor, dispensing traditional medications, herbs and roots and tisanes.

Then he meets the umulaye, Lelato. And they talk.

They both care mainly about helping the ill and the injured. The exchange of ideas can be dangerous.

This is a gentle, thoughtful story, with characters who live and breathe and feel. Edelstein's far-future, fallen and only partially recovered civilization is complex and interesting and lived-in. And the enemy here is ignorance and the loss of knowledge everyone is struggling against. If some of the choices seem clearly better to us than others, the other choices on how to fight that loss of knowledge are still grounded in positive motives and real concerns about the risks of the other path.

Highly recommended.