A Retired Physician Explores the Medicine and Politics of Ancient Rome

The Kirkus review of Cy Stein’s latest book, Caligula and I, calls the book’s depictions of Roman-era medicine “gory,” but that’s not a criticism. The review also goes on to call the book “a gripping, multifaceted story of an emperor and his era.” Stein thinks the reviewer got it just right. “It is gory, because it was gory and continued to be gory until the 19th century when anesthetics were first developed,” he says. 

Caligula and I is the story of the Roman emperor Caligula and his childhood companion, Publius Decimus Silvanus, a medicus, or doctor. Gaius Romulus Saccius, a later medicus, unravels the emperor’s story when he discovers a set of scrolls Silvanus left behind.

Stein himself is a physician, now retired, and he says his medical experience has allowed him to bring an authentic voice to his fiction. “There are scenes where I used what I’ve gleaned from being in this business for almost forty years,” he says. But Stein knows that Silvanus’ medical practice has little in common with his. “The Romans, given the tools that they had, did an incredible job of handling certain problems, particularly military medicine,” he says. “But in terms of internal medicine, [they] were usually worse than useless.”

Roman medicine, for Stein, is a historical curiosity best left to the past or to fiction, like this treatment for fever featured in the book:

“Does the patient have a dry tongue?”

“I believe so, doctor.”

“Then mix rose oil with honey and coat his tongue with it. For his shaking chills, force him to vomit. Then proceed with an enema. The chills arise from something bilious oppressing the stomach. But if this treatment fails, let him eat garlic and drink hot water with pepper. Both raise his internal heat, which will repel the chills.”

It’s a past that Stein is well acquainted with, though, courtesy of an enduring interest in Rome that goes back to his childhood. “I remember reading the story of Antony and Cleopatra,” he says. “I just thought it was the coolest stuff I’d ever read. Of course, by that time I hadn’t read much.” And he recalls an elementary school dispute with a classmate over Julius Caesar’s date of birth. Thanks to his already-extensive reading about the Roman Empire, young Stein was convinced that his classmate was in the wrong. As an adult, he learned that the history was a bit more complicated: “Turns out nobody really knows when Julius Caesar was born, so we were both right.”

Stein’s passion for Rome continued into adulthood—“I read all of Gibbon, all three thousand pages”—and he enjoyed learning about the broader context as well as names and dates. “I was always very interested, for some reason, in the fall of the Roman Empire, how a huge civilization managed to collapse completely.” He sees resonances between the Roman Empire and the present day, and in addition to reimagining primitive medical techniques, Stein sees Caligula and I as a topical exploration of interpersonal relations. “It’s about how an individual is stuck dealing with a malignant narcissist when he has no choice,” he says.

About a decade ago, Stein began devoting more of his time to writing thanks to a new job that took him across the country. When he became the Chair of Oncology at City of Hope, a Southern California hospital, his wife joined him but made frequent visits back to their East Coast home. “When she would travel back to New York, I had really not too much to do, and I just sat down and started to write,” he says. “I have this interest in writing, I have this interest in the Roman Empire. So let’s come up with some stories.”

He spent several years honing his craft—his unpublished “practice book,” he says, “will never see the light of day”—before publishing his first book, The Medicus Codex, in 2016. He describes himself as a largely self-taught writer with his last formal writing class dating back to his high school years. Instead, he learned through practice, through sharing his work with trusted critics, and through a serious and thoughtful embrace of their assessments. “I learned how to make a lot of mistakes, and I learned how to take very seriously people’s criticisms when [they] were well meant,” he says. “I learned a lot from just going back and reading my own stuff and developing my own style.”

Caligula and I is the second book in Stein’s Vox Populi trilogy, following The Medicus Codex. “They’re prequel and sequel to each other, but they stand as independent books,” he says, written as distinct stories with characters who appear in both books. The trilogy’s third volume is in the works now, and Stein says it will tell the story of Marco, Gaius Romulus’ nephew. “He’s a very important person at the Mint, and the Mint gets in quite a bit of trouble in third-century Rome.” 

The medicus Gaius Romulus is not, Stein wants everyone to know, meant to be a stand-in for the physician/author. “A lot of people have said to me, ‘Oh, Gaius Romulus—that’s you!’ That’s not true….Gaius Romulus works under a whole bunch of different constraints than I work under.” Stein says that of all the characters he has created, he has the most in common with Benny Peskin, the protagonist of A Time for Lies, the book he is working on now. The second volume in Stein’s other historical fiction series, the book is set in the McCarthy era, allowing Stein to continue his exploration of authoritarians throughout history.

When Stein isn’t writing, he’s either spending time with his family, which includes two daughters and four grandchildren, or reading. He has always considered reading for pleasure essential, even at the busiest times of his career. “Every day, no matter what I was doing, I read a little,” he says, and he has tracked his habits in a reading journal he began in 1973. By now it includes more than a thousand titles from a wide variety of genres. History is one of his favorite topics, he says, but “I read anything, as long as it’s not garbage. I won’t read garbage.”

Sarah Rettger is a writer and bookseller in Massachusetts.