Outside the abbey’s main gate, Rob waited in the rain for Zev to arrive. His cousin was late, which wasn’t even within shouting distance of the unexpected, but Rob still felt annoyed—partly from waiting for Zev in lousy weather, and partly because after a hectic day, he found himself with too much time to think.

That afternoon, one of his students had asked Rob and the rest of the class for guidance regarding a toddler with bowed legs and frequent bone breaks. The boy was the seventh child of an impoverished family, and even in flush times they didn’t have much food. 

After ruling out child abuse—the parents didn’t drink any more than was typical, and the injuries centered on the legs instead of arms and skull—Rob suggested the boy was suffering from severe malnutrition. He needed proper food, including a reliable calcium source, if his body was to ever mature properly. 

The student was happy to have something concrete to tell the family, the class was excited to learn a new medical term, and Rob was left to worry about the welfare of his unborn child.

Even if life here wasn’t a safety committee nightmare, with axes and alcohol mixing freely with child labor and open flames, there were still dozens of ways a child might die. Rob couldn’t help ticking them off while waiting in the rain: Birth complications. Untreated infections. Measles, mumps, scarlet fever. 

Hell, the flu could kill someone with a still-developing immune system if they hadn’t been vaccinated.

And there were no vaccinations here. There were no booster seats for carriages or corner bumpers for workbenches or child safety locks to keep youngsters from falling through an outhouse’s splintery seat. Kids died all the time here, and while the parents certainly grieved, it was just the way things were. Which scared the shit out of Rob.

Yesterday, he hadn’t been able to comprehend becoming a father. Today, he didn’t think he could face losing a child.

“Hey,” Zev said, arriving just as the skies began to clear. “Sorry I’m late. Service at the Chinese restaurant took for-fucking ever.”

“Hilarious.”

“I know, right? You’d think we were way past the lunch rush. Dude, everything all right? You’ve got that wavy thing going on around your eyes.”

Rob shook his head, hoping to shake off his dark thoughts as well. “Just remembering some stuff we talked about in class.”

“Spare me the gory details, okay? Let’s roll.”

After a few minutes of silent walking, Rob turned to Zev. “Did you say Chinese restaurant?”

Zev winked at a pretty girl passing by. “More of a noodle house, really. You haven’t tried them? Not as spicy as I’d like, and they don’t give you nearly enough dumplings to justify the price, but what are you going to do around here.”

“Are you joking?”

“Dude, like, for realsies.”

“You just ate Chinese food.”

“Yeah, I couldn’t get through the line at that new taco truck.”

“Now you’re joking.”

“Maybe a little, but only because you’re so easy to wind up. Now, where are we headed?”

“To see about a pair of shoes,” Rob said.

The Shoemaker straddled a workbench, carefully sewing the leather top of a shoe onto its slightly thicker sole. He greeted Rob and Zev by jabbing a finger in the air as if to say, ‘one moment, please,’ while a boy of not more than 10 years old stood by the Shoemaker in silent attendance. The child didn’t so much as look Rob’s way, but remained focused on the Shoemaker’s hands.

Without books, schools, or YouTube, this was how children learned a trade—by watching and memorizing, watching and memorizing, until they’d absorbed everything a craftsman knew how to do. 

At first, Rob had been astounded at the prodigious memories of the illiterate people he met, but he quickly came to realize that those who weren’t able to memorize the mechanics of their profession would likely starve to death. And death was a powerful motivator.

“Zev, isn’t this leather smell just—” Rob started to say until he noticed that Zev had plunged his nose into one of the slipper-like shoes that filled the shop.

“Dude,” Zev exhaled as he put down the shoe. “That’s better than a bong hit. Well, not better, but different. Yo, you think they have weed here? That could bring in some cash.”

“Will you stop it?” Rob said. “I’m working right now. And you are, too, remember?”

“Yeah, yeah. P.A. Physician’s assistant. Your personal gofer.”

“It’s more than that. Hans covers the business side of my practice, but a lot of times I need help with patients, either during visits or with follow-ups. And Hans isn’t really . . .”

“A people person,” Zev finished.

“A people person, yes.”

“I still feel like a gofer.”

“Look, do you want this job or not?”

“Yes. I need it, don’t I? Look, I’m going to browse until this dude’s ready for us. You think there’s different sections for men and women? I’d hate to be poking around the lady merch by mistake.”

Rob glanced at the shoes lined up in the shop. There were slip-on moccasins and shoes whose split tops rose above the ankles. Some footwear had ‘belts’ that ran around the ankles instead of laces, and a few pairs boasted silver buckles to secure them to their owners’ feet. 

None of the shoes showed even the hint of a heel, and Rob guessed that arch support remained centuries away.

A handful of shoes sitting on a high shelf behind the Shoemaker’s work bench featured lace, embroidery and even patterns stamped into the leather. One pair of fancy footwear caught Rob’s eye; they were dyed black with a long, pointed toe, and the laces had been tipped with silver.

“I don’t think any of these are big enough for me,” Zev said, holding shoe after shoe up against his size 13 soccer flats.

“Let’s be professional, please,” Rob said as the Shoemaker rose from his bench, stretching out his curved spine and shaking his cramped hands. In this pre-ergonomic age, Rob found widespread chronic pain and repetitive stress injuries among craftsmen, and he could almost guess how long a person had worked at their trade by the amount of time it took them to unfurl themselves from their work posture.

“Son, go find your grandfather,” the Shoemaker said, and the boy scampered through a door into the back of the house. “Doctor, thank you for coming. My father hasn’t been himself in . . . I couldn’t even say how long.”

“Weeks?” Rob asked. “Months?”

“Months, but the changes came on gradually, so it’s hard to say when they began. He’s forgetful and angry. He’s stopped leaving the house, and he claims not to recognize me. And the elves! Always with the elves. I know these things can happen as a man ages, but it’s been hard to witness his decline.”

The Shoemaker touched his hand to his cheek before continuing. “He was always such a strong, capable man, and now—wait, here he comes.”

From the back room, the boy carefully led an elderly man into the shop. The man shuffled over to where the Shoemaker’s tools and unfinished shoe still lay, and dropped his withered, hunched figure onto the work bench.

Rob unslung his doctor’s bag from his shoulder before sitting down beside the old man. “Hello, sir. I’m Dr. Lang.”

“The elves have been back,” the old man rasped in a voice barely louder than a whisper. “More shoes today. The elves have been back.”

“Papa, no,” the Shoemaker said, placing his hand on his elderly father’s shoulder. “There are no elves. I made the shoes.”

“No. I am the shoemaker,” the old man said. “I didn’t make these shoes. Elves! Elves make them.”

“Papa.”

“Elves!”

“There are no elves, Papa.”

“Why do you call me Papa? You’re not my son. You’re old. You have whiskers. That boy, there, he must be my son.”

“No, Papa, he’s your grandson. I’m your son, and you’re my father. I’ve told you this before. You must work harder to remember.” The Shoemaker’s voice was rising in volume, and Rob didn’t need to be a social worker to see that the man was at the end of his rope.

“Zev,” Rob said, digging into his jeans pocket. “Here’s some money. Why don’t you and this young fellow go buy some honey cakes for us to share? Take your time.”

“You got it, boss,” Zev said. “Come on, little dude.”

The boy’s nervousness at going off with a stranger was quickly overcome by the prospect of free honey cakes, and after a nod from the Shoemaker, he zoomed out the door with Zev hot on his heels.

“For now,” Rob said to the Shoemaker once Zev and the boy had gone, “let’s not worry about your father not recognizing you.”

“But the elves—”

“Let’s not worry about them, either. All right?”

The Shoemaker clasped his hands across his well-fed belly, holding it tenderly. “I won’t interfere.”

“Don’t go away. I’ll need you in a minute.” Rob turned his attention to the old man. His cheeks were sunken, and even in the sunlight, his face appeared grey. “Can you tell me your name?”

“No,” he said in his hoarse whisper. “I can, but I won’t.”

“What about the date,” Rob continued in his gentlest voice. “Can you tell me what day it is today?”

“Don’t you know? Why are you asking?”

“I want to hear your answer.”

“Do you know how to make shoes? I bet you can’t make shoes.”

“Papa,” the Shoemaker pleaded, but Rob held up a hand for quiet.

Rob returned to his questions. “Do you know where you are?”

The old man nodded quickly. “My workshop.”

“And do you know this man?” Rob said, pointing to the Shoemaker.

The old man’s cloudy eyes flicked to the Shoemaker and then back to Rob. “He’s a robber. He’s stealing from me.”

“Okay,” Rob said. “Do you mind if I hold your hand? Perfect.” The man’s hand felt cold, suggesting poor circulation, and his skin looked brittle, like wax paper. A dime-sized sore on his wrist oozed clear pus, and Rob guessed he’d find more on his shins and ankles. His skin had become so delicate that even simple bruises were refusing to heal.

But Rob knew that wasn’t why he was here. The man was delusional, perhaps a bit paranoid, and almost certainly depressed. Given his age and history of symptoms with extended onset, Rob felt comfortable diagnosing him with dementia, possibly Alzheimer’s, but that distinction seemed far less important than the question of whether he could do anything for his patient. 

The first step in that process, Rob decided, was to help the patient’s son.

“Let’s talk,” Rob said to the Shoemaker, getting up and leading him to the fireplace. The old man remained on the bench, turning scraps of leather over in his hands as if he knew he should be able to make something out of them but couldn’t quite remember how.

“Your father is suffering from dementia,” Rob said quietly, partly so the old man couldn’t hear, and partly to soften the blow. “The forgetfulness, irritability, fear—it’s all part and parcel, I’m afraid.”

“Friends said we might take him to church, to see a priest.”

Rob shook his head. “The priest might lend some comfort to your family, but there isn’t anything he can do for your father. In fact, there isn’t anything I can do, except try to make him comfortable.”

“Perhaps a course of bleeding—”

“No bleeding,” Rob said. “Even if I thought it might help, his skin is too fragile. I saw a sore on his wrist. Does he have others on his body, perhaps near his feet or hips? I should have him disrobe so I can properly examine him.”

“He doesn’t like having his clothes taken away from him.” The Shoemaker bit his lip in an attempt at stoicism, but tears welled in his reddening eyes. “I know I should be satisfied that he’s lived this long, yet every day it becomes harder to let him go.”

Rob nodded in sympathy. “Your father has a little more time. I can’t say how much longer he’ll be with you, but in the meantime, it’s important to keep him fed and feeling safe. And if he says that elves are making shoes? Don’t argue. You’re never going to win that battle.”

“He knows, though. Sometimes I can see it in him. He knows!”

“If he did, he doesn’t anymore. No amount of logic or encouragement is going to bring your father back to what he once was. I’m sorry.”

The shoemaker wiped his eyes. “He’s dead already, isn’t he?”

Rob sighed as much for himself as for the Shoemaker. He hated these end-of-life talks with family members, mostly because they made him feel like he was giving up on his patient, or that the simple act of acknowledging a person’s mortality might somehow hasten their end. 

He’d rather spend 15 hours in the O.R. attempting to excise a difficult tumor than 15 minutes explaining to a family why their loved one wasn’t likely to survive the night. Yet somebody had to do it. From Rob’s experience, the only thing worse for family members than hearing bad news was being kept in the dark about bad news.

“Your father may be lost to the present,” Rob said. “And he may never recognize you again. But you might be able to get him to talk about the past. People with dementia sometimes retain older memories until the very end. See if he’ll tell you stories about his childhood, or from when you were a boy. It’s not much, I know. But I hope it’s something for you two to share before he’s gone.”

“Yes,” the Shoemaker said, wiping his nose with a sleeve. “We can do that. Can you come back again? My wife will be here, and she and I can help you disrobe my father. To examine him.”

“That’s fine. And either my P.A. or I will bring some lotion or ointment for his sores.” Rob wasn’t sure where he might find these things, as the nearest drugstore was several hundred years away, but now that he’d said it, perhaps he and Hans could come up with something.

Just then, Zev banged in through the door, the boy trailing happily behind him. Both their mouths were littered with crumbs. Rob and the Shoemaker jumped, startled by Zev’s explosive entrance, while the old man remained unmoving on the work bench, lost inside himself.

“We’re back,” Zev announced. “But we ate all the honey cakes. Warm out of the oven, you know? Only human, dudes.”

“Don’t worry about it,” Rob said, and the Shoemaker turned away to dry the tears from his eyes.

“But we didn’t come completely empty-handed.” Zev stepped aside from the doorway to reveal a regal blonde with sharp green eyes and a full-lipped smile. She wore a racily tight tunic that had been dyed a brilliant yellow, along with a hat that rose above her head in a fashionable peak. “We brought you a customer, yo.”

“Shoemaker, Shoemaker,” the woman said, the words dripping languidly off her tongue. “I do have a weakness for shoes.”