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But it was late in the afternoon, and a film of clouds had formed across the sun. In the time it would take him to buy milk and ice and then mix the ice cream, the children would no longer be so eager. Best to wait until tomorrow. He tied down the contents of his cart and began his slow trudge up the street, head bowed, watching his own feet as they moved, black shapes against a field of gray.

      It would’ve come as a great shock to his neighbors to know that the man they called Ice Cream Saleh, or Crazy Mahmoud, or simply that strange Muslim who sells ice cream, had once been Doctor Mahmoud Saleh, one of the most respected physicians in the city of Homs. The son of a successful merchant, Saleh had grown up in comfort, free to pursue his studies and then his profession. In school, his excellent marks won him entrance to the medical university in Cairo, where it seemed the entire field was transforming as he watched. An Englishman had discovered that one could avoid postsurgical gangrene simply by dipping the surgical instruments into a solution of carbolic acid. Another Englishman soon established an irrefutable link between cholera and unsanitary drinking water. Saleh’s father, who’d heartily supported his studies, grew angry when he learned that in Cairo his own son was dissecting corpses: did Mahmoud not understand that on the Day of Judgment these desecrated men would be resurrected unwhole, their bodies opened and organs exposed? His son drily replied that if God was so literal in his resurrections, humanity would be brought back in a state of decay so advanced that the marks of dissection would seem minor in comparison. In truth he’d had his qualms as well, but pride kept him from saying so.

      After completing his studies, Saleh returned to Homs and established a practice. His patients’ living conditions continually dismayed him. Even the most affluent families had little notion of modern hygiene. Sickrooms were kept closed, the air poor and stifling; he flung open the windows, ignoring the protests. Sometimes he even encountered a patient who’d been burned on the arm or chest, a thoroughly discredited practice meant to draw out ill humors. He would dress the wound and then berate the family, describing to them the dangers of infection and sepsis.

      Though sometimes it seemed he waged an impossible battle, Doctor Saleh’s life was not without its joys. His mother’s half-sister approached him regarding her daughter, whom he’d watched mature into a young woman of beauty and gentle character. They were married, and soon they had their own daughter, a darling girl who would stand her little feet on Saleh’s and make him walk her about the courtyard, roaring like a lion. Even when his father died, and was lowered into the grave next to his mother, Saleh took comfort in knowing that the man had been proud of him, despite their differences.

      And so it went, the years passing quickly, until one evening, a wealthy landowner came to the door. He told Saleh that the Bedouin family who tended his lands had a sick girl. Instead of a doctor, they’d brought in an old healer woman without a tooth in her head, who was using the most outlandish of folk remedies to try to cure her. The man couldn’t stand to see the child suffer and said that if Saleh agreed to examine her, he would pay the fee himself.

      The Bedouin family lived in a hut at the edge of the city, where the carefully tended farmland gave over to scrub and dust. The girl’s mother met Saleh at the door. She was dressed heavily in black, her cheeks and chin tattooed in the style of her people. “It is an ifrit,” she said. “It needs to be cast out.”

      Saleh replied that what the girl needed was a proper medical examination. He told her to fetch him a pot of boiled water, and went into the hut.

      The girl was in convulsions. The healer woman had scattered handfuls of herbs about the room and now sat cross-legged next to the girl, muttering to herself. Ignoring her, Saleh tried to hold the girl down long enough to peel back one of her eyelids—and succeeded just as the old woman finished her incantation and spat three times upon the ground.

      For a moment, he thought he saw something in the girl’s eye leaping toward him—

       And then the thing was inside his head, scrabbling to get out—

      Unbearable pain seared through his mind. All went dark.

      When Saleh came to, there was foam on his lips and a leather strap in his mouth. He gagged and spat it out. “To keep you from biting off your tongue,” he heard the healer say, in a voice that sounded hollow and distant. He opened his eyes—and saw kneeling above him a woman whose face was thin and insubstantial as onionskin, with gaping holes where her eyes should have been. He screamed, turned his head, and vomited.

      The landowner fetched one of Saleh’s colleagues. Together they loaded the half-conscious man into a cart and took him back home, where the doctor could conduct a thorough examination. The evidence was inconclusive: perhaps a bleeding in the brain, or a latent condition that had somehow been triggered. There was no way to be certain.

      From then on, it was as though Saleh had stepped away from the world. An unreality permeated all his senses. His eye could no longer measure distances: he would reach for something and it would be nowhere near his grasp. His hands shook, and he couldn’t properly hold his instruments. Occasionally a fit would overtake him, and he would fall down and froth at the mouth. Worst of all, he could no longer look at a human face, be it man’s or woman’s, stranger or beloved, without succumbing to nauseated terror.

      Weeks and months passed. He tried to return to medicine, listening to complaints and making simple diagnoses. But he couldn’t disguise his malady, and his remaining patients disappeared. The family adapted a more frugal lifestyle, but within months, their savings were gone. Their clothes grew shabbier and the house fell into disrepair. Saleh spent his days alone in a shaded room, trying to consult medical texts he could barely read, searching for an explanation.

      His wife became ill. She tried to hide it at first but then turned feverish. Saleh sat by helplessly as his former colleagues offered their aid. Still she worsened. One night, burning and delirious, she mistook Saleh for her long-dead father and begged him for ice cream. What could he do? There was a churn sitting in a cupboard, purchased during more extravagant days. He rolled it into the kitchen and washed the dirt and dust away. His daughter’s chickens had laid that morning. Sugar they still had, as well as salt and ice, and milk from a neighbor’s goat. Laboriously he set out the supplies, moving slowly lest he fumble and spill. He smashed the ice with a hammer, then beat together the eggs and sugar and goat’s milk. He added the ice and rock salt, and packed the mixture around the inside of the churn. He wondered, when had he learned this? Certainly he’d watched his wife make ice cream, as a treat for their daughter and her friends, but he’d never paid any particular attention. Now it was as though he’d done it all his life. He fixed the lid on the churn and turned the crank around and around. It felt good to work. The mixture began to stiffen. A clean sweat broke on his forehead and in his armpits. He stopped when it felt right to do so.

      He returned to the bedroom with a small dish of ice cream and found that his wife had descended into chills. He set the dish aside and held her shaking hand. She did not return to consciousness, and died as dawn was breaking. Saleh hadn’t recognized the beginnings of the death throes, and thus hadn’t been quick enough to wake their daughter to say good-bye.

      The next afternoon, Saleh sat alone in the kitchen as his wife’s sisters prepared her body. Someone came in and knelt next to him. It was his daughter. She wrapped her arms around him. He closed his eyes so that he could remember how he used to see her, her dark hair and bright eyes, the sweet freckles on her cheek. Then she noticed the churn.

      “Father,” she said, “who made the ice cream?”

      “I did,” he said. “For your mother.”

      She did not remark on the strangeness of this, only dipped two fingers inside the churn, then brought them to her mouth. Her red-rimmed eyes blinked in surprise.

      “It’s very good,” she said.

      After that, there was little question as to his path. He needed to support himself and his daughter. The house was sold, and his wife’s brother’s family took them in; but they were not wealthy people, and Saleh had no wish to strain their charity. And so, with a white cloth wrapped around his head to keep away the sun, Doctor Mahmoud became Ice Cream Saleh. Soon he was a common sight in the streets of Homs,

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