When I look at you, I don't see prisoners.
I don't see criminals or slaves.
I don't even see gladiators.
I see legionaries,
Dedicated to protecting this great empire.
Help me.
Help me to protect the citizens of rome,
And you will win your freedom!
caesar! Caesar! Caesar!
The colosseum is the roman empire
Distilled to its most basic essence.
It is a symbol of conquest.
It's a symbol of dominance.
It's a symbol of imperial power
Radiating throughout the roman world.
Now!
Any emperor had the colosseum at his disposal
To use as a tool to reassert his power and authority.
The message to the roman people
Is that life is a combat.
It was also a judicial warning.
Do not test the power of rome.
It was a death penalty offense.
If you live by the sword...
You die by the sword.
It demonstrates the power of the colosseum.
It made slaves into heroes,
It's all there--
The blood, the glory, the magnificence,
And the flaws that made rome the greatest empire
That europe has ever seen.
Narrator: 162 a.D.
Rome's golden age.
The empire of the mid-second century,
It's at its pinnacle, in terms of
Its territorial expanse and its wealth.
It's an empire that is leading the world
In science, in culture, in philosophy, and in medicine.
Rome is really the cultural center of the universe
In this moment.
Authors, doctors,
Architects, philosophers flock to the city
Because they are enticed by rome itself.
Narrator: Among those entranced by rome
Is galen of pergamon,
A brilliant medical scientist
Whose works are still studied today.
Galen is probably the single most influential figure
In the history of medicine.
He was an author, a philosopher,
A scientist, a doctor,
And an incredibly ambitious man.
His writings survive, which is true
For very, very few doctors from this period.
And we know that he's exceptionally skilled,
And he has an ego to match.
Narrator: Galen comes to the colosseum
To catch the eye of emperor marcus aurelius,
One of the empire's great minds.
Marcus aurelius comes at the tail end
Of the five good emperors.
These were the emperors who ruled
During what's known as the pax romana,
During the very height of the roman empire
In the second century a.D.
Marcus aurelius was an intellectual
And was very much engaged in philosophical reflection.
And in fact, his nickname
Is sometimes the philosopher king.
He was an extraordinary character.
He'd been chosen as a very young man
And trained to be emperor.
And for once, they got it absolutely right.
Narrator: But marcus aurelius does not rule alone.
For the first time in roman history,
Two emperors govern side by side.
Marcus aurelius's adopted brother, lucius verus,
They were almost opposites.
They reigned together perfectly
Because they were two sides of a coin.
There's no greater example of how absolute opposite
These men were as to their attitude
To the colosseum and to the games.
Someone like marcus, who was so intellectual,
So philosophical, for him,
The endless and pointless bloodshed made no sense.
Lucius, on the other hand, absolutely lives for it.
Yes, it's a vulgar sport,
It's a vulgar vice to have,
But he adores it.
Narrator: A surgeon like galen plays a crucial role
In keeping gladiators alive.
But he wants more.
Galen was such an ambitious and driven individual
That he wanted to become the world's greatest doctor.
He already thought of himself as such.
He just wanted people to acknowledge it.
Narrator: These two men in rome
At the height of the empire's powers
Will also be present at the start of its decline.
Galen's journey to this moment begins
Almost two decades earlier and 800 miles away
From the city of rome.
Galen's hometown
Is the ancient city of pergamon,
A greek hub near the coast of the aegean sea,
Now in western turkey.
Pergamon is one of the crown jewels
Of the eastern part of the roman empire.
It's a sophisticated city with lots of fine buildings,
Including a temple to asclepius,
The god of healing.
If you wanted to become a doctor,
Pergamon was a pretty good place to start.
Galen was extremely well-educated.
He had tutors,
First in philosophy and then in medicine.
He came from a family that was wealthy and cultured.
He was set up for success.
Narrator: In 157 a.D.,
Galen lands his first official medical role.
Galen gets an incredible opportunity,
Which is to become the doctor at a ludus,
At a gladiator school.
Gladiators, contrary to popular opinion,
Were not expendable commodities.
They were extremely valuable.
The amount of money
That went into these athletes,
Preserving them, making them famous,
Training them, was a huge cost to the school,
And they had to get a return on that cost.
Any way they could to preserve that gladiator,
They would have done, and that included
Getting fantastic medical care.
Narrator: Galen's appointment at the ludus
Follows years of unusual study.
There's a real turning point in galen's life.
His father passed away at the age of 19.
What he gained was a massive inheritance,
And he uses that inheritance
To go on sort of a learning pilgrimage.
He spends the next 10 years traveling,
And then eventually, he ends up in the city
That really makes him,
Which is the city of alexandria in egypt.
Alexandria was the one place in the ancient world
That had a tradition of human dissection.
Now, there was a very narrow window
Where that was practiced back in the ptolemaic era,
In the third century b.C.E.
However, the tradition and the knowledge continued.
Galen's knowledge, the ability to learn
From the works of physicians who had actually
Participated in dissection, gave him an opportunity
To understand the body unlike any other physician
At the time.
Narrator: Now galen applies
His unique knowledge of anatomy
To treat the gladiators in the school at pergamon.
Gladiators would give a young physician
A lot of opportunities to practice.
You're talking about a lot of lacerations,
A lot of broken bones, high-speed impacts.
Every single injury was a window onto the human body.
It was an opportunity to work on his craft.
Get him ready.
He has a fracture
To the frontal plate of the skull.
Internal swelling causes pressure on the bone,
And that bone needs to be chiseled away
To release that pressure.
Still with us?
All right.
In terms of the tool kit at galen's disposal,
There actually isn't that much difference
Between what he had access to
And something that a doctor would have been using
150 or 200 years ago.
He has some anesthetics available.
He has opiates, mandrake root mixed with wine.
He has scalpels.
He has forceps.
He's able to set broken bones.
When you get someone like galen, who understands
That you have to disinfect your tools,
That you have to disinfect wounds,
How to stitch, how to close,
His understanding of the body--
There was nobody like him at that period.
Galen revolutionizes ancient medicine.
We're talking about a guy who, 2,000 years ago,
Was able to identify seven cranial nerves,
And he knew the difference between arteries and veins.
Good as new.
Now, we only have his own account,
But he tells us that his predecessors
Had 60 gladiators die in the course of five years,
And he only saw the deaths of two of them.
This was an astounding track record.
You did well today, helius.
Thank you.
I wonder, think their skulls are the same in rome?
I expect so.
Why?
There's only one way to find out.
Narrator: For galen,
The next steps are clear.
His road leads to rome.
Narrator: In 162 a.D., galen arrives in rome
Seeking both knowledge and influence.
Rome was, at the time, the largest city in the world.
It had a population of about a million or more.
If you wanted to be connected to power
And prestige and wealth and fame,
That was really the place to be.
For galen, who had already spent four years
Working as a doctor with gladiators,
There was no greater stage in the whole roman empire
Than the colosseum.
Narrator: Galen had one goal, to become personal physician
To the empire's most important man.
By 162 a.D., marcus aurelius has been co-emperor of rome
For less than a year.
The empire that he and his brother lucius inherit
Is vast and powerful, stretching from the deserts
Of syria and the nile river to scotland
And the forests of germania.
Marcus aurelius governs it unlike any previous emperor,
According to the rules of stoic philosophy.
Marcus aurelius is probably best known
As the author of "the meditations"
And meditations specifically on stoicism.
He was a believer in that ancient philosophy
Of sacrifice and duty and obligation.
A lot of the philosophy is based on the idea
That one should live in accordance with nature.
Nature was governed by reason and divine providence.
And so that meant observing virtuous conduct.
Virtue was very much the idea of what one should aim for.
Narrator: Galen's records confirm that he shares
The same views as marcus aurelius
On the preservation of human life.
Galen was a doctor.
He was a healer.
And marcus aurelius had no great love
For the games and the blood sport of the colosseum.
death! Death! Death!
When a mortally wounded gladiator was at the end,
A figure dressed as dis pater, who's a god of the underworld,
Comes out.
I can save him!
He delivers a coup de grace,
A hammer blow to the head
Of the defeated gladiator.
We know this because it's depicted in art,
Because roman writers talk about it,
And because we have found the skulls of gladiators
With this distinctive pattern of fracturing
That could only have come from this hammer.
Marcus aurelius was someone who prized human life,
Understood suffering,
Didn't take pleasure in slaughter for its own sake.
I've had enough.
He doesn't really like the colosseum or the games.
He sees them as being violent and vulgar.
This is a problem for galen.
If the emperor does not like gladiatorial games,
Well, that's a bar to galen being able to make
His name any further.
If galen wants to make a name for himself,
Then he's gonna have to look beyond the colosseum for work.
Narrator: By the time galen arrives in rome,
He's more than just a great surgeon.
Galen, in addition to everything else,
Was an expert pharmacologist and interested
In hunting out the most efficacious ingredients
Anywhere in the mediterranean area.
One of the things that galen was most proud of
Was a medicine that he created called
Theriac or theriaca from the greek word therian,
Meaning wild beast.
And this is because it contained
64 ingredients, some of which contained
Parts of wild animals.
And one magic ingredient, opium.
Theriac was seen in the ancient world
As a wonder drug.
It would cure everything from a sprained ankle
To a heart attack to hair loss.
It was also most importantly
An antidote to poison.
- You're the emperor. - Mm-hmm.
What do you fear most?
Barbarians.
Poison.
You see, every emperor has enemies.
Now, the emperor might not care to see me
Save some gladiators,
But he must want to save himself.
I'm making the antidote.
Poison and the fear of poison
Is always on every emperor's mind.
I mean, this was the quickest and easiest
Way to kill someone.
Claudius, nero's predecessor, was allegedly killed
With poison mushrooms, so you can understand
How marcus aurelius was always afraid
Of history repeating itself.
Narrator: Galen believes his knowledge of poison antidotes
Could make him indispensable.
And he knows someone on the inside
Who can make an introduction to the emperor.
When galen arrives in rome, one of the best contacts
He's got already in the city is his old philosophy teacher,
Eudemus, who is a personal friend
Of the emperor marcus aurelius.
Eudemus was really galen's ticket
To upper class roman society and the cultural elite.
Eudemus.
It is good to see you.
Oh, mighty caesar.
I want to introduce you to one of
The brightest students I ever taught.
I'm honored to meet you and wish to offer my services.
I didn't realize I was in need of them.
I've invented a theriac.
It's the most effective preventative against poison
And illness ever known.
Galen, is it?
I'll let you know if I'm ever in need of your services.
He wanted to practice medicine in that elite circle.
He wanted to treat rome's most powerful people.
But in fact, marcus aurelius doesn't try
To contact galen at this point.
Narrator: Galen's quest to join rome's elite
Seems over for now.
Narrator: Galen's attempts to advance his status
In rome appear stalled.
Then, a year after his arrival in the city,
His friend eudemus contracts a mysterious illness.
Eudemus was very well-connected
With the roman aristocracy,
So galen knew that if he could cure eudemus,
Then these very powerful people would think
He was a great doctor, and his reputation
Might come to the ear of the emperor.
Old friend.
Old friend. Let me see.
On the other hand, there was a lot of other doctors
Who had their own opinions
About the course of eudemus' illness,
And galen had to compete against them
In order to land this patient.
I'll have to take a sample of your urine, I'm afraid.
Whatever it is they're offering you, please don't take it.
Galen had a simpler approach.
Taking the pulse, asking the patient questions,
Observing very carefully the course of disease,
Comparing this against data
That he had observed elsewhere.
Galen is unique in that he really has science behind him,
Or what we would consider science.
And he manages to work out that eudemus
Is suffering from quartan fever,
Which is a type of malaria.
There are a lot of difficulties
About living in urban rome,
And one of them is that rome,
Throughout antiquity, remains malarial.
There are always large breeding grounds
In the riverbanks of the tiber for insects.
And those insects carried malaria.
We both know...
I may not make it.
Eudemus, you will live.
Galen really knew there was no cure
For what eudemus was facing.
However, though, he was able, because of prognosis,
By carefully observing the course of eudemus's fevers,
That eudemus was gonna pull out of this.
Like apollo, he was able to prophesy
What was going to happen in the course of an illness.
Eudemus' powerful friends now thought of galen
As this phenomenally effective doctor
And really prognostication.
This was a very big step in his career in rome.
Narrator: To harness his growing reputation,
Galen treats anyone in need.
Rather than holding out a fancy medical degree,
The way you search your preeminence
Is on the public stage.
You do not become an ancient doctor
Unless you want to become a public orator as well
Because you have to be constantly
Explaining your methods and defending your methods.
Galen is doing public demonstrations.
He is arguing against his rivals.
He's writing. He's studying.
But most important, he's treating folks
From every social stratum,
From rome senatorial class
Down to the humblest of slaves.
And galen's reputation is growing as a result.
Narrator: Then from the far reaches of the empire
Comes a shocking development.
News comes from the northern frontier,
The danube, that there's been an invasion.
Barbarian tribes launched their attack
From germania, and for once,
Rome's army can't push them back.
The northern frontier was crumbling.
There were very serious incursions threatening
Roman interests, especially by a very dangerous tribe
Called the marcomanni.
What starts as what might seem a fairly small invasion
Turns into what are known as the marcomannic wars,
And they occupy marcus for the rest of his reign.
The marcomannic wars on the northern frontier
May be seen as the first of the barbarian invasions
From the north that will chip away
At the very foundations of the roman empire.
Narrator: In response, rome's two emperors
Travel 350 miles north
To reach their military headquarters
At aquileia on the border of Italy
And modern day slovenia.
Marcus aurelius had a very strong sense of duty,
And also, he was a political realist.
And as much as he would have preferred
To leave the fighting to his subordinates
Or even to his co-emperor, verus,
He realized that this required his personal intervention.
This was a threat that was serious enough
That both marcus aurelius and lucius verus
Went to the frontier to deal with.
Narrator: When the emperors reach the camp,
They confront a new kind of enemy.
A deadly and mysterious disease
Is running rampant through the cramped legions.
The men in aquileia have experienced
Nothing like this before.
By all accounts, the plague
Was a horrible, horrible disease.
I mean, in addition to the expected diarrhea
And vomiting and fevers, what happened to the skin
Was really disconcerting.
Scabs would form and then fall off,
Leaving horrible lesions.
It was devastating in its effects.
People didn't seem to have any previous immunity,
And it killed a large percentage of the people
That it infected.
Narrator: No one is spared, including emperors.
Not you too.
It's nothing.
There's a doctor I met once.
He cured eudemus when no one else could.
He claims to have an antidote to any poison.
You want to bring him here, to this?
I cannot simply watch you die.
The roman empire has never been free of diseases.
But epidemics like the one that marcus aurelius
Is experiencing, that's something new.
It rapidly became apparent to the high command
And to the emperor himself that they were wrestling
With a health crisis of the highest order.
Marcus aurelius reacted by summoning galen from rome.
Imagine that kind of emotion
That would have been in galen at that time.
Here's my chance to actually serve the emperor directly.
And on the other hand, it's like,
This is a really bad situation I'm going into.
Narrator: Galen sets out to serve the emperor,
Not knowing if he'll ever return.
Narrator: Two years into the war
With the marcomanni tribe, galen arrives
At rome's military headquarters
To find an army in crisis.
The situation that galen found
When he reached aquileia
Was more severe than anything he could have imagined.
Galen gives us some pretty detailed description
Of symptoms, and based on those symptoms,
We think it was likely smallpox.
It might have been the first appearance
Of smallpox in the mediterranean world.
There's some argument that he's seeing
A lot of hemorrhagic smallpox,
Which is a really lethal form of smallpox,
Where you get a lot of bleeding under the skin.
This crisis comes in many ways for the empire,
But in a very different and essential way
For galen, the defining challenge of his life.
More than perhaps at any point in human memory,
Disease had become an existential threat
To rome itself.
Narrator: As the plague continues
To wipe out their troops,
The two emperors return to rome
To replenish their diminished legions.
They leave the army under galen's care.
The winter that he spent at aquileia
Was very difficult for him.
It's rare for him to express despair
Or feeling of being overwhelmed,
But that is exactly what he does.
He treated hundreds of plague victims,
And he says that the whole population
Struggled to survive that winter of plague in 168.
Narrator: On the journey to rome,
Lucius verus dies,
Leaving marcus aurelius solely in charge
Of an empire in peril.
Verus didn't make it very far,
Only 50 miles from aquileia.
For marcus aurelius, he is left on his own
To rule an empire that's stricken by plague,
Has enemies at the borders,
An army that's been devastated by this disease.
He knows that the responsibility is his
To rule the roman empire by himself.
Narrator: After a year on the front line,
Galen is summoned back to rome by marcus aurelius.
It doesn't take very long for the plague
To ravage all of Italy and to spread
From the legions to the civilian population itself.
Under these circumstances, rome would have been
A horrible place to be.
There was nowhere in the world
That was more conducive to the spread
Of a highly transmissible and lethal disease
Than the city of rome.
Galen returns to rome,
And he finds a transformed city.
And in fact, galen's family itself is not spared.
Almost everyone in his own household dies.
One can really empathize with galen at this point.
This is a physician who's devoted his entire life
To helping folks from every imaginable walk of life.
But it's the scale of this plague,
Of this disease, that's just overwhelming.
And of course, no one knew for how long it would go on.
His observations of an understanding
Of what was happening were ahead of many other doctors.
And of course, that brings him close to marcus aurelius,
Who, first of all, doesn't want to become
A victim of the plague himself,
But is also desperate to understand how to stop it.
The doctor galen
And the emperor marcus aurelius
Were more than nearly exact contemporaries.
They also had deep affinities.
They both seem to have had an impulse
Towards kind of something like seriousness of purpose.
Narrator: Now galen's mission is to keep
Emperor marcus aurelius alive.
He probably reserves his special treatment, theriac,
For the emperor alone.
I added cinnamon this time.
It didn't help.
Now I need to record exactly how you're feeling.
Science.
Of course.
To what end?
Who will be left to read about your science?
Perhaps I will be saved.
But rome?
While on one hand, the reign of marcus aurelius
Marks something of a high point in the roman empire,
It also marks the point when the seeds were planted
That were going to define the next couple of centuries
Of rome's existence.
Narrator: Though neither the emperor nor his physician
Know it, the plague,
Coupled with the barbarian invasion,
Marks a turning point for rome.
Narrator: Despite the ongoing crisis
And amidst the devastating plague,
Marcus aurelius holds games in the colosseum
To honor his brother lucius.
He's joined by his son and heir, commodus.
The colosseum actually remained open
While all of this was going on.
After all, the romans didn't understand
Person-to-person transmission of disease,
So there was no thought that this
Might be a disease vector.
There is death in the streets.
The economy is failing.
So this is the point where marcus realizes
The importance of the colosseum
And uses it to great effect.
You do what you do to appreciate the gods.
You have your sacrifices.
You have your religious events.
You have your games.
It's all part of a normal life in the roman city.
And in a time of crisis,
You've got to keep people unified.
Marcus aurelius was a very popular emperor,
But he made one very unpopular move.
And that is, he made the contestants fight
With wooden swords.
The romans were used to 400 years
Of gladiatorial fighting with live steel.
And the notion that gladiators would now fight
With wood swords went down like a lead balloon.
Narrator: Marcus aurelius intends something shocking,
Enlisting gladiators to replenish his army.
Thanks to galen, he's learned they are
One of the few groups in rome untouched by the plague.
They're healthy.
I want to know everything about them.
Their training, their food, their sleep,
Their bowel movements.
The gladiators live in a sheltered community.
They don't have any connection to the outside world.
They're exceptionally healthy.
They're getting three square meals a day.
They've got great medical care.
So they're probably the fittest people
In rome at that moment.
We have to remember, of course,
That what the gladiators were trained to do
Was fight.
That is what marcus aurelius needed.
Narrator: That marcus aurelius makes this decision
Suggests unprecedented strain.
How could these degenerates and criminals
Defend the honor of rome?
Could they be trusted on the battlefield?
The gladiators were slaves, often drawn from,
In the roman view, the lowest born peoples of the empire
And engaged in a sordid occupation.
To have them vaulted into a kind of prestige role
Of soldiers on behalf of the empire itself
Was a startling transformation.
Line up for the emperor.
Take up these arms.
You are now roman soldiers.
When I look at you, I don't see prisoners.
I don't see criminals or slaves.
I don't even see gladiators.
I see legionaries,
Dedicated to protecting this great empire.
Help me to protect the citizens of rome,
And you will win your freedom.
caesar! Caesar! Caesar!
That is my solemn promise.
In some sense, it speaks to the desperation
That marcus aurelius is facing in that moment
And the tremendous risk he's willing to take
In order to make sure that the empire will endure.
Narrator: In the fall of 169 a.D.,
Marcus aurelius assembles his legions
From across the empire.
Galen expects to be called back to the battlefield.
Ready the horses.
And as for you, galen--
Marcus, I'm sorry.
I can't go.
Not again.
I'm a scientist.
I'm not a warrior.
Is that so?
Well, the empire needs both.
Commodus.
I was going to ask you to look after my son in my absence.
Caesar.
Galen is still traumatized
By the last time he was on the front lines.
And when the emperor asks him why he cannot go,
He said, "well, I had a vision from a god who said,
'do not go. Do not go.'"
And one thing about the romans,
They believed in omens.
Depending on what you believe,
You can either think that galen was clearly
Blessed by the gods, or you might think
That it just happened to conveniently be
That the gods spoke to him at that particular moment
And saved him from going to a miserable place
To do a miserable job.
Narrator: Now as personal surgeon
To rome's heir apparent,
Galen's task is to ensure the eight-year-old
Lucius commodus does not succumb to the deadly plague.
At the same time, marcus aurelius
Heads north to aquileia.
With gladiator battalions at their heart,
His legions confront the barbarian armies.
After months of fierce fighting,
They turn back this invasion.
The marcomannic wars along the danube frontiers
With the germanic peoples are a wake up call for rome,
And a wake up call into, we might say, a nightmare.
Narrator: A decisive victory remains out of reach,
And marcus spends most of the rest
Of his reign on a battlefield.
This marks a turning point in roman imperial history.
What marcus aurelius was seeing
Was really the future of the roman empire.
There's going to be waves of incursions from goths
And vandals and many northern tribes,
All out to vanquish Italy.
Narrator: 350 miles away in rome,
Galen devotes himself
To the pursuits of medical science.
Galen must have been very relieved
Not to be on the front lines.
And now he can turn his attention
To his favorite activities:
Reading, writing, composing scientific works,
Journals, and the like.
Galen is probably the single most influential figure
In the history of medicine.
He left us a massive collection of medical texts.
In fact, he's probably the most prolific author in antiquity.
His greek works comprise about one-eighth
Of all ancient greek manuscripts that we have.
The knowledge that galen's medical texts contain
Defined islamic and european medicine for 15 centuries.
Narrator: Despite the best medical care
The empire can offer, marcus aurelius will die
At his military headquarters on March 17, 180 a.D.,
Most likely from smallpox.
Under galen's care, his heir survives.
Galen's babysitting duties
Turn out to have unintended consequences.
Thanks to him, the heir to the throne
Grows up to be a healthy young man.
The irony is that commodus turns out to be something
That rome will come to regret.
In fact, commodus turns out to be
One of the most disastrous emperors
In the history of rome.
Ultimately, he'll grind it
Into a long, slow, and painful decline.