The state of the medical profession in Begma is one of horrifying, almost reckless Progress. Those who study medicine in Begma are constantly involved in pushing the boundaries of knowledge, and seeking new methods of Curing Disease and Improving Public Health. Unfortunately, the same attitudes prevalent elsewhere in Begma are applied to medicine, and the same cavalier attitudes toward failure have much more dire consequences.
The average lifespan of a Begman is a mere 150 years, with the wealthy and comfortable likely to reach 200, and the poor working class lucky to see 100. This is a shockingly brief lifespan for the Golden Circle, and scholars struggle to figure out why. There are some surviving records before the Civil War that indicate a much longer lifespan, which may be a clue. Certainly, the accelerated pace of Begman life can put stress on the body, and there are a number of industrial diseases present, but even this cannot account for such a sharp decrease in lifespan. Indeed, there are those who theorize that the absurd pace of Begman society is because of their shortened lives, and their desire to fill them as completely as they can. The cause is definitely tied to Begma itself, though. Begmans who live elsewhere in the Golden Circle, and especially in Amber, find their lives lengthened, as do those who have a parent from another land.
Still, despite the abbreviated term, the general health of Begma is better than usual. Civic engineering is very important to Begma, and clean running water and sewage access is nearly universal in the city. Food is widely available, and while the poorest classes go hungry from time to time, there are a number of Charity Programs that see to distributing food to the needy. The basics of disease transmission are well understood in Begma, and communicable illness is quickly pinpointed and quarantined.
Begman doctors are eager to push their knowledge of the working of the human body, and in recent decades they have advanced surgery to a careful science. With the advent of chemical antiseptics, post-surgical infection has fallen below 20%, and the actual rate of survival for all surgical patients is now well over 75%.
Anatomical studies are provided at the University of Begma, at the Walpole-Watson College of Medicine. Cadavers are provided by the prison system, so many a Begman doctor's first handling of a human body is one that has been hung. Once graduated, however, access to the University cadaver supply is cut off, so many doctors find themselves continuing their studies with corpses supplied through less scrupulous means. While no ethical doctor would ever pay for a body that was specifically killed for research, a desperate man sometimes does not ask all the questions he should when he needs to practice a difficult procedure.
Medicine is not regulated in Begma; the belief is that market forces will cause good medicine to become popular, and bad medicine to fail in the marketplace. The obvious logical fallacies are overlooked. Begma has a booming market in patent medicines, secret concoctions that make outrageous and sometimes impossible health claims. Most of these medicines are merely high-proof alcohol solutions, or occasionally tinctures of opiate drugs. Recent estimates claim that a full third of Begma's lower classes are addicted to laudanum obtained through these nostrums.