Gurdweill bought a bar of chocolate and some oranges and got onto the tram. The journey took about three-quarters of an hour; he had to change trams twice, standing crushed between working-class women carrying hot food in baskets and knapsacks for their sick relations. The institution was situated outside the city. It stood in large grounds on the top of a hill and was conspicuous from a distance — a secluded, self-contained city surrounded by a high iron fence, with the golden dome of the hospital church gleaming dully against the cloudy sky. The closer he came to his destination, the more uneasy he felt — an uneasiness that was tinged with fear. When the tram finally jolted to a stop and the noise of its engine died down, a terrible silence fell. Life came to a standstill. The passengers seemed dazed, uncertain whether to dismount or stay in the tram. And suddenly a blood-curdling shriek rent the silence: the high, continuous, animal-like shriek of a woman, which seemed to come from far away, beyond the broad valley sweeping down at the foot of the institution. An icy tremor passed through Gurdweill, and for a moment his heart stopped beating. Then there was silence again, a silence more profound than before. An old woman next to him exclaimed, to no one in particular, ‘Poor sick people — they’re suffering.’ Gurdweill got off with the rest of the visitors, paused for a moment next to the tram, and then approached the gate. From the other side of the fence there was a loud burst of mocking, demonic laughter, mingled with the high, clear voice of a woman singing a merry tune from an operetta. Gurdweill could not make out the words, but he was familiar with the tune, which everyone was singing in the city below. And hearing this merry song here made a profoundly depressing impression on him, as if it alone expressed all the sorrow and anguish of the inmates, and of humanity as a whole.