After she got the ticket she drove more cautiously but the coughing began, a series of rasping asthmatic spasms that shook her whole frame as she hunched over the wheel.

He endured the sound as long as he was able. “Get off the highway and find a drug store,” he said. “I’ll write out a prescription for ephedrine.”

But she continued to drive.

Dusk was falling when finally she pulled the car to a stop in front of the hospital. They hadn’t interrupted their travel to eat and Adam was weary once more, hungry and emotionally frazzled.

He placed his bag on the sidewalk.

He could hear her coughing as she jammed her foot down on the accelerator. The Plymouth jolted into the center of the street, in and out of the path of an oncoming taxi whose driver cursed and leaned on his horn.

Adam stood on the sidewalk, realizing suddenly that they hadn’t remembered to take the fish out of the refrigerator. Next time Gaby used her cabin there would be another disgusting reason for remembering their interrupted holiday. He felt borne down by conflicting emotions, worry, guilt and regret. He had filled her up to her ears with seamy confessions of the most degrading sort, and then he had allowed himself to . . .

Damn it, he thought, did I make any promises?

Did I sign a contract?

But in sudden self-disgust he knew that while he had treated her body with tender gentleness he had torn her soul like an animal.

He threw back his head and looked up at the old monster of a building.

Well, I’m back, he told the hospital.

The lights were going on as darkness fell and the hospital looked back at him with many eyes. He thought of what was going on inside, all the ants within the hill, wondering how many patients now in the wards would be operated on by him in the week to come.

As a human being I’m a sorry mess and a fool, he thought, but I can function well as a surgeon, and that has to count for something. God give them wisdom that have it; and those that are fools, let them use their talents. Will Shakespeare.

He picked up his bag. The front door opened like a mouth and the grinning building swallowed him.

After he had unpacked he went down to the ward to steal a cup of coffee and almost at once he was doubly sorry to be back.

Mrs. Bergstrom had been doing fine, Helen Fultz told him, but since early that afternoon there had been signs that she was rejecting the kidney. Her temperature was 101.6° and she complained of malaise and pain in the wound.

“Is the kidney putting out urine?” he asked.

Miss Fultz shook her head. “It’s been doing beautifully, but today its output went way down.”