“Yes. He’s been complaining of discomfort and tenderness. Dr. Potter said he has a very low pain threshold. He ordered 100 mgs. of Demerol,” she said, pointing out the order on the chart.

Something else to worry about, he thought as he waited for the elevator.

When he got to bed he lay and peered into the darkness at the alternative paths his life could take.

If they kicked him out, perhaps some of his former professors could help him get into one of the New York hospitals.

But he would have to leave Dorothy. He couldn’t afford to marry her yet; he wouldn’t want Uncle Calvin to support his wife.

The Mortality Conference that would consider the Donnelly case was only a week away . . .

It was the last thought he had until he awoke in the false light of early dawn, the sheets damp with perspiration despite the fact that the room was cold.

He could remember clearly that he had dreamed both of the girl and of the Death Committee.

When he came into the ward on Saturday he saw that Macmillan had become much worse. The man’s face was flushed, his lips dry and cracked. He was groaning with pain he said came from deep within his rigid abdomen. His pulse hammered 120 times a minute and his temperature was 102°.

Potter had departed on a much-publicized excursion to the fleshpots of New York City. Oh you miserable slob, I hope you enjoy it, Spurgeon thought, I hope you catch everything. He went to the telephone and got Dr. Chin, the Visiting Surgeon who was on call. “We’ve got a guy here who’s pursuing a classical septic course,” he said. “I’m almost certain it’s peritonitis.” He described the case.

“Call the OR and schedule him right away,” Dr. Chin said.

When they took him downstairs and opened, they found that the stump of the appendix had blown. Swollen with edema, the tissue had forced itself against the tight ring of catgut like cheese against a sharp knife, and with the same results.

“Who tied this goddam thing?”

“Dr. Potter,” Spurgeon said.

“That guy again.” The Visiting shook his head. “The tissue is waterlogged. It’s too friable to play with. If we touch it with a forceps it will fall apart. We’re going to have to pull the cecum up to the abdominal wall and do a cecostomy.”

Under the older surgeon’s patient direction, Spurgeon cleaned up Potter’s mess.

Monday morning there was a duty rotation and he found himself facing five weeks in the Emergency Room, up tight inside because it was a place where he had already failed once; a place where things happened very fast; where, when decisions had to be made, they had to be made quickly. A repeat of the Donnelly incident, he knew, and . . .

He tried not to think about it.