Always at the dream’s beginning he was climbing the ladder into blinding sunlight. It was very real: he could feel the coolness of the steel frame vibrate in his hands whenever it was hit by the wind. The wind worried him. As he climbed he looked straight up to the perch at the top, where the ladder narrowed high above him like a pencil point, until the sun made his eyes tear and he had to close them. He never looked down. When he finally reached the perch he stepped onto it and looked out at the world stretching one hundred feet below him, his buttocks tight, his mouth dry, the platform swaying, shuddering in the wind, the swimming pool flashing tiny and hard in the sun, more like a dog-tag than a life net. He stepped off the platform, let his head fall back, spread his arms as his body twisted high, high in the air, and felt the wind catch him like a sail, pushing, destroying his balance, throwing him off just enough. He tried desperately to compensate, knowing he might as well miss the pool altogether as land anywhere but in the deepest part where the water was ten feet of shock-cushion. He would land badly, he thought dully, hanging grotesquely suspended, the water rushing up at him. He would be hurt and he would never be a surgeon.

O God.

The dream always ended halfway between the top of the tower and the water. He would wake and lie in the dark and tell himself that he was never going to do anything that foolish again, that he was already a surgeon, that nothing would stop him now.

Why was the dream recurring?

He could think of no reason until, one night in Pathology, he closed his eyes and breathing deep was transported by a scent, the raw essence of formaldehyde, through time and distance into Lobsenz’s pathology lab, where he had first had the diving dream.

It was during his third year at the medical school in Pennsylvania, the period of his most extreme financial difficulty. The shame and disgust of the aging mistress and her dole were behind him. The coal-shoveling had paid his way through the cold winter, lasting until early spring when he began to fall asleep in class regularly, and then he had quit because if he had kept the job he would have been dropped from two courses. He became so accustomed to desperation that most of the time he was able to ignore it. He already owed six thousand in student loans. He was behind in his room rent, but the landlady was willing to wait. He eliminated lunches on the grounds that he was eating too much and for two weeks was annoyed by midday hunger and afternoon faintness, but then from the beginning of April until mid-May he pulled duty at the hospital and by cultivating the right nurses ate ward food at no expense.