For her help in preparing the manuscript, I am grateful to Mrs. Ernest Lamb, Jr.; for general assistance, to Miss Lise Ann Gordon; and for their assistance and courtesy, to the staffs of the Framingham Public Libraries, the Framingham State College Library, the Boston Medical Library and the Francis A. Countway Library of Medicine.

For their continued unquestioning support and invaluable judgment, I thank my literary agent, Miss Patricia Schartle, and my editor, Mr. William Goyen. With Lorraine Gordon, they made this book possible.

N. Gordon

1966–1968

“A person

gives money

to the physician.

Maybe

he will be healed.

Maybe

he will not be healed.”

—The Talmud
Tractate Kethubot: 105

“A resident

enters one end

of a tunnel,

something happens

on the inside

and

gradually,

after

six or seven

more years,

he emerges

as a surgeon.”

—Medical World News
June 16, 1967

Prologue

By the time Spurgeon Robinson had been riding the ambulances thirty-six hours on and thirty-six hours off for three weeks, the driver, Meyerson, had long since gotten on his nerves and he was shaken by the gore and troubled by the traumas and didn’t like the duty even a little bit. He found that sometimes he could escape by using his imagination, and on this trip he had just about convinced himself that it wasn’t an ambulance, it was a goddam space ship. He wasn’t an intern, he was the first black man in orbit. The wail of the siren was the jet stream turned into sound.

But Maish Meyerson, the clod, refused to cooperate by acting like a pilot. “Wehr fahrbrent,” he snarled at the operator of a stubborn Chrysler convertible, hurling the ambulance around it.

In a city like New York they might have had trouble locating the construction job but in Boston there were still only a few really tall buildings. Because of the red steelmill paint on the naked metal the skeletal structure jabbed into the gray sky like a bloody finger.

It beckoned them right up to the scene of the accident. Spurgeon slammed the door just as the siren whimpered into silence, and the knot of men unraveled around the figure on the ground.

He squatted. The unscathed half of the head told him the patient was a young man. His eyes were closed. A tiny trickle of fluid dripped from the fleshy lobe of one ear.

“Somebody three floors up dropped a spanner,” a man with a paunch, the foreman, said in answer to the unasked question.

Spurgeon parted the matted hair with his fingers and beneath the lacerated flesh felt the fragments of bone move loose and sharp like bits of shattered eggshell. It was probably cerebrospinal fluid leaking from the ear, he thought. There was no point in trying to debride the injury while the poor guy lay on the ground, he decided, and took a sterile gauze dressing and dropped it on the wound, where it turned red.

The man’s fly was open and his penis was exposed. The fat-bellied foreman saw Spurgeon noticing. “He was taking a leak,” he said, and Spurgeon could see it, the workingman easing his urgent bladder and gaining wry satisfaction from christening the building he was helping to raise; the wrench falling, falling, falling with unerring accuracy, as if God were remonstrating against dirty little human acts.