He was a better man and a better surgeon than that one, and yet Silverstone threatened his existence from both directions.

He smiled mirthlessly, thinking that Longwood evidently had decided that there were worse things than a Cuban in the family. The Old Man had been quite shocked at the sight of Liz with Silverstone. Ever since that night he had been almost warm and friendly, as if trying to indicate that he knew that his niece was very difficult.

But now Longwood was putting more pressure on him every day to make certain that he and not Silverstone would win the faculty appointment.

Meomartino chewed on self-doubt.

Saint Raphael, he said.

Am I not sufficiently male? I am a physician, I know that at the moment we are finished with one another she is satisfied.

Indicate to me what I must do. I promise that I will make Confession, take Communion, that I will become a true Catholic once again.

It was quiet in the dark room, only the sound of her deep breathing.

He remembered that despite all his kneeling before the statue he had failed Latin and that his body customarily was black and blue with the bruises inflicted by Guillermo until the day he had grown strong enough to vanquish his older brother.

Saint Raphael had not helped him then, either.

In the morning, heavy-eyed, he went to the hospital and struggled through the early hours. His mood was already foul by the time he led the house officers through morning rounds, and it was not improved when he reached James Roche, a 69-year-old gentleman with an advanced carcinoma of the colon, who was scheduled for surgery early the following morning.

While nurses and dieticians hustled through the cavernous ward carrying trays, Meomartino quietly outlined the case, with which most of the house officers were familiar, and prepared to ask a few teaching questions.

But he stopped talking in mid-sentence.

“Cristos. I can’t believe it.”

Mr. Roche was eating his lunch. His plate contained chicken, potatoes, string beans.

“Dr. Robinson, why is this man eating what he is eating?”

“I have no idea,” Spurgeon said. “The order to change his diet is in the book. I wrote it there myself.”

“Please get me the order book.”

When he opened the book the order was there, written in Robinson’s neat, controlled hand, but it didn’t assuage his anger.

“Mr. Roche, what did you have for breakfast?” he asked.

“Usual breakfast. Juice, an egg, little cereal. Farina, it was. And a glass of milk.”

“Scratch his name from the surgery schedule for tomorrow morning,” Meomartino said. “Reschedule him for day after tomorrow. Goddammit.”

“Oh, and toast,” the patient said.