A bastard, they told each other with their eyes.

Silverstone led the way, followed by a long line of residents and interns. He stopped only at certain beds, chatting for a moment with the patient, speaking briefly of the case history, asking a question or two in a sleepy, almost disinterested voice and then pushing on. The group made its way around the perimeter of the large room.

In one of the beds a colored woman whose red hair came from a cheap bottle stared through him as he stopped in front of her and she was surrounded by a silent wall of white-clothed young men.

“Hello,” Silverstone said.

She looked very much like half a dozen hookers in the old neighborhood, Spurgeon thought.

“This is . . .” Silverstone checked the chart. “. . . Miss Gertrude Soames.” He read for a few moments. “Gertrude has been in the hospital before for a number of symptoms which can be attributed to the fact that she’s had some liver cirrhosis—which probably can be attributed to the usual fact. There appears to be something palpable there.”

He threw back the sheet and lifted the rough cotton gown, exposing thin shanks rising to a melancholy muff and a belly with two old incision scars. He probed her abdomen first with the fingertips of one hand and then with both, while she turned her gaze upon him now. Spurgeon thought of a dog wishing but not daring to bite.

“Right here,” Silverstone said, taking Spurgeon’s hand and placing it.

Gertrude Soames looked at Spurgeon Robinson.

You’re the same as me, her eyes said. Help me.

He glanced away, before his eyes could say, I can’t help you.

“Feel it?” Silverstone asked.

He nodded.

“Gertrude, we have to take something called a liver biopsy,” the Chief Resident said cheerfully.

She shook her head.

“Oh, yes.”

“No,” she said.

“We can’t take it if you don’t want us to. You have to sign a paper. But there’s something wrong with your liver, and we won’t know how to help you unless we make this test.”

She was silent again.

“It’s just a needle. We put in a needle and when we take it out there’s a speck of liver on the end, not very much but for our purposes plenty, enough for us to test.”

“That’s a painful thing?”

“It hurts just a little bit, but there’s no choice. It has to be done.”

“I’m not your damn guinea pig.”

“We don’t want a guinea pig. We want to help you. Do you understand what may happen if we don’t?” he asked gently.

“You say it that way, I understand.” Her face remained as stone, but the dull eyes shone suddenly, and there were tears that ran down toward her mouth. Silverstone took a tissue from the bed-stand and reached to wipe her face, but she jerked her head away.

He replaced the gown and adjusted the sheet. “You think it over for a while,” he said, patting her knee, and they moved away.