“Thank you,” Rafe said, finding it impossible to hate him. “What does the V stand for?” he asked as they stood.

“The V?”

“In V. Stephen?”

“Oh,” Samourian smiled. “Vasken. An old family name.”

They walked outside together. On the sidewalk the sun struck them twin blows and they blinked as they shook hands.

“Good luck, Vasken,” he said. “Watch out for young Mexican gardeners.”

Samourian looked at him as though he were mad.

That afternoon, with the visiting professors from Cleveland attending, there was a conference about the week’s surgical complications. Rafe scarcely listened to the ebb and flow of their voices. He sat and thought of many things, but in a little while he realized it was Longwood they were now discussing.

“. . . I’m afraid he’s reached the end of the line,” Dr. Kender said. “The machine can go on sustaining him but he refuses more treatment, and this time he means it. He chooses to face uremia and then death.”

“We simply can’t allow that to happen,” Miriam Parkhurst said.

Sack grunted. “It would be nice, Miriam, if we had some sort of choice about all these matters,” he said. “Unfortunately, we don’t. We can offer a patient dialysis, but we can’t force him to accept it.”

“Harland Longwood is not just a patient,” she said.

“He is a patient,” Sack said, pained as usual by emotionalism. “He must now be considered by us only as a patient. No more, no less. That’s the best thing we can do for him.”

Dr. Parkhurst refused to look at Sack. “Forgetting what Harland already has given to each of us and to surgery,” she said, “there’s a compelling reason why we cannot allow him to do this to himself. Some of us have read the manuscript of a book he’s been working on. It’s a genuine contribution, the kind of text that will affect whole generations of young surgeons in the most important way.”

“Dr. Parkhurst,” Kender said.

“Well, the lives of people not in this room will be affected if this man is allowed to die.”

She was right, Meomartino remembered.

She looked at the two visiting professors from Cleveland. “You people are kidney men,” she said. “Can you suggest anything we might try?”

The doctor named Rogerson leaned forward. “You must wait until a cadaver donor with B-negative blood type becomes available,” he said.

“But we can’t,” she said scornfully. “Haven’t you been listening?”

“Miriam,” Dr. Kender said. “You must accept the situation. We can’t obtain a B-negative cadaver. And we’re not going to be able to save Harland Longwood without a B-negative donor.”

“I’m B-negative,” Meomartino said.

They dwelt too long, he thought, on the chances of decreasing his life expectancy. “I have kidneys like a horse,” he said. “One will last me as long as two would have.”