The prospect of undergoing prostatectomy was annoying; it meant he would have to take time off and he was just beginning a project he had been working toward for years, the writing of a new general surgical text.

But it soon became apparent that it wasn’t his prostate.

“Have you had a sore throat recently?” Arthur Williamson had asked him when finally he had invited the internist to examine him. It was precisely the question he had been expecting and therefore it annoyed him.

“Yes. It lasted only a day. About two weeks ago.”

“Did you have a culture?”

“No.”

“Did you take an antibiotic?”

“It wasn’t streptococcus.”

Williamson had stared at him. “How do you know?”

But they both suspected that it had been, and somehow he knew with a curious resigned certainty, even before the tests were done, that the infection had damaged his kidneys. Williamson turned him over to Kender immediately.

They had placed an arteriovenous shunt into a vein and an artery in his leg.

From the start he was a very bad patient, fighting the kidney machine emotionally the instant they mated its tube to the shunt. The apparatus was noisy and impersonal and during the blood-cleansing procedure, which took fourteen hours, he lay restlessly on the bed and suffered violent headaches, inefficiently attempting to work with the three-by-five file cards on which he had accumulated the material for the first chapter of the book.

“Often the kidneys pick right up and begin to function again after a few sessions with the machine,” Kender told him encouragingly.

But he performed the obscene rite with the damned machine twice a week for a month and it was apparent that his kidneys were not responding, and that only the apparatus was going to keep him alive.

They gave him standing appointments, every Monday and Thursday evening at 8:30.

He took himself off all surgery schedules. He considered resigning and then decided, dispassionately, he hoped, that he was too valuable as an administrator and a teacher. He continued to make daily rounds.

On the Thursday of his seventh week on the machine, however, without any planning at all he simply did not go to the Kidney Laboratory. He left word that they should put another patient on the machine in his place.

He thought that perhaps Kender would attempt to persuade him to return to the machine, but the next day the kidney man made no attempt to see him.

Two nights later he noticed that his ankles were swollen with edema. He lay awake most of the night and then in the morning for the first time in years he called his secretary and told her he wouldn’t be in that day.

A couple of capsules allowed him to sleep until two o’clock. He awoke feeling nervous and irritable, made himself some canned soup he didn’t really want, then took an additional grain-and-one-half and went back to sleep until five-thirty.

For want of anything better to do he showered and shaved and put on some clothes. Then he sat in the darkening living room without switching on a lamp. In a little while he went to the hall closet and took down from the back of the shelf a bottle of Chateau Mouton-Rothschild, 1955, that had been given to him three years before by a grateful patient who had advised him to save it for an occasion. He opened it with only a little difficulty and poured a glass, then he went back into the parlor and sat in the dusk and sipped the warm, dusky wine.