He was terrified, how could he dare to practice again? The dream made Ephraim understand his God-given duty to return to medicine. He saw that he had let his own doubts stand in the way. But he did not know if he was capable; so much had happened in medicine since 1878. He was a fool, a coward, he’d run away from doctoring and forced these wandering years on his loyal loving wife. After all her sacrifice, could she forgive a turn-around?

‘Still bearing fruit when I am old, still green and full of sap,’ Ephraim quotes Psalm 92 in Chapter 35, Still Full of Sap. He is awed by becoming a father again at age 58. The birth of a boy, Leo, can never make up for the death of William, but at last Ephraim feels the call to his former profession. After nine years he ends his self-banishment and in 1887 applies to the state of West Virginia for his medical license.