…looking down at the revolving wooden operating table beneath the skylight high above, the patient already lying under white sheets; Ephraim and Burns adjusted their sightlines from the sixth tier. What would the surgery be?

The buzz of speculation quieted as Dr Wood entered, his black silk gown fastened tightly at neck and wrist — modestly black, as he had no need to display its evidence of previous operations, unlike boastful surgeons so proud of their blood-stiffened whites. His house surgeon followed, wearing an everyday suit, its left buttonhole dangling a dozen or so waxed ligatures ready for service.

In Chapter 13 Ephraim continues and completes his three-year medical course, with training practice at Bellevue Hospital in New York, 1858-59. The surgery demo scene (thankfully not pictured above!) is historically true, as is Dr James Rushmore Wood (1813-1882). Medicine had a long way to go and Ephraim grows with it. But for now, the 29-year-old has to wait to learn what destiny his sponsors plan for him. My thanks for medical history and the image to the Wellcome Library. In 1860, a year after Ephraim’s graduation, the college changed its name to Columbia Medical School