FIVE-MINUTE BREAK. DR. JOEY Ledford sat on the shaky remnants of a wooden chair, smoking a Marlboro and sweating while monsoon rains slammed the tin roof of the makeshift medical clinic of United Nations Refugee Camp Five. Somewhere, doctors and nurses were performing surgeries in antiseptic, air-conditioned rooms that were packed with every conceivable device of the medical arts, with storage areas nearby bulging with vital, lifesaving medicines. They were listening to Bach or Norah Jones or Latin jazz as they performed meticulous cuts and closed wounds with care, taking all the time they needed to do it right. Somewhere, the magical art of medicine was a smooth choreography conducted by well-educated professionals in offices and clinics and hospitals. Somewhere, but not here.

Ledford exhaled, and twin streams of cigarette smoke flowed from his nostrils. The rain was not a gentle and sweet thundershower like back in Iowa. Instead of giving life to crops, this was unrelenting and fell in great sheets, as if some angry demon had ripped open the bellies of the fat black clouds. He looked out at the sprawl of the camp, where thousands of people were hiding under whatever shelter they could find. Armed guards were at the clinic door to keep them out. They had been driven out of their homes by overflowing rivers and leaking dams and were still being pursued by water. Poor creatures, Ledford thought. Poor, damned souls.

Sweat caked his T-shirt and khakis, and when he dropped the cigarette and ground it out, he noticed the bloodstains on his black rubber boots had become deep, splotchy layers during the day, and he could not recall the individual patients from which the blood had come. He would wash it off later. Break over, Ledford ducked back into the tent, back into the world of misery.