Neither of the two remaining doctors seemed certain how to run the antiquated X-ray machine. They fussed around it like a pair of elderly sisters who had been asked to cook Thanksgiving dinner for the entire family and had forgotten how to start up the gas oven.

Eventually the sultan lost his temper. "Enough!" Sultan Omay barked.

Though startled, the men seemed relieved to abandon the old device. The sultan was sitting on a lovingly preserved black-leather examining table. It looked like a museum piece. The doctors approached their nation's ruler.

Omay was stripped down to the waist. His skin was dark, his chest broad and coated with a thick blanket of coarse black hair. Only lately had some gray begun to emerge.

"Could you raise your arm again, please, O Sultan?" one doctor asked.

The sultan did as he was instructed, although he released an impatient sigh.

The doctor probed the lump with his fingers. He frowned gravely as he turned to his colleague. The second doctor was frowning, as well.

"How long has this been here?" the first doctor asked.

"I only just noticed it," the sultan said.

"Hmm," said the doctor. His frown grew even deeper. It seemed to extend down onto his wattled neck.

"It is not normal?" the sultan had queried. "Normal?" asked the doctor, surprised.

"No. No, it is not normal." He probed the armpit some more. The sultan winced. The area was growing tender to the touch. It had not been so that morning.

"It is not right," said the first doctor.

"No, it is not," agreed the second.

"What must I do?" asked Omay.

"Go to England," the first doctor instructed firmly.

"America is better," reminded the second.