Roy has his first overnight shift as the on-call doctor, supervised by the Fat Man. An elderly woman named Anna O. is admitted, and the Fat Man says that “[her] admission will be approximately number eighty-six” (69), indicating that Anna is frequently in and out of the hospital. At first, Anna is unconscious, and Roy thinks she has died. The Fat Man revives her by putting the earpieces of his stethoscope into her ears and yelling into the bell, and he tells Roy how to take care of her. After attending to her, Roy goes to sleep in the on-call room and is awoken from a sexual dream about Molly when Molly comes in to ask him about another patient, who has broken out of her restraints and is yelling at her reflection in a mirror, which she breaks. He tries to go back to sleep but is awoken, again by Molly, when a man in his fifties who used to be a physician at the House of God, named Dr. Sanders, is admitted. 

Dr. Sanders knows that something is likely seriously wrong with him, potentially terminal cancer, but is encouraging to Roy, saying that he remembers being in his situation.