Larch walked behind the piano and through the only open door. He entered into a room with nothing in it – not a piece of furniture, not a window. There was only a closed door. Larch opened it and found himself in the waiting room. There were newspapers and fresh flowers and an open window; four people sat in pairs. No one read the papers or sniffed the flowers or looked out the window; everyone looked down and continued to look down when Wilbur Larch walked in. A man was sitting at a desk and eating something out of a bowl. The man looked young and strong and indifferent; he wore a pair of work overalls and a sleeveless undershirt; around his neck, like a gym instructor's whistle, hung a key – obviously to the cashbox.

Without looking at Wilbur Larch, the man said: “Hey, don't come here. It's only for ladies.”

“I'm a doctor,” Dr Larch said.

The man continued eating, but he looked up at Larch. The singers took a deep breath, and in the silence Larch heard the sound of someone vomiting. One of the women in the waiting room began to cry, but the choir sang again. “Something about Christ's blood,” Larch thought.

“What do you want?” the man asked Larch.

“I'm a doctor, I want to see the doctor here,” Larch said.

“There is no doctor here,” the man said. “Just you.”

“Then I want to give advice,” Larch said. “Medical advice. Free medical advice.”

The man studied Larch's face. “You're not the first one here,” the man said, after a while. “Wait for your turn.”

Larch looked for a seat. He was shocked by everything. He tapped his foot nervously and looked at a couple sitting next to him – a mother and her daughter. The daughter looked too young to be pregnant, but then why, Larch wondered, had the mother brought the girl here?

Wilbur Larch stared at the shut door, behind which he had heard unmistakable vomiting. Suddenly he heard the scream.

It was louder than the choir. The young girl jumped from her seat, sat down, cried out; she put her face in her mother's lap. Larch realized that she needed the abortion – not her mother. The girl didn't look older than ten or twelve years old.

“Excuse me,” Larch said to the mother. I'm a doctor.”

“So you're a doctor,” the mother said, bitterly. “And how can you help?” the mother asked him.

“How many months is she?” Larch asked the mother.

“Maybe three,” the mother said. “But I already paid them here.”

“How old is she?” Larch asked.

The girl looked up from her mother's lap. “I'm fourteen,” she said.

“She'll be fourteen, next year,” the mother said.

Larch stood up and said to the man with the cashbox key, “Pay them back. I'll help the girl.”

“I thought you came for advice,” the man said.

“To give it,” Dr Larch said.

“When you pay, there's a deposit. You can't get a deposit back.”

“How much is the deposit?” Larch asked. The man drummed his fingers on the cashbox.

“Maybe half,” he said.

When the evil door opened, an old couple looked into the waiting room. Behind them, on a bed, a woman lay under a sheet; her eyes were open but unfocused.

“He says that he's a doctor,” the cashbox man said, without looking at the old couple. “He says that he came to give you free medical advice. He tells me to pay these ladies back. He says that he'll take care of the young lady himself.”

Larch realized that the old white-haired woman was the abortionist; the old white-haired man was her assistant.

“Doctor Larch,” Dr Larch said, bowing.

“Well?” the woman asked, aggressively. “What's your advice, Doctor?”

“You don't know what you're doing,” Dr Larch said.

“At least I'm doing something,” the old woman said. “If you know how to do it, why don't you do it?” she asked. “If you know how, why don't you teach me?”

The woman under the sheet looked shaky. She sat up and tried to examine herself; she discovered that, under the sheet, she still wore her own dress. This knowledge relaxed her.

“Please listen to me, “Dr Larch said to her. “If you have a fever, you must come to the hospital. Don't wait.”

“I thought the advice was for me,” the old woman said. “Where's my advice?”

Larch tried to ignore her. He went out to the waiting room and told the mother with her young daughter that they should leave.

“Pay them back!” the old woman told the cashbox man the angrily.

She put her hand on Dr Larch's arm. “Ask her who the father is,” she said.

“That's not my business,” Larch said.

“You're right,” the old woman said. “But ask her, anyway – it's an interesting story.”

She spoke to the mother. “Tell him who the father is,” she said. The daughter began to cry; the old woman looked only at the mother. “Tell him,” she repeated.

“My husband,” the woman said, “her father.”

“Her father is the father,” the old woman said to Dr Larch. “Do you understand? About a third of them get it from their fathers, or their brothers. Rape,” she said. “Incest. Do you understand?”

“Yes, thank you,” Dr Larch said, pulling the girl with him.

After he had helped the poor girl, Larch became very popular with the unhappy women who needed him badly. He had a feeling that they followed him everywhere asking for help. Finally, he decided to return home.

Wilbur Larch applied to the Maine State board of medical examiners for a useful position in obstetrics. While they sought a position for him in some developing community, they liked his Harvard degree and made him a member of their board. Larch waited for his new appointment in his old hometown of Portland, in the old mayor's mansion where he had spent his childhood.

Larch often thought about the orphans of the South End. In 189—, less than half the mothers were married. According to the rules of the lying-in hospital, only married or recently widowed women of good moral character could be admitted. But in truth almost everyone was admitted: there were an astonishing number of women who said that they were widows.

He wondered why there were no orphans, no children or women in need in the tidy town of Portland. Wilbur Larch did not feel of much use there. He looked forward to getting a letter from the Maine State board of medical examiners.

But before the letter arrived, Wilbur Larch had another invitation. He was invited to Boston to have dinner with the family of Channing-Peabodys and friends. Larch knew that Channing and Peabody were old Boston family names, but he was unfamiliar with this strange combination of the two.

He felt uncomfortably dressed for the season – his only suit was a dark and heavy, and he hadn't worn it since the day of his visit “Off Harrison.” When Larch lifted the big brass door knocker of the Channing-Peabody house, he felt the suit was too hot. Mrs Channing-Peabody opened the door to receive him.

“Doctor Larch?” Mrs Channing-Peabody asked.

“Yes, Doctor Larch,” answered Larch and bowed to the woman with a tanned face and silver-gray hair.

“You must meet my daughter,” the woman said. “And all the rest of us!” she added with a loud laugh that chilled the sweat on Wilbur Larch's back.

All the rest of them were named Channing or Peabody or Channing-Peabody, and some of them had first names that resembled last names. Mrs Channing-Peabody's daughter was young and unhealthy-looking. Her name was Missy.

“Missy?” Wilbur Larch repeated. The girl nodded and shrugged.

They were sitting at a long table, next to each other. Across from them there was one of the young men. He looked angry.

The girl looked unwell. She was pale; she picked at her food. The dinner was delicious, but there was no subject for conversation.

The old retired surgeon who was sitting on Wilbur's other side – he was either a Channing or a Peabody – looked disappointed when he learnt that Larch was an obstetrician. The old man was hard of hearing and asked young Larch to speak louder. Their conversation was the dinner table's only conversation; they were talking about operations.

Wilbur Larch saw that Missy Channing-Peabody's skin was changing color from milk to mustard to spring-grass green, and almost back to milk. Her mother and the angry young man took the girl to the fresh air.

Wilbur Larch already knew what Missy needed. She needed an abortion. It was clear because of the visible anger of the young man, the old surgeon's interest in “modern” obstetrical procedure and the absence of other conversation. That was why he'd been invited: Missy Channing-Peabody, suffering from morning sickness, needed an abortion. Rich people needed them, too. Even rich people knew about him. He wanted to leave, but now his fate held him. He felt that he needed to perform the abortion.

Mrs Channing-Peabody took him out into the hall. He let her lead him to the room that had been prepared for him. On the way she said, “We have this little problem.”

Missy Channing-Peabody had certainly been ready. The family had converted a small reading room into an operating theater. There were old pictures of men in uniform and many books. There was a table, and Missy herself was lying in the correct position. She had already been prepared for the operation. Someone had done the necessary homework. Dr Larch saw the alcohol, the soap, the nail brush. There was a set of medical instruments.

Everything was perfect, but Wilbur Larch could not forgive the loathing which the family felt for him. Mrs Channing-Peabody seemed unable to touch him.

“These people need me but they hate me”, Larch was thinking, scrubbing under his nails. He thought that the Channing-Peabodys knew many doctors but they didn't want to ask one of them for help with this “little problem.” They were too pure for it.

“Take her temperature every hour,” Larch told the servant after he had finished operating. “If there's more than a little bleeding, or if she has a fever, I should be called. And treat her like a princess,” Wilbur Larch told the old woman and the young man. “Don't make her feel ashamed.”

When he put his coat on, he felt the envelope in the pocket. He didn't count the money, but he saw that there were several hundred dollars. It was the servant's treatment; it meant that the Channing-Peabody's were not going to ask him back for tennis or croquet.

Larch handed about fifty dollars to the old woman who had prepared Missy for the abortion. He gave about twenty dollars to the young tennis player, who had opened the door to the yard to breathe a little of the garden air. Larch was going to leave. He looked for the old surgeon, but there were only servants in the dining room – still clearing the table. He gave each of them about twenty or thirty dollars.

He found the kitchen and several servants busy in it, and gave away about two hundred dollars there.

He gave the last of the money, another two hundred dollars, to a gardener who was on his knees in a flower bed by the main door. He tried to fold the envelope and pin it to the main door; the envelope kept blowing free in the wind. Then he got angry, made a ball out of the envelope and threw it into the green lawn.

On his way back to Portland, Wilbur Larch was thinking about the last century of medical history – when abortion was legal. By the time he got back to Portland, he had made a decision. He was an obstetrician; he delivered babies into the world. His colleagues called this “the Lord's work.” And he was an abortionist; he delivered mothers, too. His colleagues called this “the Devil's work,” but it was all the Lord's work to Wilbur Larch.

He decided to deliver babies. He decided to deliver mothers, too.

In Portland, a letter from St. Cloud's waited for him. The Maine State board of medical examiners sent him to St. Cloud's.

In the first week spent in St. Cloud's, Wilbur Larch founded an orphanage (because it was needed), delivered three babies (one wanted, two unwanted – one became another orphan), and performed one abortion (his third). Dr Larch educated the population about birth control. Over the years, there was one abortion for every five births.

During World War I, when Wilbur Larch went to France, the replacement doctor at the orphanage did not perform abortions; the number of orphans doubled, but the doctor said to Nurse Edna and to Nurse Angela that he was put on this earth to do the Lord's work, not the Devil's. Dr Wilbur Larch wrote his good nurses from France that he had seen the real Devil's work: the Devil worked with weapon. The Devil's work was gas bacillus infection.

“Tell him,” Larch wrote Nurse Angela and Nurse Edna, “the work at the orphanage is all the Lord's work – everything you do, you do for the orphans!”

And when the war was over, and Wilbur Larch came home to St. Cloud's, Nurse Edna and Nurse Angela were already familiar with the language for the work of St. Cloud's – the Lord's work and the Devil's work, they called it, just to make it clear between themselves which operation was being performed. Wilbur Larch didn't mind – it was useful language – but both nurses agreed with Larch: that it was all the Lord's work.

It was not until 193— that they had their first problem. His name was Homer Wells. He went out into the world and came back to St. Cloud's so many times that it was necessary to put him to work; by the time a boy is a teen-ager, he should be of use.

After the Lord's work, or after the Devil's, the wastebasket contained the same things. In most cases: blood, cotton, gauze, placenta. Sometimes in the wastebaskets that Homer Wells carried to the cremator there were human fetuses.

And that is how Homer Wells (when he was thirteen) discovered that both the babies and the fetuses were delivered at St. Cloud's. One day, walking back from the cremator, he saw a fetus on the ground: it had fallen from the wastebasket, but when he saw it, he thought it had fallen from the sky. He looked for a nest but there were no trees.

Holding the thing in one hand, Homer ran with it to Dr Larch. Larch was sitting at the typewriter in Nurse Angela's office; he was writing a letter.

“I found something,” Homer Wells said. Larch took the fetus from him and placed it on a clean white piece of paper on Nurse Angela's desk. It was about three months. “What is it?” Homer Wells asked.

“The Lord's work,” said Wilbur Larch, that saint of St. Cloud's, because at that moment he realized that this was also the Lord's work: teaching Homer Wells, telling him everything, explaining what was good and what was bad. It was a lot of work, the Lord's work.