While some readers may find this story too sexually explicit and even offensive, it is a fascinating portrayal of a doctor who has been successful in life except perhaps in all the ways it really matters. Raw and relentless seem to be the most fitting adjectives to describe both the story and its protagonist. Like many of his other short stories, author Thom Jones has created a character in Dr. Moses Galen who falls victim to raging levels of testosterone and life’s terrible ironies.

The author also reiterates some of his frequent themes: Pain transcends just about everything else. It is sometimes difficult to distinguish between pain and pleasure. The will to live is often the most powerful human characteristic. Life is tough like a fight and death is never easy.

Moses Galen is a man of many contrasts. He possesses the brute power of a boxer and the delicate touch of a plastic surgeon. His hands are adept at perfecting physical beauty and reconstructing bodies but also capable of inflicting pain and disfigurement in the boxing ring. He takes pride in his appearance and vitality even though he realizes that his body is being ravaged by diabetes. Much like the plastic surgery he performs, Dr. Galen realizes perhaps too late that his own life has also been superficial. The end of this story describing Dr. Galen’s effort at dying is as powerful as any image in literature.