The narrator – a melancholic, retired Indian physician now living in London – rehearses his life story and its secrets that he plans on telling his adult daughter when she visits him from America. Dr. Kaiser Shah (sometimes called “Dr. K”) sent his only child, young Sara to a boarding school in America after her mother, Atiya died of cardiac arrest. Since then, father and daughter have rarely seen one another.

For more than twenty years, Dr. K worked in a hot town in the Middle East yet never got to know or understand its people. His only friend was a troubled hospital anesthetist, Biju. Dr. K was employed by the local hospital and assigned to the Accident and Emergency department. The hospital administrator, Sir Farhad (a man Dr. K feared and revered) was an enigmatic figure of authority. Dr. K was obsessed with accumulating wealth. When Farhad offered him an opportunity to earn extra money, Dr. K had no qualms accepting the new part-time position: punishment-surgeon. He would supervise criminal sentences requiring physical mutilation that were imposed by a judge.

Biju sarcastically told his friend, “You are at the cutting edge of your profession, Dr. K” (111). Yet there was no humor or humanity at presiding over the amputation of the hands of a father-son team of thieves or a maid convicted of stealing jewelry who underwent a similar clinical maiming. The hospital routinely accepted these “punishment cases” referred from the Corrections department and constructed a special operating theatre on the top floor for these “special ops.” Over a decade, Dr. K figured his involvement in this injurious punishment amounted to at least twenty cases.

Raucous Biju gets accused and convicted of stealing drugs from the hospital. His penalty was removal of a hand. Dr. K pleaded on behalf of Biju with the hospital administrator but to no avail. Dr. K was not convinced of Biju’s guilt and would not participate in the amputation of his friend’s hand. Dr. K resigned his post as punishment-surgeon and eventually settled in England with plenty of money for a comfortable albeit lonely life.