The narrator is an aging, male gynecologist who works in a small North Carolina town. The National Health Service sends a young doctor, Rachel, to work in the clinic. From Boston, she is unused to the town's racial politics. She learns slowly to understand the motivations and concerns of her patients. As she campaigns for condom distribution, she ends up insulting the white men who run the town by calling them racists.

The narrator protests that they have power in the town only because no blacks ever run for office and that their policies are meant to distribute wealth evenly. He encourages Rachel to be more gentle and womanly. She will get her way more easily if she smiles. But Rachel eventually turns her back on the narrator, too, when in order to get a violent black man out of the clinic's lobby he calls the man "boy" and threatens to call the police. Rachel moves in with a black man. The town has revenge when a hit and run driver kills her lover and Rachel is hounded out of town.


The narrator implies that Rachel is too hot-headed to be a good doctor. She sees racism where there is none. Yet the narrator and the town officials clearly are racist. It remains a question, nonetheless, what Rachel should have done to be most effective in her situation.

Primary Source

Doctors and Other Casualties



Place Published

New York



Page Count