patient. The room is brightly lit, with windows in the ceiling, and appears to have been constructed for an assembly; benches encircle a central raised platform with an operating table. Ren recognizes the doctor as the hungry-looking man from the hallway painting, though he appears older. He stands on the platform, wiping blood from a bone saw. Ren notes that his expression still holds that “hunger for sausages...even as he spit into the cloth and scrubbed away at a spot of dried blood.” Doctor Milton tells Ren that, from now on, he will arrive at the hospital at ten in the morning for a routine appointment. Ren feels a “strange sense of vertigo” as he steps up onto the platform, “as if he were balanced on the edge of a cliff.”

Doctor Milton tells Ren that his job is to do precisely what he is told. Ren assures him that he can do this job well. The doctor hands him a knife with a hooked end, which makes it “easier to cut around the veins,” and tells him to put it back. Ren takes the knife to an open wooden case on the other side of the operating table and finds the empty space where the knife goes. Doctor Milton appears pleased. Suddenly, he notices Ren’s scar and is intrigued. He inspects Ren’s arm and declares that, while the cut was “crude,” whoever cut off Ren’s hand “knew what they were doing.” He tells Ren that his early training involved amputations and that he is fascinated by the regenerative capabilities of skin. He asks Ren if he can take a sample of his scar tissue. Before Ren can respond, the doctor uses a knife to quickly excise a small piece of his scar. Using tweezers, he places the sample on a glass dish and carries it to a microscope “as if he had just peeled a piece of bark from a tree.” He tells Ren that “normal skin looks like scales,” but that scar tissue is smooth because it does not contain hair follicles or sweat glands. He invites Ren to look, and Ren sees that his own scar tissue is “smooth on one side,” but underneath it is a pattern of spindly lines “like frost on a windowpane.” Doctor Milton explains that he has seen identical patterns on hearts, livers, and muscle tissue. He says that the inside of the human body is beautiful, especially muscle tissue that is close to a bone. He pinches parts of Ren’s arm, listing each type of muscle, before storing the piece of Ren’s sample in a jar. He asks Ren what his scar tissue looked like, and Ren replies that it looked like “old cobwebs.” Doctor Milton records Ren’s response in a notebook.

Doctor Milton then tells Ren that Mister Bowers has told him that Ren, Benjamin, and Tom are trustworthy and asks Ren if this is true. Ren silently recalls that Mister Bowers was paid to tell Doctor Milton about their trustworthiness, but he assures the doctor that they can indeed be trusted. Doctor Milton’s expression changes “from sausages to Christmas goose and custard pie.” He hands Ren a set of keys and says that he needs four bodies—no more than two days deceased—by the following Thursday, and that they should be brought to the basement door. Their story is that Ren is visiting Doctor Milton every week because his scar is infected and the doctor is trying to keep him from losing even more of the arm. Doctor Milton orders Ren to tell Sister Agnes, who is the nun who met Ren at the front gate, their story. Ren tells her immediately because she is waiting for him on the bench outside the operating room. He decides that he will wear his arm in a sling next week. Sister Agnes escorts Ren outside and asks if he would like her to pray for him. He remembers the feeling of Brother Joseph’s thumb drawing a cross on his forehead when handing over The Lives of the Saints and gives her permission. As Benjamin and Tom return in the wagon, Sister Agnes places her hand on Ren’s head. Benjamin and Tom are openly impatient to leave, but Ren waits until Sister Agnes finishes her prayer.

Analysis

While Benjamin, Tom, and Ren’s arrival in North Umbrage subtly shifts the novel’s tone into to one of dread and suspense, it is Ren’s disturbing experience at the hospital that firmly establishes the novel as a work of gothic fiction. Gothic literature traditionally blends horror and Romanticism, often incorporating supernatural events or forces over which humans have no control. Common attributes of gothic novels include somber, deteriorating settings, supernatural beings like monsters or ghosts, insanity, romance, and an overall tone of suspense, fear, and discomfort. Both North Umbrage and Doctor Milton’s hospital have gloomy and decaying qualities; the former seems half-abandoned and dangerous, and the latter is a sinister “castle out on its own,” nestled in an overgrowth of trees, grass, and shrubs. The hospital appears more like an insane asylum than a prison, with mostly unresponsive patients confined to their beds as they await the care of a nun with eyes so black that they appear to be mostly pupils. Doctor Milton himself seems more like an evil villain than a doctor. The novel’s incorporation of gothic conventions strongly encourages the reader to anticipate future supernatural forces or events.

The gothic qualities of Doctor Milton’s hospital showcase the novel’s ambivalence about science and technology more than ever before. The doctor, who performs a torturous and possibly unnecessary amputation in front of a group of young doctors, looks more hungry than intelligent. Ren believes he specifically hungers for sausages and then for a Christmas goose and custard pie. Science and technology are dehumanizing, as is evident by the nonchalance of every person—besides Ren—who is not a patient; the doctor is unmoved by the pleas of his victim while the young doctors watch the operation without objection. Even the nun carries the man’s leg as if she were only carrying an infant. Furthermore, Doctor Milton treats Ren as though he were not human; he cuts a piece of Ren’s arm and handles it as though he had “peeled a piece of bark from a tree.” He also speaks of the human body in a dehumanizing way; he catalogues muscle groups as though listing parts of a machine, speaks casually about looking inside bodies, and demands four corpses as though he is placing an order for material goods. His hunger is reminiscent of Victor Frankenstein’s hunger for fame in Mary Shelley’s iconic Gothic novel, Frankenstein. Doctor Milton appears to symbolize the very worst of scientific and technological advancement.