Endo's significant fiction is unfortunately being published here out-of-order; so far it's hard to tell, then, which steps advanced his art or moved merely laterally. Again, as in When I Whistle, a medical theme dominates in this relatively early (1958) novel: a series of terrible vivisections performed by Japanese doctors, in a medical school during the war, on captured American pilots. Surrounding this awful act are hospital politics which make research for research's sake imperative; and the paradox of healers-turned-killers is given an extra dimension of physicality by the fact that the hospital is in a city bombarded night after night: willed death inside a place of health which itself is within a place of death. Endo, with a tighter, more crystalline touch than Graham Greene (to whom he's so often compared), is most effective in the short vignette or the long, tense set-piece: a tired doctor slapping an old woman patient's face out of frustration over his impotence to help her; her parsimonious clinging to a miserable existence; the actual medical butchering of a healthy man. But the moral after-shocks and recriminations of the participants are not done as well or as subtly as in other Endo novels: this vivid, if overly-wrung book seems to have tested Endo's capacity for the gruesome--but is of itself less than his best.