New York City enters the novel as a place of medical crisis and decision for Alexander A. Gideon. His planned radiotherapy at Mount Sinai Hospital and the judgment of doctors there that further surgery is pointless help explain why his illness becomes inseparable from his return to Israel, his changing dependence on others, and the arrangements for his estate.

Medical Destination

In a telegram to Manfred M. Zakheim, Alexander A. Gideon says he is going into Mount Sinai Hospital in New York for a week of radiotherapy. He asks Zakheim to arrange a quiet private clinic with chemotherapy facilities should he decide to return to Israel, and gives him discretion over his property on the condition that he remain with him. The message makes New York part of an unsettled plan: treatment is under way or imminent, while a return home remains possible.

Zakheim replies that arrangements are ready if Gideon chooses to come back, including a private doctor and nurse. He also says he has instructed an investigator to drop the inquiry into the Sommo family and Boaz, and that he is investing Gideon’s cash in Tentpeg while leaving the real estate untouched. Gideon then tells him not to come, says he feels well, and notes that an updated will is on its way. The exchange places medical care, privacy, friendship, and control of the estate in the same correspondence without resolving whether Gideon will return.

The Doctors’ Judgment and Return

In a later letter to Michel-Henri Sommo, Gideon explains that he contracted kidney cancer a year earlier and underwent two operations. The growth has spread in his abdomen; doctors in New York see no point in another operation. He describes his condition as miserable and connects it to his unannounced return to Israel, where he wants to see Boaz and stay in the house in which he grew up. The account retrospectively clarifies the urgency behind the earlier messages: New York is not presented as a cure, but as the place where the limits of further surgery became clear.

The correspondence also shows how little certainty accompanies the treatment plan. Gideon had asked Zakheim to prepare for a possible return and then rejected his offer to come; later, he is back in Israel and expects to enter Hadassah Hospital for radiotherapy. The sequence distinguishes the treatment proposed at Mount Sinai Hospital from the subsequent plan in Israel, without establishing that every proposed treatment took place.

Narrative Significance

New York City marks a threshold in Gideon’s story rather than a lasting home. The medical news from there makes his remaining time newly explicit, while his messages about the estate reveal how he tries to arrange practical matters even as his plans change. His return shifts the center of the narrative from distant reports and decisions to the childhood house, where illness increasingly makes him reliant on care from Ilana Brandstetter-Sommo and Boaz.

The city’s significance is therefore carried through letters and reported medical judgments rather than through scenes of urban life. New York supplies a decisive piece of knowledge—another operation is not considered worthwhile—but the consequences unfold elsewhere, as Gideon returns to Israel and the relationships and memories of his former home take over the story.