United States
Los pacientes del doctor GarcíaThe United States is a distant but consequential presence in the novel: the hoped-for destination of intelligence and refuge, the home of a congressional campaign against Franco, and ultimately the power whose Cold War calculations help accommodate his regime. For Rafael, Meg, Manuel, and Sal Burnstein, the country is alternately a promised escape, a political audience, and evidence that exposure does not necessarily lead to justice.
A prospective refuge and intelligence destination
The United States first matters as the destination imagined for the dangers of undercover work. When Manuel explains the plan for documenting the trucks carrying looted art and valuables out of Spain, he promises that Rafael’s name will not appear in the dossier. If publication goes ahead and the pressure succeeds, the two men will be taken out of Spain before the owner of Rafael’s transport agency understands what has happened. Manuel imagines that they might meet in Washington, then return to Madrid when Franco has fled El Pardo. The promise joins personal loyalty to political expectation: escape is not meant to sever the agents from Spain, but to make their return possible after the dictatorship falls.
That future remains conditional. Rafael hopes that French customs will stop and inspect a shipment, thereby interrupting the operation; the loads instead reach their destinations without incident. The information is to be collected first, and the Allies are to trace the shipments and recover the stolen property later. The United States is thus part of a chain of delayed accountability: the evidence travels, but the cargo continues onward, and the hoped-for intervention depends on decisions not controlled by the people taking the risk.
The possibility of American protection also surfaces after Manuel’s report reaches Sal Burnstein’s circle. On February 16, 1950, Meg tells Rafael that she is returning to Washington because Burnstein has obtained Manuel’s report, which exceeds expectations. She says she is being removed from Spain before publication to avoid trouble and hopes the consequences for Franco will be grave. The report, assembled from Manuel’s dangerous work in Buenos Aires, gives the campaign a concrete target and a documentary basis. Yet Meg cannot say when it will become public: support must be built in Congress, public opinion stirred, and newspapers brought into the debate. Washington is a place where action may be organized, not a guarantee that it will be immediate.
Burnstein’s campaign and its limits
Burnstein’s political commitment takes shape after Meg brings him a proposal focused on Clara Stauffer and her escape network. The meeting gives his opposition to Franco a specific mission, an objective, and an identifiable adversary. His interest is not merely abstract: the network’s protection of Nazi fugitives connects the Spanish dictatorship to a continuing international problem. The novel presents political work as dependent on information and on the people willing to carry it across borders, but also on institutions prepared to receive it.
The campaign costs Burnstein his place in ordinary party life. His insistence on confronting Franco and the crimes associated with fascism alienates Democratic colleagues, who frame their objections in the language of pragmatism, peace, security, and the danger of strengthening communism. His son-in-law Bill Mattioli presses that argument most persistently, warning that removing Franco could have consequences in a world shaped by Soviet power. Burnstein, by contrast, keeps returning to the plain moral vocabulary of crime, victims, dictators, and killers. The dispute is not resolved by the report’s arrival: it exposes the distance between naming an injustice and persuading a government to act against it.
Burnstein eventually leaves politics and settles in Rockport, Massachusetts. Before withdrawing, he asks Andy Sanders not to abandon the report’s author, who remains in Buenos Aires, surrounded by Nazis and pretending to be a war criminal. Sanders assures him that the United States will help Manuel leave Argentina, offer him residence, and may even employ him. Burnstein’s last request makes clear that the intelligence operation has created a personal obligation as well as a political asset. But his departure also marks the campaign’s loss of its most committed advocate: the man who pressed the evidence into political view can no longer direct what happens next.
From wartime neutrality to Cold War alignment
The United States’ relationship with Spain changes in ways that sharpen the gap between public disapproval and practical policy. In 1953, the two governments sign the Madrid Pact, a government-to-government agreement rather than a treaty requiring approval by the United States Senate. The unequal rank of the signatories signals the imbalance: Spain sends two ministers, while the United States is represented by its ambassador and a chamber of commerce leader. Franco’s government had sought a higher-status agreement, but the American administration chooses a form that can proceed without Senate approval.
The pact’s political effect is more important than its formal rank. Publicly, Franco’s regime repels senators; strategically, the relationship becomes advantageous to the United States and still more valuable to the dictator. The Spanish people, the account emphasizes, are once again excluded from knowledge of decisions made in their name. When President Dwight D. Eisenhower visits Madrid on December 21, 1959, the visit serves as the public culmination of a process begun by the 1953 agreement. The event makes visible how far the earlier hope of using American pressure to dislodge Franco has receded: diplomatic engagement now confirms the regime’s international standing rather than threatening its survival.
The novel places this accommodation within a wider history of American anti-communist policy. After the 1976 coup in Argentina, United States officials anticipate repression and express a willingness to support the new rulers rather than make them feel isolated. The account traces the dictatorship’s violence not only to the coup itself but to a political climate in which anti-communism can license military rule. It describes the earlier Operation Independence as a campaign that divided Argentina into military zones and targeted civilians under a rationale of suppressing subversion; the later regime’s terror expands that precedent into systematic disappearance, clandestine detention, torture, executions, and the theft and reassignment of children.
The promise and the cost of intervention
Manuel’s anger at the changing international order gives the United States’ role a human voice. When Fred Goodwin says that the world has changed and invokes Stalin, Manuel replies that Stalin won the war for the Allies and asks why Stalin’s tyranny had not mattered when Allied forces entered Berlin. His protest comes from a Spanish exile’s sense that the country’s suffering can be set aside once it no longer serves the priorities of powerful states. The exchange connects the earlier expectation of a return to Madrid after Franco’s fall with the later abandonment of that prospect in favor of Cold War calculation.
Across these episodes, the United States is neither simply a rescuer nor merely a distant antagonist. Its officials and political actors can receive evidence, provide protection, and offer refuge; its domestic debate can also stall action, while its strategic agreements and anti-communist commitments help preserve authoritarian governments. The contrast is especially stark between the promise made to Rafael that he and Manuel might return to a liberated Madrid and the later reality of Eisenhower arriving as Franco’s guest. The country remains a destination for those in danger, but the novel refuses to treat arrival there—or the transmission of proof—as equivalent to justice.