Nelson wonders why, no matter how cheerful and blameless the day's activities have been, when you wake in the… — John Updike
Nelson wonders why, no matter how cheerful and blameless the day's activities have been, when you wake in the middle of the night there is guilt in the air, a gnawing feeling of everything being slightly off, wrong – you in the wrong, and the world too, as if darkness is a kind of light that shows us the depth we are about to fall into.
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"Did Nelson ever tell you the story," Pru asks Annabelle, "how he lost the agency up his nose?"
His voice is hurrying, to keep up with his brain.
[Annabelle] "...health care is an expanding field, as the world fills up with people that would have been dead a hundred years ago. Everybody winds up needing care, pretty much."

