Chapter iv consists of one long memory of the scenario in which Joe loses his best friend and his girlfriend all at once in high school. The scenario is connected in Joe's mind with the severe bodily pain that he experiences by working one day on a railroad section gang in the desert at that same time. This remembered bodily pain is, of course, connected to Joe's current bodily pain as he emerges from his operation in a fevered state. The connection between Joe's loss of friends and his physical and emotional pain highlights the individual isolation of pain, which is felt inside oneself and cannot be communicated to others.