In the Twilight, in the Evening

Cheney Duvall travels from New Orleans to San Francisco, escorted by Shiloh
Irons. In the St. Francis de Yerba Buena Hospital, Dr. Baird and most of
the others treat her with respect, but she finds some of the medical personnel
are doubtful of her character, her intent, and her skills. She must prove 
herself and assert her authority again and again.

Outside the hospital walls, San Francisco teems with brothels, criminal
gangs, and poverty-stricken vagrants and immigrants. The hospital has decreed
that none of these people will receive treatment, and when Cheney
fights to combat these prejudices, she finds that the only support she can
count on is from Shiloh Irons. But when catastrophe suddenly strikes, even
Cheney finds that none of her medical education has prepared her for such
an overwhelming disaster. With so many casualties and severe injuries, who
will help?