The chapter introduces Dr. Austin Sloper, a physician whose learning and skill are evenly balanced. Dr. Sloper possesses great wit and moves in New York City's best society. Described as scrupulously honest, the doctor marries a beautiful, intelligent, and charming heiress, and he is a devoted and happy husband. Mrs. Sloper’s societal position only enhances Dr. Sloper’s position and practice, and he has numerous wealthy patients.

The couple has a son who dies when he is only three years old. Two years later, Mrs. Sloper gives birth to a daughter to the disappointment of Dr. Sloper, who would have preferred a son. The mother dies unexpectedly from complications only a week later. The loss of his wife and son only makes Dr. Sloper more interesting in society, and his practice continues to flourish. He names the girl Catherine after her mother. She grows up healthy, so Dr. Sloper never fears losing her as he lost his wife and son.

Dr. Sloper has two sisters, Lavinia Penniman and Elizabeth Almond. Mrs. Almond is the doctor’s favorite; she is attractive, reasonable, and charming. She married a prosperous merchant and bore several children. By contrast, Mrs. Penniman married a clergyman, who died when she was 33, leaving her without children or fortune.