Thanks to Paul Torek for some thought-provoking comments, to which
I shall reply in two parts.  Firstly, I should like to comment on
his intriguing suggestion on how Rawls might react to my hypothetical.
Second, I'd like to make some comments on Torek's own criticisms.

1. Rawls and the Hypothetical

There is the interesting side-issue that I cannot
help but stray into.  Namely: how would a Rawlsian reply to my thought
experiment?  I had considered Torek's suggestion during the original
writing, but I thought I'd leave it to come out in the discussion.

Now at first glance, it appears that Torek is completely correct:
for if Rawls' first principle of justice, giving priority to liberty
means anything, it means that slavery is impermissible. 
Redistribution comes into its own only after there are some
re-distributable goods, at which point the second principle (the
Difference principle) make operate without violating the priority
of the first principle.

But I seriously doubt that Rawls would consider this a correct
application of his principles.  It is quite clear that he does not
think that coercive paternalism violates his first principle:

     The problem of paternalism deserves some discussion here,
     since it has been mentioned in the argument for equal liberty,
     and concerns a lesser freedom.  In the original position
     the parties assume that in society they are rational and able
     to manage their own affairs...But once the ideal conception
     is chosen, they will want to insure themselves against the
     possibility that their powers are undeveloped and they
     cannot rationally advanced their interests...[Mention of
     children and the mentally disturbed as prime examples,
     but continues as follows] It is also rational for them to
     protect themselves against their own irrational inclinations
     by consenting to a scheme of penalties that may give them
     a sufficient motive to avoid foolish actions and by 
     accepting certain impositions designed to undo the unfortunate
     consequences of their imprudent behavior.  (section 39, pp.248-249)

And when Rawls describes what he has in mind with the first principle,
the right of self-ownership does not seem to be quite what he has
in mind:
     
     The basic liberties of citizens are, roughly speaking, political
     liberty (the right to vote and to be eligible for public office)
     together with freedom of speech and assembly; liberty of 
     conscience together with freedom of speech and assembly;
     liberty of conscience and freedom of thought; freedom of the
     person along with the right to hold (personal) property;
     and freedom from arbitrary arrest and seizure as defined by 
     the concept of the rule of law. (section 11, pp.61)

(One might argue that the right of self-ownership is in that list
somewhere, but it hardly seems like that is what Rawls is saying;
rather, he has very much the civil libertarians' narrow view
of liberty even leaving aside mention of private property).

And finally, I would point out Rawls' many denials of the claim
that individuals have deserve their natural talents.  To take
only one example:
     
      Perhaps some will think that the person with greater natural
      endowments deserves those assets and the superior character
      that made their development possible.  Because he is more
      worthy in this sense, he deserves the greater advantages
      that he could achieve with them.  This view, however, is
      surely incorrect.  It seems to be one of the fixed points
      of our considered judgments that no one deserves his place
      in the distribution of natural endowments, any more than
      one deserves one's initial starting place in society...
      Thus the more advantaged representative man cannot say that
      he deserves and therefore has a right to a scheme of
      cooperation in which he is permitted to acquire benefits
      in ways that do not contribute to the welfare of others.
      (section 17, pp.104-105)

If this doesn't seem to be an affirmation of the propriety of
redistribution even in the pure service economy, I don't know what
is!  Basically, a common sense reading of Rawls' principles
makes it _seem_ that Rawls would answer as Torek says he would.
But Rawls actually gives such a qualified and tortured interpretation
of his principles that I have to wonder if he would shrink from
redistribution in my hypothetical.  My bet is that he would happily
impose a "tax" such that every hour of paid medical care
imposes an obligation to provide e.g. twenty minutes of unpaid
care to the poor; and then he would rationalize this by saying
that this isn't really coercive, since the surgeon could pick
how many hours to work (and plus he doesn't deserve his natural
assets anyway...)


2. Torek and the Hypothetical

Well, first of all, I did give a few transition stages, and I'm
curious about your reaction to those.  For example, I considered
a slight modification where we add money ("labor notes") to the
pure service economy.  Do you still agree that redistribution is
impermissible then?

Now Torek was quite right to point out Nozick's objection to the
"labor mixing" formula.  But I didn't advocate that view, and
in fact did deny the deducibility of homesteading from self-ownership.
Rather, I was considering the similarities of some of the negative
arguments against private property, and showing that they also apply
to self-ownership, too.  This wasn't meant to defend property rights
in objects, except insofar as refuting objections to something 
constitutes a defense.

Now I'm trying to get a clear grip on your point that private property
prima facie seems to restrict liberty.  As far as I can tell, I agree
with your conclusion.  Namely, we must _first_ establish ownership
in order to say that infering with continued possession reduces
liberty; and once we establish that someone owns something, then it
no longer makes sense to claim that their action reduces liberty.
Again, I think the parallel between self-ownership and ownership of
objects is quite good: for just as a woman's refusal to have sex
with a man does not constitute "reducing his liberty," (since she
justly owns her body), the same woman's refusal to take the man
in as a free tenant in her home "reduces her liberty" iff she
justly owns the home.  (In a parallel fashion, the rapist might
deny that the woman justly owns her body.)

Just to take a stab at the underlying question: what justification
could be given for ownership of things?  I make no attempt to "deduce"
it from self-ownership.  Rather, I think that it just a second,
almost as plausible principle that a person who produces something
from previously unowned materials is entitled to own it.  I do
however think that once you accept the idea of self-ownership, that
the homesteading principle is likely to seem plausible as well.
In particular, if you consider my hypothetical and find that the
objections to self-ownership don't convince you, then you may
find that they aren't very good arguments against property in things
either.  At least, the seemingly overriding importance of care for
the poor, equality, etc. will be considerably devalued.