The morning Casualty shift had been a conveyor belt of textbook fall injuries hips, wrists, collarbones and tailbones, wheeled out of the ambulances, into X-ray and thence to the winding queue for the plaster room. Mrs Spelko had attempted to speed things up by zoning the waiting area according to injuries. Spencer had heard her shouting 'wrists to the left, to the left' at a bewildered porter, and had shortly afterwards come across Vincent, his friend the psychiatrist, watching the scene with quiet wonder. 'Evidence is mounting,' he'd muttered to Spencer. 'Recurrent grandiosity and delusional behaviour in this case she obviously thinks she's an air traffic controller. My file is building and I hope soon to have her removed under Section 4 of the Mental Health Act.'

There were now only six weeks left of Spencer's contract, and he was experiencing the unfamiliar sensation of looking forward to something to several things, actually. To waving goodbye to Mrs Spelko, for a start; to the end of the relentless shift system to which his body clock had never really adjusted; to the impersonality of Casualty, through which patients pa.s.sed with the speed and anonymity of car factory components a door bolted on here, a wing mirror there but most of all he was looking forward to leaving hospitals behind him; G.o.d knows he had spent too much time in those places in recent years. That smell, compounded of antiseptics and air fresheners and bedpans, that atmosphere of fear and boredom and desperate hope, the terrible rattling sweep of curtains drawn around beds, the colours never seen elsewhere jaundiced skin under fluorescent light, iodine splotches on bleached sheets he never wanted to hear, see, feel any of it again.

'Is there somefing wrong with that?' It took a moment for Spencer to realize who was speaking. The man behind the counter had his back to him, and was using a large knife on something that crunched unpleasantly, but in the long mirror that lined the wall, his heavy-lidded eyes were focused on Spencer's plate.

'Yes,' said the man, 'I'm talking to you with the books. Is there somefing wrong with your meal?'

'I haven't tried it yet,' said Spencer.

'Well if you don't like it hot, you won't like it cold.'

'It's good food, that,' said the old man with the pudding, pointing with his spoon. 'Put hairs on your chest, that will.'

'Right,' said Spencer.

'He doesn't like the licker,' said the man behind the counter.

'It's full of goodness, that.'

'I told him it's traditional.'

'Licker's the best bit. Go on, son, try it.'

'It's normally ladies who won't try the licker.'

'Go on, son,' said the old man, as if urging a slow but willing horse.

The construction workers, having reached the f.a.gs and Sun portion of the meal, were watching with what looked like mild contempt, and Spencer could feel that the number of comments might soon multiply and darken. He reloaded his fork with as much pie and as little green stuff as possible, and raised it to his mouth.

'Good?' asked the old man, keenly, before he'd swallowed.

Spencer nodded, smiling, and gave a thumbs-up. The atmosphere lightened, and the construction workers went back to their paper.

'You fought it would taste fishy, din't yer?' The man behind the counter had turned, and Spencer could see he was holding a decapitated eel in one hand. He nodded, still unable to speak.

'And it don't, does it?'

He shook his head. The man looked satisfied and slapped the eel back on the counter. It flipped its tail and Spencer turned away hastily. To be honest, the bolus of flavours in his mouth gravy browning, cheap stewing steak, unb.u.t.tered, unsalted, lukewarm mash seemed strangely familiar, almost comforting. He swallowed and remembered: school dinners.

He opened Microbiology for the General Pract.i.tioner at the chapter on food poisoning, and started to read, mechanically inserting forkfuls with his left hand and making notes in the margin with his right. He had brought his textbooks to the shop as part of a new regime, inst.i.tuted out of desperation. Faced with failing both his exams and his promise to Mark, he had started combining the two disciplines. Thus, within recent weeks he had revised obstetrics at the oyster bar in Harrods' food hall, s.e.xually transmitted diseases while sheltering in a doorway during the ceaseless rain that accompanied the Lord Mayor's Show, and paediatrics while queuing to see Santa at the Hanley Cross Shopping Centre. The latter wasn't actually on Mark's list, but const.i.tuted a long-held promise to his G.o.d-daughter. Nina had been so excited at the prospect of seeing Father Christmas that she had sung 'Rudolf the Red-Nosed Reindeer' throughout the car journey and then fallen asleep in her buggy for the entire forty-five minutes it took to inch through the Pixie Glen. Spencer had found a textbook in his bag and been pleasantly surprised by the degree of concentration he'd achieved, shuffling along with the book held in front of him while a tapeloop of 'Jingle Bells' boomed from the tannoy. He'd woken Nina just before they reached the grotto and she'd been understandably cross and sleepy, refusing to give her name or even look at Santa, although she'd taken the present with a disdainful hand. The chief pixie helper had greeted Spencer by name, and he'd been startled to recognize a two-day relationship from a couple of years back, now minus a moustache, but sporting a little pointed hat and matching tunic. The helper (Simon? Stuart?) had been busy fending off the next child in line who was trying to punch him, so hadn't had time to chat, but he'd looked well; it was always a grim relief when someone you hadn't seen for a while looked well.

The really odd thing about that afternoon was that now, whenever Spencer heard 'Jingle Bells', he instantly recalled the five commonest causes of non-haemorrhagic childhood rash. It was a pity he couldn't bring a tapedeck into the exam.

'Enjoy that then?' The counter man was removing his plate, and Spencer realized that he'd eaten the lot, green gravy and all.

'Yes it was lovely,' he said mendaciously.

'Spotted d.i.c.k?'

'No thanks.' He felt a pang at the missed opportunity of the question; Mark could have come up with half a dozen replies, each cheaper than the last.

'More tea?'

'No thanks, I'd better be going.' He checked his watch and saw that it was much later than he thought; Dr Petty had suggested he arrived at four thirty and it was already twenty past. He grabbed his books and coat, and hurried out into the cold.

The Christma.s.sy decor at the Sarum Road Practice began in the car park, where someone had spray-painted fake-snow holly leaves onto the surgery wall, continued in a small way at the door (plastic Yule wreath), the doormat ('Merry Xmas' in Gothic script) and the umbrella stand (dangly Santa) and achieved full glory in the waiting room where no inch of wall was free of tinsel, no surface of beaming snowmen, and even the receptionist wore three-inch earrings in the shape of Christmas trees. She was on the phone when Spencer entered, and gave him a raking stare before pointing to a chair and resuming her conversation.

'Like I said, there's nothing in the book until Tuesday.' She was in her very early twenties, black, slightly buck-toothed and strikingly well-dressed for the job in a fuchsia crossover top and black lycra trousers, her hair teased into an elaborate weave dotted with pink and white flowers. Even her nails continued the theme, each one a deep pink, encrusted with white dots like a mini-snowstorm. As she listened to the person on the other end of the line, she examined them one by one, first from a couple of inches away and then from arm's length. 'Like I told you, there's totally nothing I can do about it,' she said, scratching an invisible stain from her thumbnail. Her tone was mildly sympathetic with an undercurrent of deep boredom. She leaned across the counter towards Spencer and put her hand over the mouthpiece.

'Are you Dr Spencer?'

He went over to the desk. 'Dr Carroll, you mean?'

'Carol?' she said disbelievingly.

'That's my surname. Carroll. Spencer's my first name.'

'Right. But you're definitely the one who's starting in February?'

'Yes, I '

'Excuse me just one moment.' She unblocked the mouthpiece. 'All right, Mrs Latham, you're going to go for Tuesday then? Ten thirty? All right, then. Merry Christmas, Mrs Latham.' She put the phone down and made a note in the appointments book.

'OK Dr Spencer, Dr Petty's sorry but he had to go on a call. You're late.'

'Yes I know, I got lost in the one-way ' The phone rang again and she picked it up with an automatic 'Sarum Road Practice, how can I help you?'

Spencer leaned against the counter, being careful not to nudge the flashing nativity scene, and took a covert look around the waiting room. Evening surgery wasn't due to begin for forty-five minutes but the seats were already starting to fill. Compared to their counterparts in Casualty, the patients looked slightly older, slightly shabbier and slightly less likely to shout obscenities and punch a member of staff; it was odd to think that in a few weeks he would know some of their names, and in a few months be able to recite their entire medical and family histories. They sat in silence; the quiet was punctuated only by sniffs and coughs, and the occasional sharp snapping noise. It took a moment or two for him to realize that the latter was the receptionist clicking her fingers at him. She was still on the phone, but she pointed a tiny blizzard at an unmarked door next to the leaflet rack and mouthed 'wait in there', before turning away to riffle through the repeat prescriptions book.

He edged round the table where neat rows of magazines lay untouched and knocked on the door, waiting a good few seconds before turning the handle. Someone said, 'Come in,' just as he opened it and out of some strange reflex he half closed it again, banging his knee and forehead and dropping his briefcase. There was a stifled t.i.tter from the waiting patients as he picked it up again and entered the room with as much dignity as he could muster.

It was a Christmas-free zone, a large and cluttered area that obviously served several purposes meeting point, kitchen, office the one function flowing into the other so that the kettle was on the desk and the easy chairs piled with folders and printouts. Crouched in the corner, an open black bin liner in front of her, was a women he vaguely recognized.

'h.e.l.lo Spencer,' she said, straightening up. She was almost his height not far off six foot with grey-streaked shoulder-length hair and a pink-and-white complexion that made her look oddly girlish. She held out a hand. 'We've met a couple of times. I'm Fran's next-door neighbour.'

'Oh, of course.' He was used to only seeing her top half over the garden wall. 'Violet, isn't it?'

She grimaced. 'Iris.'

'Sorry. I knew it was a flower.'

'It was actually one of my great aunts. The other two were called Olive and Myrtle, so I suppose it might have been worse. Anyway, welcome to the practice.'

'Right, thanks.' He was still feeling the slight disorientation of seeing someone out of context. 'So... you work here?'

'Yes, I'm the ' She paused. 'I don't really have a t.i.tle. Practice Administrator I suppose; I do a bit of everything.' She looked rather ruefully at the bin bag.

'What have you lost?'

'Not me,' she said. 'Dr Petty accidentally threw away his invite to a medical dinner and he can't remember where it is, or who's giving it. And he's not sure whether he threw it away here or at home. Or he might just have lost it.' She rolled her eyes.

'One of those satisfying little tasks then?'

'Mmm.'

'I was supposed to be meeting him at four thirty for a chat and a look around the surgery.'

'I know. I organized it.'

'Oh G.o.d, well I'm sorry I'm so late.'

'It doesn't matter. I can do the showing round and Roger's chats go on far too long anyway. Tea?'

'Please.'

'I'd seen your name on our trainee list for a while, but it took me ages to make the connection.'

As she filled the kettle and washed a couple of mugs, he wondered who it was she reminded him of, with her mid-calf navy skirt and matching blouse, her shining cheeks and bobbed hair. There was an image hovering in his head of a woman with one foot on a bus platform and the other jauntily in mid-air; a 1920s clippie, he suddenly realized all she needed was the ticket machine and a cloche.

'Milk?'

'Please.'

She poured a little into his empty mug and set it on the table. 'Do sit down just shove all that stuff onto the floor. I was in the middle of a tidy-up when Roger had his crisis. Have you ever met him?'

'Briefly. He was on the traineeship selection panel.' He remembered a voice that could have been borrowed from Trevor Howard, a silk tie, a tailored shirt and a great deal of mature-model-quality white hair. 'What's he like?'

'Well he's ' She hesitated, clearly weighing up a number of possible answers. 'He's rather patrician,' she said at last, and he had the feeling that she'd gone for the tactful option. 'He does tend to p.r.o.nounce on things, which some patients like of course...'

'Right,' said Spencer, getting the picture. 'And what about the ones that don't?'

'They can see Dr Steiner.'

'And what's Dr Steiner like?'

'He's ' The same weighing-up process took place, Iris's eyes roving around the room as she searched for the correct adjective. 'He's very ' She paused again.

'Difficult to describe?'

'Odd, I was going to say.'

'Odd in what way?' asked Spencer, fascinated.

She moved her head, hesitantly. 'Well you know Mr Spock in Star Trek '

He let out a great bark of laughter, startling himself. It was such an uninhibited sound, so unfamiliar to him in recent months that he'd forgotten he could make that noise. Iris was looking amazed.

'That wasn't actually supposed to be a joke,' she said. 'It's quite an accurate comparison.'

'The ears?'

'Not the ears, no. Just the general air of... otherworldliness. Ayesha she's the receptionist she calls him The Martian.'

'And what's she like?'

'Very efficient and confident and rather patronizing. Well, she patronizes me, anyway,' she added, humbly.

'Is she the Christmas fan?'

'Yes. It's a bit excessive, isn't it? I did try to say something but well, to be honest she thinks I'm very old and not altogether worth listening to. And a killjoy, of course.'

'How did you keep this room clear?'

'Oh, I just reminded her that Dov Steiner's Jewish and he'd be offended if we forced Christian symbolism on him.'

'Would he?'

'No. I doubt he'd even notice.'

'Anyone else I should know about?'

'Magda, the practice nurse. But she's quite normal.'

He laughed, and again she looked surprised, as if unused to being found amusing. 'She is, you know. Well, compared to Dov, anyway. Though she's a Mormon so there are certain subjects you have to avoid.'

'Like what?'

'Oh, you know... wedding rings, that sort of thing.' This time, when he laughed, she looked rather pleased. 'To be honest, I've been looking forward to you coming; I do miss having ordinary conversations.'

The tea she made was only marginally weaker than that at the pie and mash shop, and Spencer sipped it cautiously. He had found that if he started night shift on a caffeine high, then by 3 a.m. even patients who were quite ill themselves started enquiring whether he was feeling all right, and by 8 a.m. he was wide awake again, ready to go through the whole dreadful insomnia cycle once more.

Iris spotted his hesitation. 'It's too strong, isn't it? I'll make you another.' He started to protest but she was already turning the kettle on again and rinsing out his mug. 'I always do that. I grew up in a household where it was one spoonful per person and two for the pot, and I've never lost the habit.'

'Where was that, then?' he asked, vaguely imagining some tea-steeped Orwellian tripe shop, though her accent was unexceptionably middle-cla.s.s.

'Just round the corner from here, actually. About five minutes' walk.'

'Oh. You haven't moved far, then.'

'No,' she said, rather broodingly, her hand poised on the milk carton. 'No distance at all.'

'And your dad still lives here, doesn't he?' he asked, suddenly remembering a piece of Fran gossip.

'Mmm. That's right.' She gave him a suspicious look and Spencer felt as if he'd inadvertently prodded a tender spot. He searched for a neutral topic.

'So what's this area like?'

'Oh, it's got a bit of everything. There's nearly five thousand on the list is this better?' She showed him a mugful of a more acceptable shade.