'What they eat?'

'Yes, mine only eats paper. It can't be normal.'

Frank rotated his jaw a couple of times as if chewing cud. 'I don't know about that,' he said. 'If it was a lovebird, I'd have said you were operating under a misapprehension. You see, they tear up paper and you might just get the impression that they're eating it. They're not, though, they use it in their mating rituals.'

'Yes, but I've got a tortoise,' said Spencer.

Frank tutted, as if that had been a bad decision. 'Can't help you, I'm afraid. They eat them in Togo,' he added, inconsequentially. 'Boiled, apparently.'

The rows of seats were beginning to fill again, and after Frank had been X-rayed and sent home with a tubular bandage, Spencer rallied himself for the last two hours of the shift. It was easy, towards morning, to let the pace drop but he knew how demoralizing it was for the 9 a.m. staff to be greeted by a bulging waiting room, and he rattled through the list with as much efficiency as he could muster. Finally he hefted Callum's notes a four-inch thick bundle bristling with staples and extraneous bits of paper, and held together with a rubber band and opened the door of Examination Room 3.

Marsha's team had worked very hard and the room reeked of antiseptic soap, beneath which only the faintest hint of UHU was detectable. Callum was asleep. He was dressed in clean clothes and his face looked almost babyish despite the tattoo. Spencer laid the notes on the table. He knew the whole pathetic history well; Callum told his story to everyone who would listen. He had been on glue since the age of twelve, but had lived at home in Musselburgh until five years ago, when a mate of his had done the tattoo with a pin and a biro, creating a symbol almost as potent as a leper's bell.

Spencer lifted one of Callum's hands and looked at the swollen and bluish nails.

'You're always interested in my nails.'

Callum had woken, and while he still looked terrible the whites of his eyes yellowish, his lips a web of cracks the slurring had largely dissipated.

'It's because you've got clubbing,' said Spencer, tilting the hand so Callum could see the nail bases. 'You see how puffed up the ends of your fingers are?'

'What's that mean then?'

Spencer hesitated. 'It means your lungs are...' He groped for the right word.

'Totally f.u.c.ked?'

'Yes, they're not in great shape.' He pulled his stethoscope out of his pocket. 'Can you sit up and let me have a listen?' Callum struggled up and lifted his shirt to reveal a skeletal though surprisingly hairy chest.

'Take a deep breath in.' The normal quiet sweep of air entering the lungs had been transformed into a mess of liquid crepitations, as if a giant with wet hands was squeezing a family-sized bag of crisps.

'And out.' The giant blew through a straw into the last dregs of a milkshake.

Spencer took out the earpieces.

'What do you cough up normally, when it isn't blood?'

'Green stuff. Wi' big yellow lumps in.'

Spencer hesitated over the notes card, his pen describing little circles in the air. After ten years of glue and five living rough, Callum's lungs resembled tea strainers clotted with pus and his X-ray was regularly shown to medical students as a horrible example. If admitted, he absconded in under a day, in search of glue. He was probably incapable of finishing a course of antibiotics, since the tablets could be pa.s.sed off as painkillers and sold.

'I went to see a plastic surgeon.' Callum was back on his favourite topic.

'Oh yes?'

'He wanted twelve hundred quid to laser it off.'

'Right.'

'So I went to a charity.'

'Uh huh.'

'And they said they'd only pay if I got off the glue.'

'Right.'

'And I said I couldn't get off the glue with this on my head.' He smacked the tattoo with one hand. The skin on his forehead was criss-crossed with scars and burns where he'd attempted self-removal in the past, and Spencer doubted if anything less than an extensive skin-graft could get rid of it. No sane doctor would dare put him under general anaesthetic; the plastic surgeon and the charity were most likely figments of Callum's imagination.

'Did you try going to that hostel? The one in Clerkenwell.'

'I went,' said Callum. 'I went. And it was real kind of you to arrange it, Doctor ' he raised a hand in acknowledgement ' but it was full of filthy f.u.c.king smackheads with their f.u.c.king AIDS-y needles and I couldn't take it. Sorry for swearing.'

Spencer nodded resignedly. Callum's only source of pride was that he'd stayed off heroin.

'You do realize that unless you get off the glue there's no real point in treating you.'

'I know, I know it, but how can I with this on my face? All I need is the money for the laser and I'll be all right.' His eyes were wide and guileless.

Spencer had once looked all the way through the great wodge of notes. They were an A to Z of doctors' att.i.tudes: the sympathetic, the unsympathetic, the boneheaded, the useless. Over the course of a single eventful month, two years ago, Callum had been thrown out of Casualty by the police; interviewed by the social services; sent away with three different types of medication; referred to the hospital chaplain, and booked into a plastic surgery clinic. He had failed to attend the appointment. Since a run-in with Mrs Spelko last year when she had referred to him, within earshot, as a waste of NHS resources and he had counter-attacked by calling her a b.l.o.o.d.y great heifer (this was not in the notes, but had become part of Casualty folklore) he had stuck to night visits, and as a result often managed to get a few hours' sleep and some breakfast.

'Tell you what,' said Spencer, 'if I phone the Salvation Army Hostel, and then I arrange for the prescription to be sent to the warden '

There was a knock at the door, and Marsha stuck her head round. 'Thought you might like to know that Mrs Spelko's in.'

'Already?' Spencer checked his watch, and Callum almost threw himself off the couch and started fumbling for his boots, coughing violently as he bent over.

'It's her orthopaedic clinic on Tuesdays.'

'Oh b.u.g.g.e.r. Hang on, Callum.'

He was almost at the door, coat over his arm, laces trailing. Marsha blocked his way and he peered over her shoulder, nervously. 'It's all right,' she said. 'I won't tell her you're here.'

'Honest, Nurse, I've got to go.' He coughed again, a great ocean of sound which turned his face dark red. 'Honest,' he repeated, when he got his breath back. 'Please, Nurse.' With a sigh, Marsha removed her arm and let him shuffle away.

'I should have seen him earlier,' said Spencer, annoyed with himself. In the distance he could hear Mrs Spelko talking on the phone, the volume of her voice rising with every sentence until the words 'it's absolutely confidential' ricocheted around the department.

Marsha shrugged. 'I guarantee you'll see him again.'

7.

The shopping expedition turned out to be a bit of a disappointment; in fact if Iris had not become inured over the years to life's dull and regular setbacks, she might have felt quite depressed. The Sat.u.r.day after making her New Year's list, she took the bus to Hanley Cross with the aim of buying a completely new outfit. It was pouring with rain; the bus was packed and the interior foggy with condensation. Everyone got off at Shopping City and she pa.s.sed with the herd between the automatic doors, through a wall of hot air which instantly dried her face to a taut mask, and into the roaring void. The centrepiece of the mall was a lavish gushing fountain beneath a high gla.s.s roof, the pool fringed with palms and surrounded by a low wall occupied exclusively by winos whose empty cans of Diamond White bobbed in the foaming water. Next to it was a map which detailed the shops available over the three levels.

During the week she'd bought a sheaf of expensive fashion magazines but her studies had only led her to the usual observation that everyone in the world was younger than herself, and that most of them wore lycra. In desperation, she'd moved downmarket and bought a Woman's Weekly. Besides a double-page spread on cut-price power dressing (the only fashion in the world, she felt, that would suit her even less than leggings) she'd found a minimally helpful article on colours 'Which season are you?' picturing readers holding swatches of fabric against their faces. 'It'll be obvious when you find your range of tones: your skin will seem to glow, your eyes brighten, you'll gain an almost visible aura.' When the twins were out one evening, she had experimented with as many colours as she could find in the flat. While some were obviously wrong a fuchsia book jacket sucked the colour from her face, while Robin's orange t-shirt made her look like a carrot her aura remained resolutely absent. Whatever the hue, she looked just like herself.

It was hard to gauge from the list of shop names precisely who they catered for. How old was the She of What She Wants? Did Oasis specialize in beachwear? Was Wallis for men or women? She went there first, mysteriously drawn by a vision of Wallis Simpson in the thirties equivalent of a power suit, and was rea.s.sured by the age of the clientele, most of them comfortably into their thirties.

'Are you looking for anything in particular?' asked an a.s.sistant, and she didn't know how to answer. A whole new image? Appropriate attire for the current season? A polyester/wool dress in midnight blue that can be teamed with a tailored jacket for a sleek evening look? 'Something green,' she said.

She left Shopping City two and a half hours later with a skirt and a top, and the uneasy sensation that they were not really her choice but that she had merely caved in under pressure. She had bought them from a relatively empty store called Heaven Sent, situated in a mercantile backwater between a shop that sold glue-together model aircraft kits, and a seating area full of slumped pensioners. When Iris had wandered in, one of the a.s.sistants had detached herself from a bored group by the till and approached her like a heat-seeking missile. There was no escape; only by continually repeating the mantra 'I can't spend more than 40' had Iris got away with less than an entire winter wardrobe.

At the bus stop, she furtively opened the bag and examined the contents. The shirt was plain enough, navy blue with small shiny b.u.t.tons, but the patterned skirt which had seemed rather subtle, almost dappled, in the harsh shop lights now appeared to be a rioting yell of colour, a vigorous mixture of greens and blues overlaid with textured mustard-yellow blotches, as if someone had glued a handful of cornflakes to the material. She drew it up to the mouth of the bag to get a better look.

'Nice,' said the old lady standing next to her.

'Do you think so?'

'Oh yes. Bright. Youngsters nowadays just wear black, don't they? You'll cheer the place up.'

Back at the flat, she tried on both shirt and skirt, and walked into the living room where the boys were watching football.

'What do you think?'

They looked at her for a moment and then Tom slumped backwards on the settee, clawing at his face. 'Blind, I'm blind. For pity's sake help me, my eyeb.a.l.l.s are burning up.'

'Seriously, what do you think of it?'

'It's a bit bright, Mum,' said Robin. 'I mean, you look nice, but...'

By the time she'd returned to Shopping City and been informed by the now tight-lipped a.s.sistant of the unalterable 'Exchange but No Refund' policy, and spent twenty minutes trudging round the racks on her own, trying to avoid another sartorial disaster, it was too late to go on her usual Sat.u.r.day pilgrimage to the library. She watched the wide oak doors slide past the bus window, and glimpsed the notice on the wall announcing reductions in opening hours. She felt as if she'd failed to visit the sickbed of an old friend.

She wore the new outfit to work on Monday, but since it consisted of a dark blue skirt and a dark blue shirt over which she wore her most comforting jumper, n.o.body at the surgery noticed. In any case, she spent most of the day tucked away at a small desk in the filing room, engaged as she had been for the past two months in computerizing the practice records. The narrow shelves bristled with notes, creating a wall of paper that deadened and displaced every noise, so that the click of her fingers on the keys seemed to come from yards away. Every once in a while Ayesha would crash open the door from the waiting room, and search through the shelves, muttering a running commentary on the patient whose notes she was attempting to find: 'Old lady old lady old lady old lady... yes!' Through the open door could be heard the autumn soundtrack of coughs and phlegmy throat-clearings.

'You all right there, Iris?' Ayesha's head would be c.o.c.ked to one side, her tone bright and patronizing.

'Yes I'm fine. Any problems?'

'Nah. You can stop worrying.'

She'd swing out again with the notes, b.u.mping the door shut with her hip and leaving Iris gritty with irritation.

It was seventeen years since Iris had started working at the Sarum Road Practice, and in that time she'd graduated from part-time secretary to full-time administrator, a job description that encompa.s.sed everything from cleaning out the fridge to organizing the payroll. Until the Great Computerization, she had also worked on reception three times a week, and had been vastly relieved to hand the job over to Ayesha. 'When the surgery's full, it can be really nightmarish,' she'd warned at the interview. 'There might be someone on the phone shouting at you and someone in the waiting room shouting at you. Patients are far more likely to take out their frustrations on you than on the doctor.'

Ayesha had shrugged. 'I worked on the desk in a club, there was always people giving me grief and I always kept my calm. My rule was if they get mouthy at me, I never get mouthy back. That way, I stay in control. Also,' she'd added, breezily, 'my mother's from Jamaica and my dad's from Scotland so I always see both sides of everything.'

Duly appointed, Ayesha had turned out to be efficient and fearless, handling verbal aggression by standing with folded arms and averted eyes, like a mother sitting out a toddler's tantrum. She dealt with phone rants by holding the receiver away from her ear and scrutinizing her nails until the stream of abuse had slowed to a trickle before resuming the conversation at exactly the place she'd left it. 'There's totally nothing I can do about it' was her favourite phrase to patients, and the only time Iris had ever seen her lose her cool was when a child had been sick on the waiting-room floor. Ayesha had bolted into the staff kitchen, hands over her mouth, and remained there until every last trace of vomit had been removed. 'I can't take it,' she'd said afterwards, 'my stomach's too delicate.'

'Surely Jasmine must be sick sometimes?' Iris had suggested.

'I don't touch it. My husband cleans it up.'

She treated Iris like a slightly dim elderly maiden aunt, one who has been gently nurtured and knows nothing of the ways of the world. Which was, Iris admitted to herself, possibly understandable, though hard to take. 'This man was swearing away in here about his test results not being back, Iris, and I told him to shut his mouth before you came back in.'

'I've heard swearing before, you know.'

'Yeah, but this was strong.'

She had never met Robin and Tom, and a strange look would creep over her face if Iris ever mentioned them, as though she suspected her of making them up. 'Why aren't you married?' she'd asked once, in the filing room.

'Oh I don't know, it just never happened.'

'You don't live with no one then?'

'Well... I live with my sons.'

'Oh yeah, right. Do they ever see their dads then?'

Iris had felt herself start to blush, and kept her face turned to the computer screen, though she'd imagined the perspex reflecting a reddish glow. 'No. And they're twins.'

'Oh yeah.' Ayesha had giggled. 'One dad then. But if you don't want to talk about it, that's OK.'

'Thanks,' Iris had said, grimly typing.

Her only other visitor that Monday was the junior partner, Dr Steiner, who loomed round the door once he'd finished afternoon calls. 'Are you staying on, Iris?'

'Uh huh.' She saved what she was working on and turned towards him. He was wearing an astrakhan hat pulled low over his ears, the dent in the top inverted so that the material, stuck up in a long crest. 'I'm going round to Dad's this evening, but he's out at indoor bowls till six.'

He zipped his green quilted coat up to the last possible tooth and started to pull on a pair of large, stiff, sheepskin gloves. 'How is your father? I haven't seen him for a month or so.'

'Oh... up and down. Mainly down, actually. Last week would have been their ruby wedding anniversary so he's been a bit depressed.'

He nodded sympathetically, and then rocked on his toes a couple of times, having run out of conversation. His gloved hands stuck out like garden forks. Iris half turned back to the keyboard. 'Any problems?' he asked, suddenly.

'What?'

'With the computerization?'

'Oh, right. No. It's fairly straightforward.' The silence lengthened, broken only by the hoa.r.s.e honk of a pa.s.sing train, clattering towards Liverpool Street on the embankment track that overlooked the surgery. Patient opinion of Dov Steiner was divided sharply into those who (like her father) a.s.sumed that his absence of small talk was a professional choice which freed up his intellect for brilliant diagnosis, and those who (like Ayesha) referred to him as The Martian. Iris had become adept at judging into which camp a new patient would fall, and would divert people who required regular communication to Dr Petty, who liked talking so much that he rarely did anything else.

As she wondered whether she could resume work without appearing too rude, a low buzzing noise gradually became audible which, after a few baffled moments, she identified as Dr Steiner humming. There was no particular tune, but the sound rose and fell in pitch as if a distant stunt plane were looping the loop. He was staring past her shoulder, apparently at the computer, although his gla.s.ses had caught the light in such a way as to be completely opaque; he looked as though he had taken root.

'Is there anything I can help you with, Dov?' she asked, tentatively. The humming stopped.

'No, no. Nothing. I was just thinking.' He scratched his nose with a rigid finger.

'Only I really do have to get on.' She riffled some pages of notes to back up her statement.

'Right.' For a moment, nothing happened, then to her relief he swivelled on the spot and disappeared back into the waiting room. He walked like a pair of scissors, hinged from the waist and almost on tiptoe, and his diminishing staccato footsteps became lost under the noise of her fingers on the keyboard. Then the exterior door slammed, and she was left on her own.

The surgery stood on the edge of an artisans' estate, built in 1889 for the 'hygienic and practical habitation of foundry workers and their families'. The phrase was quoted on a ceramic plaque screwed to the side of the house that Iris grew up in, and it was the first prose that she had ever learned by heart. The foundry had long gone and the estate had reverted to the council, but the houses were still deemed hygienic and practical enough to have spiralled in value, and the fourteen streets contained an uneasy amalgam of tenants and owners. Her father had long been retired when the opportunity to buy presented itself, and it was his running, bitter refrain that he could have been sitting on a diamond mine by now.