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  ‘Yes,’ Amy said. ‘Twins, a boy and a girl. They’re nearly eighteen.’

  ‘Oh.’ Mrs Lewis’s face mirrored her own worries. ‘My little girl is nearly twelve. Sara, she’s called. She’s just got a scholarship to the grammar school.’

  ‘That’s wonderful,’ Amy said. ‘She must be very clever.’

  Mrs Lewis smiled – a thin, humourless smile – and walked to the door. ‘She is, for what that’s worth. She says she wants to be a doctor when she grows up but I can’t see much chance of that. You’d have to be well off for that, wouldn’t you?’ She went out, closing the door behind her.

  Amy sighed. Mrs Lewis was right, she supposed. There wasn’t much chance of that, the way things were, for a child like Sara.

  Amy had a home visit to do after the surgery, to one of the tenement houses off Ladbroke Grove. Room four, she was told, on the first floor.

  The front door was open and she walked inside and up the dingy stairs. These houses were all much the same. This one had dark-brown shiny paint below the dado and a dull green above. She knew what she would find – a cramped room with a single bed, a chest of drawers, a battered easy chair, a wireless. In the winter these rooms were often freezing cold, scarcely heated by a guttering gas fire. Her patient, almost always a woman, would be swathed in layers of tattered cardigans, often with woollen mittens on their chapped hands. At least it was warm today.

  She knocked at the door and went in. ‘It’s the doctor, Mrs Kelly,’ she said.

  Mrs Kelly was in bed, wearing a worn but clean nighty, her hair in a net. ‘I’ve got a bad cough, doctor,’ she said.

  Amy helped her off with her nighty. She was thin and scrawny. Most of these old ladies were undernourished. She listened to her chest and looked at her throat.

  ‘Your chest is quite clear, Mrs Kelly,’ she said, ‘and your throat’s a bit sore. I think you just have a cold. I’ll leave you a prescription for some cough medicine.’

  Mrs Kelly put her nighty on again. ‘Thank you Doctor,’ she said. ‘The landlady will get it. Your two-and-six is on the chest of drawers.’

  Amy took the sixpence, leaving behind the two shillings. Some of the ladies got annoyed if she took nothing. They had their pride. Sometimes they paid her off at sixpence a week. Sometimes she didn’t charge them at all.

  She gave a little shrug, feeling uncomfortable, a goose walking over her grave. Ever since she had come into this room she had the odd feeling that she was being watched. There was a large photograph of a young man in uniform on the chest of drawers, and beside it a single flower in a little vase He was almost certainly a son, killed in the war, but it wasn’t him watching her. She raised her eyes and gave a sharp intake of breath. All around the picture rail there were perched grey, sooty-looking pigeons. They were sitting quite still, looking down at her with beady, malevolent eyes. ‘We are watching you,’ they seemed to be saying. ‘What are you doing with Mrs Kelly?’

  Mrs Kelly saw her surprise. ‘They’re my friends,’ she said. ‘I feed them and they know me.’

  ‘You really shouldn’t …’ Amy began, but Mrs Kelly waved her words away.

  ‘I know,’ she said. ‘I know all about the diseases they’re supposed to have but they’ve never done me any harm. They’re my friends. They keep me company.’

  Amy left and got into her car to drive home. She sighed. How sad, how shameful, that in this huge city her only friends were a bunch of scrawny London pigeons. War, and the aftermath of war. How shameful.

  She drove home for a quick lunch. Charlie wasn’t home – out with his friends, probably.

  Mrs Parks was busy in the kitchen. ‘Do you want lunch, Doctor?’ she asked.

  ‘Just a sandwich please.’ Amy ate her lunch at the dining-room table and drank a cup of coffee. Mrs Lewis had stayed in her mind, and her little girl – Sara, was it? She sounded so bright and ambitious. Why couldn’t these children be helped? Why did so few working-class children ever make it to university? Half the country’s brains were going to waste.

  She finished her brief lunch, drove to Gower Street and waited for Tessa inside Lewis’s bookshop. She glanced through a selection of second-hand books for medical students, some of them thumbed and grubby, some of them almost new. She smiled. You could tell who had worked hard.

  Tessa arrived. Amy watched her as she came through the door, bright, happy, confident. Tessa could do what she wanted; achieve what she wanted, not like little Sara Lewis. They were so lucky; they had so much. Sara Lewis’s chances of doing medicine, as her mother said, were just about nil. Even if the fees were somehow paid, the expenses were enormous – books, lab coats, instruments, and keeping alive for six years. And then, if you wanted to be a general practitioner, you’d have to buy into a practice. It all took money.

  ‘Hello, Mum.’ Tessa kissed her cheek. ‘I need the Gray’s and a book on embryology. Come and help.’

  Amy followed her. ‘I expect things have changed since I was a student.’

  Tessa laughed. ‘I don’t think anatomy has changed much. We haven’t evolved at all, have we? We’re just the same.’

  Yes, Amy thought, her mood dark, humanity was much the same – just as mad, apparently.

  ‘Bacteriology,’ Tessa said. ‘I’d better have that. I shall need to know about the little blighters.’

  Amy pictured her in the pathology lab, inspecting the colonies of bacteria growing in Petri dishes, learning which was which, looking down a microscope at the little dots and dashes on the slides – at those tiny, tiny things that were so deadly.

  ‘What’s up, Mum?’ Tessa said. ‘You look rather serious.’

  ‘Oh – nothing.’ Amy smiled. ‘I was thinking about bacteria. At least we have sulphonamides now. We had nothing before.’

  Tessa looked at her for a moment. She knows what I’m thinking, Amy thought. Why do we even have to think about war?

  ‘Let’s go and have tea,’ Tessa said. ‘Can we go back to Derry and Toms? I want to see the roof garden again.’

  Amy drove to Kensington High Street. They went into the store and up in the onyx and black-marble lift to the Rainbow restaurant on the top floor.

  ‘I love these lifts,’ Tessa said. ‘Very Art Deco.’

  ‘Tea first,’ Amy said, ‘then we’ll go up to the roof garden.’

  The waiter brought tea and cakes.

  ‘Mum,’ Tessa said, ‘why did you change to general practice after the war? You did surgery then, didn’t you?’

  Amy nodded. ‘You and Charlie came along and I didn’t want to be out all day and never see you. And I wanted to do more for the families. Some of them lead wretched lives, Tessa, even now.’

  ‘Do you think there’ll be another war?’ Tessa said. She spoke quietly, without emotion, without fear or excitement.

  ‘I don’t know,’ Amy said.

  Tessa pressed her lips together. ‘It’s Charlie …’

  Amy forced herself not to react, not to show her terrors to her daughter. But she was a woman now, about to embark upon a career that would bring her face to face with distress and disaster. She couldn’t give her childish assurances. She looked down at her hands, clasped in her lap. ‘I don’t know,’ she said again.

  ‘Charlie says he won’t just kill people. He says they can’t make him.’ She paused. ‘They shot people who wouldn’t fight in the last war, didn’t they?’

  Amy turned her head away, looking out across the restaurant at the well-dressed women taking tea, the quiet hum of conversation, the waitresses in their neat uniforms. For a moment she couldn’t speak. ‘They shot some men who ran away,’ she said. ‘It was utterly disgraceful. What those men went through … They didn’t shoot conscientious objectors.’

  ‘I don’t think he’s a conchie, exactly,’ Tessa said, ‘But he says he won’t just kill people indiscriminately; certainly not civilians, women and children.’

  Oh Charlie, Amy thought. She couldn’t see him hurting a fly.

  ‘It’s all ri
ght for me,’ Tessa said. ‘I’d defend my country against anybody if I had to, but I’ll never have to make the choice, will I? I’ll be doing the other thing, patching people up.’

  She doesn’t know, Amy thought. She can’t imagine what it was like, the mud and the blood and the rats and the disease and the screaming hell of it all. ‘Let’s go up to the roof garden,’ she said.

  They went up to the garden and strolled among the trees and flowers.

  ‘Amazing, isn’t it?’ Tessa said. ‘All this and the pool and the pink flamingos, on top of the world.’

  Amy nodded, but didn’t speak. In the last war, German bombers had been seen from Kensington High Street, dropping their bombs, destroying and killing.

  ‘Cheer up, Mum,’ Tessa said. ‘It may never happen.’

  When his mother left Charlie got out his bike and rode to Kensington Gardens. He sat in the sunshine by the Round Pond, watching the children sailing their little boats. It was as tranquil as ever, since he and Tessa sailed their boats here with their parents, or with the nanny they’d had then. On the surface nothing had changed. Now, he couldn’t be sure. No one could be sure. All those men last night, not much older than he was, going on and on about what was going to happen. Was it? Those army types behaved as if they were glad about it: excited, anyway. Was there going to be a war, and what would he, Charlie, have to do about it? What would he be made to do? What would all of them be made to do?

  He felt a kind of tension, his insides contracting. It wasn’t fear, exactly; he knew that. He even understood their excitement, those army chaps. He felt a sort of excitement himself. It would be a chance to overcome, to prove himself as a man. He had read enough history to hear that call. But that last war – it was not a battle, but from what he had read, or gathered from his parents’ occasional remarks, it was a spirit-numbing weary war of attrition, a bare-knuckled mindless slogging until both opponents were on their knees, battered and barely conscious. He didn’t even really know what it was about. Did anyone?

  What he felt, he realized, was revulsion. He tried to imagine himself pointing a gun at some man, looking him in the eye, deliberately pulling the trigger and killing him. He tried to imagine himself hating someone he didn’t even know. None of it seemed real or possible.

  In front of him a young boy was trying to catch his little boat, that had floated out of his reach, and he looked to be in danger of falling in. Charlie got up and fished it out for him. The child’s mother smiled and thanked him. He remembered, with a shock, that the Government was already arranging to give out gas-masks for children.

  Chapter Two

  1938

  Dan scrubbed up at the sink in the small room beside the operating theatre. The first patient was probably an appendicectomy, then two inguinal hernias, then an exploratory laparotomy that might take some time. He scrubbed the soap up his arms, around his nails and between his fingers.

  He did this several times almost every working day. The routine of it had calmed his memories, but now and again they would edge back in, subtle and undermining, knowing they were unwelcome. Sometimes a faint whiff of infection as he opened an abdomen, or sometimes the brutal wounds of a road accident would revive it all, and for a few seconds he would be back in the sickening horror of the war in 1914, in the overwhelmed and spirit-numbing hospitals in France.

  It happened less frequently now, but Amy’s distress this morning had brought it back. He remembered holding her in his arms at the war’s end, the day she said she would marry him. He remembered what she said: ‘At least we know that our children will never have to go through that hell.’ Now that happy assurance was thinning and fading. He would not admit to her that he was worried too, that the prospect of another war filled him with dread: dread on Charlie’s account, and for everyone, women and children included. It would not be confined to the military any more – the advances in aircraft design, the newest bombers, would see to that. German bombers had bombed the defenceless town of Guernica in Spain and killed a thousand helpless civilians. The Germans seemed to regard that as some kind of successful experiment. If killing and intimidation and submission were what you were after, he supposed that it was.

  Bob Reed, his registrar, appeared beside him and began to scrub up. ‘Morning, Dan,’ he said.

  Dan nodded in reply, ‘Morning.’

  ‘The appendix needs doing,’ Bob said. ‘He’s pyrexial and has definite rebound tenderness this morning, so I put him first on the list.’

  ‘Fine,’ Dan said.

  There was a silence as they scrubbed, then Bob said, ‘what do you think’s happening, Dan? They brought round gas-masks for my kids yesterday. My wife’s in a bit of a state. Gas-masks! For children! Good God!’

  ‘They say it’s just a precaution.’ Dan glanced at Bob, who was concentrating on his hands, frowning. ‘I don’t believe they would use gas on civilians. The repercussions would be terrible for them too.’

  ‘You could say that about everything, couldn’t you? The prospect of them winning would be bad enough. God knows what they might do if they were losing.’

  ‘I don’t think even they would use gas,’ Dan said. He almost believed it.

  ‘You were in the last lot, weren’t you?’

  ‘Yes,’ Dan said shortly. ‘I was in a hospital at Etaples.’

  There was another silence. ‘Bad?’ Bob said.

  There was no use in playing it down, especially to Bob, who was young enough to be conscripted. ‘Yes,’ Dan said. ‘It was bad enough.’

  ‘You know what the Ministry is saying?’ Bob went on. ‘If there’s another war they’re expecting at least a million civilians dead in air raids. They’re stockpiling thousands of cardboard coffins, planning to dig lime-pits. I’m wondering whether to move my wife and kids out of London, but where could they go to be safe?’

  Dan shook the water from his hands and reached for a sterile towel. ‘No good anticipating the worst,’ he said. ‘We must hope for the best.’

  They moved into the operating theatre, slid their arms into the sterile gowns held out by the nurses and snapped on rubber gloves. The patient was already on the table, the anaesthetist at his head. They spread the sterile towels. Dan incised into the abdomen and the peritoneum. There was no putrid smell of infection; they had got it in time. ‘I think it’s retrocaecal,’ he said. He carefully moved aside the bowel. The appendix was lying behind the bowel, the red, infected tip almost glowing. ‘I’ve got it,’ he said. ‘It’s definitely inflamed.’ He removed it, careful not to release any pus into the abdomen, and closed up. Infection was the killer. It had taken so many lives in the war. ‘I wish we had something,’ he said, ’something to kill the damn bugs. The sulphonamides don’t stop everything.’

  They worked through the morning, and then changed into their suits and white coats and drank a cup of coffee.

  Dan sensed that Bob was going to ask him more about the war. He was reluctant to talk about it, to drag it out of the protective covering he had managed to spread over it. The thought of a million civilian casualties, woman and children, appalled him. They could never cope. The hospitals would be overwhelmed in Britain, let alone the care needed for the troops. He knew too much. He knew what a million casualties looked like.

  ‘How old are your kids?’ Bob said.

  ‘They’re twins. They’re eighteen next week.’

  ‘Oh.’ Bob’s silence was expressive. Then he said, ‘You’ve got a boy, haven’t you?’

  ‘Yes,’ Dan said shortly. ‘He’s going up to Cambridge this year.’

  ‘Perhaps he’d get an exemption,’ Bob said, ‘until he’s got his degree. They did that in the last war, didn’t they?’

  ‘I believe so,’ Dan said. ‘At first, anyway.’ Bob was speaking as if war were inevitable. He didn’t want to talk about it any more and changed the subject. ‘Good thing we did the laparotomy and caught that peptic ulcer. It wasn’t far from perforating.’

  The family assembled for dinner in th
e dining room. The french doors were open on to the garden and the faint summer scents filled the room. Mrs Parks brought in the roast chicken and the dishes of vegetables, and Dan carved.

  ‘Get your books all right?’ he asked.

  Tessa nodded. ‘Yes, some of them, but there are rows and rows of enormous tomes. How on earth do you get it all into your head?’

  Dan smiled. ‘I don’t know, but it seems to happen. Hard work probably has something to do with it.’ He handed round the plates.

  ‘I had a letter from Kurt today,’ Charlie said. ‘He’s invited me to stay with his family in Berlin for a week or so.’

  There was a silence. Amy and Dan glanced at each other, Amy startled and worried. ‘I don’t think so,’ she said. ‘I don’t think that’s a very good idea.’

  ‘Why?’ Charlie said. ‘Nothing much is happening, just talk, and it’s not as if you don’t know Kurt.’

  ‘It isn’t Kurt,’ Amy said. ‘He seemed to be a very nice boy, but you know as well as I do that things are very dangerous just now. We don’t know what’s going to happen.’ She turned to Dan. ‘Don’t you think so?’

  Dan nodded. ‘It’s not the best time to be travelling in Europe. What else does Kurt say?’

  ‘Only that his parents would like to repay us for having him for those half-term holidays. You can read the letter if you like. People are still going to Germany on holiday, aren’t they? Nobody seems to be that worried.’

  ‘Can I come?’ Tessa said.

  Her father shook his head. ‘Absolutely not.’

  ‘Why?’ she said, grinning. ‘Is Kurt a Nazi, Charlie? Does he wear a swastika and stick his arm up and say Heil Hitler? Did he come here to spy on us?’

  ‘He came to school for a year to improve his English,’ Charlie said. ‘We didn’t talk about politics.’

  Tessa put her finger under her nose and put her hand in the air.

  ‘It isn’t funny, Tessa,’ Amy said. ‘They’ve just taken over Austria without a by-your-leave.’