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Thrumming back through the airport tunnel, Dave looked in the rearview mirror. The fare was a stringy brunette in her late forties, thick dark hair scraped back over sallow flesh, bony as a fucking skull. When she turned to look at the scale model of Concorde, Dave saw the tendons in her thin neck, exposed by the open neck of her blouse. She wore no make-up and a series of distinct grooves ran down her long top lip. The pashmina with the embroidered hem, the naked fingers that played with it, the bifocals on a chain, the myopic eyes blinking in the gloom: all said to Dave spinnie or lezzer, one or other, and either way not an object of desire — not that he had any available; nor one of pity — not that he had any of this either. He took out his slunk of Mansize and crunched the dried snot in his pitted nose.

The cab paused at the traffic lights under the M4 flyover, then accelerated up the slip road. Dr Jane Bernal slid her tired frame to the side of the seat and leant against the rain-dappled window. After the paranoia of the flight and the bucketing descent into Heathrow, even this chilly vibration was a comfort. Could it be mere culture shock or is London dirtier, darker, sadder and madder than when I left it? I thought Carla was a screamingly tedious hostess, and the Brunswick Opera Festival worse than dull. Yet, now I'm home, Canada suddenly looks beautiful to me, the frozen lake, the Bold tartans of the opera goers' jackets, their bright cheeks, their flaxen hair. . The minute I cleared immigration and saw the drivers lined up by the rail like undertakers I wanted to be back there. Back, if necessary, with Carla, squirming my way out of her serpentine grasp. She promised she promised we could have a great time anyway, even if I wanted to keep things platonic. But she wouldn't let me alone for a second. Not a bloody second.

Still, at least Carla had been importuning in an immaculate split-level house surrounded by clean, crisp snow. There had been glasses of good wine on the glossy white rug in front of the circular, bronze fireplace. Everything clean and untainted. As I walked from the terminal to the cab rank, I stepped on sticky gum and there was spit everywhere. The people's faces were so closed up so angry. Now this cab driver, all I can see of him in the mirror is a pair of bloodshot eyes. He's exhausted, his hands shake even though they're clamped to the wheel . .Is he drunk? Withdrawing from drink or drugs — or worse? He mutters to himself, his voice is peculiar breathless — almost squeaking. He aspirates flat swear words, cunts and fucks, mixed in with what? Is it religious stuff— talk of a book, a prophet? He's going to turn to me and say he has special telepathy or a divine hot line — but how could a schizophrenic drive a London cab? He's too old for a flamboyant psychotic breakdown, surely?

On the Chiswick flyover, Jane Bernal, despite herself, fastened her seatbelt. She did it as unobtrusively as possible, pulling the strap gently, terrified it might snag, or that the crazed cabbie would swivel round, taking his eyes off the road, and berate her for her lack of faith. Crazy indeed, to've flown across the Atlantic, the whole cabin still humming with anxiety after the Twin Towers, each locked in his or her own miserable fears of being one of the holy martyrs' Chosen Ones, and to now find myself more frightened on the ground. But as the cab shimmied on into the wet city, Dr Bernal allowed her professional detachment to come to the fore. He's ill, she thought as he turned off at Chiswick Lane and worked his way through Shepherd's Bush to the A40. He's ill and he doesn't even know it.

She'd seen men like this — and they were almost always men in her consulting room at Heath Hospitaclass="underline" punctilious managers who couldn't comprehend why it was that they had to check the cooker five hundred times in succession; big-fisted brawlers who assumed foetal positions on the floor; fiery entrepreneurs doused by overwhelming uncertainty. Men of this stripe went mad the same way that they got cancers or arteriosclerosis: blindly, ignorantly, the absent fathers of their own, growing maladies — 'I'm just a little short of breath', 'They're only very quiet voices' — until the skin of their denial was stretched so taut it ripped apart.

She tried to strike up a conversation with the cabbie as they turned up Lisson Grove. 'Have you got any special plans for the holiday?'

'Very low-key, love, dead quiet, me and my old people, maybe my sister and her lot,' he began plausibly enough, then trailed off into 'I'll haveta slaughter the fucking meter … Can't afford it … Serve it up to that fucking cunt of a lawyer,' under his laboured breath.

Jane tried again as they belted past the zoo. 'Will you be working much?'

'Maybe,' he sighed. 'I might go out if I can be bothered,' running down into 'If you go into the forbidden zone and start diggin' abaht … well… what can you expect?'

As the cab chuffed up Primrose Hill, its headlights and foglamps carving a tunnel through the darkness, Jane decided she ought to do more. The man was driving a runaway train — and the points were welded up ahead. My own Christmas, well, not so bad. On the day I'll go out to Hertfordshire and see Mother. Amazing, her resilience, her good humour. My God! It would be vaguely insulting if it weren't such a relief, only she could ingratiate herself with the staff in that dreadful home, charm them into caring for her, giving her treats, petting her. For the rest, silence or good music, not much food, a lot of solitude. Walks on the Heath, the time to think while others … well, often fall apart. Not so bad, not so bad at all. Being queer and self-sufficient is the best present at this season.

The cab gargled round the bend by the Washington pub and into England's Lane. 'Which one, love?' he snapped.

'Up here on the left, please, driver, by that shop, Dolce Vita.' Jane summoned herself, grasped the handle of the bag, backed out of the door pulling it after her. On the pavement she sorted through her purse and put three cashpoint-ironed twenties together with one of her cards. Best be straightforward, the only approach that ever works. 'Here's a little extra,' she said, crumpling the bundle into his waiting palm, 'and also my card — don't be put off by the title, I think I might be able to help you.'

'Ta, love.' He didn't even look at it. 'Receipt?'

'No, thank you' — he made to drive away — 'and merry Christmas, driver.' But the cab was ten yards off already, hidden by a net curtain of drizzle and moving with the heavy inertia of a bad dream.

Dave Rudman looked at the card half an hour later. After he'd parked the cab up in Agincourt Road, Gospel Oak. After he'd clamped on the steering lock and taken out the radio. After he'd unlocked the door and pushed the chewed-up pile of loan offers and credit-card teasers across the sad mat. After he'd padded up the bare stairs and into the barer bedroom. After he'd dumped his coin holder and his cash bag on the table by the window and stripped to his rancid pants. After he'd swigged from the bottle, swallowed the pills and slumped across the unmade bed. He looked at it in the glow from the street lamp and read DR JANE BERNAL, FRCPSYCH, CONSULTANT, PSYCHIATRY DEPARTMENT, HEATH HOSPITAL. He contemplated the oblong of pasteboard for long seconds, then he shredded it deliberately with his sore fingers, a tatter of quick and cuticle. Then he threw the wad towards the radiator and heard it disintegrate with his hurting ears, each little piece falling to the dusty carpet. Then he twisted and fell across the bed, and, raising one hand above his head, slowly and methodically began to bludgeon it into the pillows, as if it were a peg and his fist an unfeeling mallet.