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‘Sorry, sorry! That woman is a crazy woman. No family.’ And touched his finger lightly to his temple, a butterfly taking to the wing.

Adrian shook his head, flustered, disappointed at the failure of his own response, but when he looked about for the woman she had gone.

He thinks about her sometimes, thinks of her now, at the open window. For days he had waited for her. But she never came.

It is nearly one o’ clock. Lunchtime. These days he is acutely aware of the hours of breakfast, lunch and dinner. Meals have become more than punctuation marks in his day, they have become events in themselves. When he was a young man, doing his training in the hospital, there were times when he would forget to eat. While he was preparing for his doctorate he would leave his books to run across the road and buy a slice of pizza from the takeaway opposite; unwilling even to wait the minutes it took the Greek owner to warm it, he would eat it as he made his way back to his study, cold congealed cheese and curled ham.

He closes the window, trapping the sounds on the other side of the glass. There is dust from the sill on his palms, a fine, red, ubiquitous dust that covers everything. At this time of year it hangs in the air, a red mist, obscuring the hills behind the city, hovering above the horizon. Adrian feels the dust in the back of his throat every time he breathes; his skin and nose itch, the wind sucks the moisture out of his pores. He finds a handkerchief in his pocket, he has taken to carrying one again, dampens it with bottled water and rubs at his palms. And though rust-coloured stains rise on the white cloth, he feels as if all he is doing is working the dust into the layers of skin. There are days he feels constantly soiled, can feel the dust trapped beneath his shirt, clinging to his damp skin.

The canteen is still empty, save for two men in porter’s uniforms hunched over scattered Lotto tickets and a newspaper. The woman behind the counter heaps rice upon his plate and then, turning to the two tureens behind her, lifts the lid of the nearest and spoons chicken and sauce on top of the rice. A fortnight or so before Adrian had noticed how the woman served the local staff in the queue from the other tureen. He had asked the woman behind the counter what was inside the other pot.

‘Chicken.’

Her unhelpfulness had provoked his insistence.

‘I’ll have some of that, please.’ The woman had duly served him with what appeared to be identical chicken stew. At the table Adrian ate a spoonful. The food was fiery with pepper. Glad to be alone, he’d reached for a glass of water and another, returned to his office without finishing his meal, his mouth and lips still smarting.

Since then the woman behind the counter nods at him, and sometimes smiles. She appears to gain no particular satisfaction from what occurred, rather it seems to give their daily encounters a modest intimacy. Adrian remembers that day for the chicken stew and also because it was the day the new patient sent for him.

That the new patient was a man of some standing was evidenced by the fact he had a private room. Adrian passed the room every day on his way to his office. Never had he seen any visitors, save a retainer carrying sometimes a cloth-covered basket, sometimes a knotted sheet of soiled bedlinen, sometimes a pile of laundered clothes. Another time Adrian had glimpsed, through the slit of the partially opened door, the retainer sitting on the bed, fanning the torpid air with a raffia fan, chasing flies and adjusting the bed sheets with a twitch of the fingers, just like the mothers on the children’s ward.

The day Adrian returned to his office, his lips smarting, he had found the retainer squatting on his haunches outside his office door.

‘Can I help you?’ Adrian unlocked the heavy door and the man rose and followed him into the room. Once inside he handed Adrian a folded slip of paper. Adrian opened the paper. It contained no more than a few lines, faint pencil strokes that meandered slowly across the page and spoke of an elderly hand.

Dear Sir,

I wish to request some time alone with you. I would be grateful if you gave Babagaleh, the bearer of this note, a date and hour convenient to yourself. I have no particular restriction on my own time, though it is, by nature of my condition, somewhat limited.

Yours faithfully,

Elias Cole Esq.

*

Out of the night, a scream. Adrian wakes, sweating and disorientated. The fan is still, the air in the room is hot. He lies and listens. The whirr of crickets, a truck somewhere in the distance, the call of a night bird. The window above his bed is open and the air carries the scent of woodsmoke, fragrant, like burning cedar. Adrian wonders if perhaps the scream belonged in his sleep, but then hears it again, plainly. A woman’s cry.

He reaches under the mosquito net and switches on the lamp at his bedside, lets his eyes adjust to the light, from the chair takes a T-shirt, slips it over his head and opens the door on to the courtyard his bungalow apartment faces. A commotion is unfolding by the hospital gates. Out of the darkness a gurney pushed by two orderlies bearing a great, bulbous shape appears beneath the greenish glow of the security lights. A nurse holds up a drip. The trolley hurtles in the direction of the operating theatre. Adrian moves forward a few paces, peering through the dim light. As the group move closer he sees the form on top of the trolley is, in fact, two people: a man crouching astride an inert form. The man is pushing down with the heels of his hands, using his entire weight — or so it seems — to press down upon the patient’s abdomen. The patient is a woman, hugely pregnant.

Someone shouts an order to stop. As Adrian watches the doctor continues to bear down upon the woman, at the same time exhorting her to push. It seems unthinkable to Adrian that a woman in her condition could possibly tolerate such treatment. His eyes are drawn to the child’s head just visible, half in, half out of this world.

The one birth Adrian witnessed took place inside a room overlooking the Thames and the Houses of Parliament. Nothing prepared him for the terror — which he tried vainly to conceal. He sensed, or thought he sensed, his wife’s forgiveness reach him from inside her cavern of pain. Later a retrospective guilt grew inside him, like the guilt of a soldier caught running away from enemy fire. Nevertheless, with or without his courage, it had happened. One moment the two of them were on one side of something huge. The next, tumbling down the other side. His daughter was born.

In the half-lit corridor, on a narrow trolley and in the dead of night, another child is being born before Adrian’s eyes. The doctor on top of the woman gives a final, mighty push. At the same time the woman utters a long, low groan. A gush of liquid, the child slips out. Adrian watches, waits for someone to step forward and pick the infant up, slap his bottom, or blow into his airways. There is a terrible stillness about the child, lying there between his mother’s legs. Adrian, who knows so little of such matters, knows this much. The life being saved belongs to the woman.

Inside the apartment he leans against the door frame and lets the breath out of his body, listens to the sound of the trolley, slower now, fade away. He pulls off his T-shirt and crawls back underneath the mosquito net. For a while he lies on his back, eyes closed. Behind his lids he sees the scene, the baby’s head, the eyes: closed and peaceful, as though he had taken a look at the world he was about to enter and changed his mind.

Sleepless now, he turns on the light for a second time and climbs out of bed. In the kitchen he pours himself a glass of water from the bottle in the fridge. Tiny red ants mass around a half-biscuit on a plate, the edges of a patch of spilled guava juice, like beasts around a vanishing water hole. He picks up the plate; the ants swarm over his fingers delivering fiery bites. He swings around, drops the plate into the sink and holds his hand under the tap, watches the flailing ants sucked into the vortex.