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They passed the Discovery.

He said nothing. He saw the young man lounging, relaxed, in the driver's seat, waiting while the wife and kids browsed in a jeweller's shop. Through the plate-glass front of the shop, he saw a flash of the young mother's hair and the kids beside her. His own driver accelerated. Then they passed the Arab, sprinting, and his thobe billowed against his legs as he ran. His face was close to Bart. He seemed to be reciting, his lips moved as if in prayer, his eyes were behind spectacles, his cheeks were clean and his moustache trimmed

– he was like any other of the young men who paraded the pavements and hospital corridors, and sat behind ministry desks. His driver was picking up speed. The Arab was lost from Bart's view. He had swivelled in the back seat, inside the constraint of the belt, and looked back at the Discovery, could just see the young man's face: first posting abroad, making the sort of money he could not hope to match back home, living in a villa with servants and a pool for the kids, and… The Discovery was a hundred yards behind them. They went through the junction.

He could have turned his head away, looked instead over his own driver's shoulder, but did not.

He saw the flash, its blinding light.

He saw a door come off and cannon across the pavement into the glass of the jeweller's window. Then a bonnet. The Discovery seemed to be lifted up, and when it came down the duststorm gathered round it. There was the thunder. His driver braked. Every vehicle around them braked. They were spewed across the road, jamming it.

Bart imagined… His own driver swung his body and lifted the medical bag – black leather and embossed with the initials S.A.L.B. – off the front seat and was passing it into the back… Bart imagined the blood spurting from severed arteries, legs amputated because they always were in a vehicle explosion, a head crushed against a shattered windscreen. Hardly turning from what he watched, Bart pushed away the medical bag. He imagined the young woman frozen in the jeweller's shop, cut by glass, and the kids clinging to her legs. He imagined the quiet groans of the young man in the Discovery, as the pallor settled on his face, because death from vehicle explosions always came later, in Accident and Emergency. He knew it because he had seen it when his life was a greater lie.

He faced his driver, who still clung to the medical bag, which held the morphine and syringes that killed pain when death was inevitable. What he should have done, what he had practised and become expert at before moving to the Kingdom, was debridement.

If there had been the smallest chance of saving life, there in the road while the patient groaned in shock and pain, he could have cut out the wounds and lifted clear with forceps – they were in his bag – the worst of the blast's debris: plastic from the dashboard, cloth material from the seating, clothing, old techniques developed by Napoleonic surgeons and still valid.

'Drive on/ Bart said.

Amazement and confusion wreathed the driver's face. Bart was a qualified medical doctor, had passed the exams and been inducted as a member of the Royal College of General Practitioners. He had sworn the oath named after the father of medicine, Hippocrates, to follow the ethics and duties required of him. He was, he knew it, dirt

… Did he care? So much of his life was betrayal. He did not care.

'Don't get involved, don't get caught up' was the mantra of expatriates in the Kingdom. 'Don't put your nose in because no one'll thank you and you'll get it bitten off instead'… Fuck the shirts, screw the ethics, fuck the ties and screw the duties… The oath had been sworn too long ago. He hated himself, and disgust squirmed in him.

'Where to, Doctor?' the driver asked.

'Back to the villa, I think. Thank you.'

When the traffic moved, when the sirens were in the road, they drove away.

Bart had justification to hate himself.

Al Maz'an village, near Jenin, Occupied West Bank.

The patient had acute diarrhoea.

He had been called by the patient's father. It was now four months since he had been embedded in the Palestinian community, and trust for him was growing.

Bart was escorted into the bedroom. In lozv light other members of the family ringed the walls, but only the mother was beside the bed where the girl lay. Four months before, the smell would have made Bart retch; he was used to it now. The mother held her daughter's hand and spoke soft, comforting words to her.

What astonished Bart was that the whole of the village was not laid out prostrate with acute diarrhoea. That part of the village was a shanty town of homes thrown together with corrugated iron, canvas and packing-case boards. No sanitation or running water. When he had left his car he had seen that this corner of the village used an open sewer.

The girl was pale and weak from dehydration. He had learned already that hospitalization was not an option for the shanty's community. At home – at what he still thought of as home – there would have been an express ambulance ride to the Royal Devon and Exeter. He was not at home, and l ikely never would be. Clean drinking water, care and love were the best that the girl could hope for. He had the water, and the parents would give the care and love. From the father's description of his daughter's symptoms, Bart had known what to expect, and had brought with him four tzvo-litre bottles of Evian water, and he told the mother how much should be given by spoon to the girl and how often; he made a point of urging her to wash the spoon in boiled water. There was a picture of Arafat on a wall and, near to it, another of a young man with doe dead eyes and a red cloth band tight round his forehead. Bart never talked politics in the village, never talked of the struggle of Arafat's people, never passed comment on the martyrdom of the suicide bombers. He did not have to. The whole village, the shanty area and the homes round the central square, knew of his bitter denunciation of the military at the roadblock outside the village. He was the worm in the apple's core. The door at the back of the room was open. Beyond it was a cooking lean-to with a table and bowls for washing, and a stove threw off the scent of damp, burning wood. It was not warm enough for rain, not cold enough for snow; the weather was driving wet sleet. What blankets they had were piled on the girl's bed, and he thought the other children and the parents would sleep cold that night, if they slept. The girl was a waif, reduced by the severity of the diarrhoea, but he smiled warmly and predicted she would be fine. At the back of the cooking area there was another door and from it came the draught.

The main door, behind Bart, which opened on to the mud alleyway where the open sewer ran, creaked open and the wind was carried inside. He saw the mother look up and flinch. Bart did not react. It was what they had told him: he should react to nothing, however minor and however major: to react was to betray himself, betrayal was death. He was saying when he would next visit, at what time the next evening. He heard the boots. The mother had flinched when the first man had entered, but her face lit with brief relief, traced with concern, at the sight of the second or the third. Bart saw a smile glimmer on the face of the sick child. Three young men crossed the room, and the last momentarily hugged the father and grinned at the girl; the third would have been the son, the brother. The face of the third young man was on the edge of Bart's vision: a good face, a strong face, a fighter's face. Bart talked about the next visit, and the need for quiet for the girl, as if that were possible in the shanty where the families were crushed together – refugees from the destruction of inner Jenin when the tanks had come in seven months before – and he had the mother's hand in his, as reassurance for her. The three young men went through the cooking area and outside into a small yard with a shed of nailed-together plywood and planks.