Cat was silent. She had been with Max Jameson for forty minutes. When she had arrived, he had wept on her shoulder. Lizzie had been sick again and was sitting in the middle of the floor, where she had fallen, her leg bent under her. Amazingly, she was only shocked, not seriously hurt.

“But how long before she falls down those stairs head first? Is that the way you want her life to end?”

“Do you know …” Max turned to Cat and smiled. He was a tall man and had been handsome but now he was haggard with anxiety and fear. His face had sunken inwards and his shaved head had a blue sheen. “… I don’t actually want her life to end at all.”

“Of course you don’t.”

He walked slowly towards Cat, but then veered away again to return to the wall with the photograph.

“You think she’s gaga, don’t you?”

“I would never, ever use that expression about anyone.”

“OK, what would you say she was?” He was angry.

“The illness has reached her brain now and she is very confused, though there may be flashes of awareness. She is also very frightened for most of the time—fear is a symptom of variant CJD at this stage. I want Lizzie to be in a place of safety so that she has as little to frighten her as possible. She also needs physical care. Her bodily functions are no longer under her control. The ataxia will increase so she will fall over all the time, she has no motor …”

Max Jameson screamed, a terrible howl of pain and rage, his hands pressed to his head.

Lizzie woke and began to cry like a baby, struggling to sit up. He went on bellowing, an animal sound.

“Max, stop that,” Cat said quietly. She went to Lizzie and took her hand, encouraging her to lie down under the blanket again. The young woman’s eyes were wide with fear and also with the blankness of someone who has no sense of their surroundings, of other people or even of their own selves. All was a terrifying confusion.

The room was quiet. In the street below someone went by whistling.

“Let me make the call,” Cat said.

After a long pause, Max nodded.

It had been less than three months since Lizzie Jameson had come to the surgery. She had been walking too carefully, as if afraid she might lose her balance, and her speech had seemed slow. Cat only remembered seeing her once before, on a birth-control matter, but had been struck then by her vibrant beauty and her laugh; she had scarcely recognised the unhappy young woman coming into her room.

It was not difficult to diagnose severe depression but neither Cat nor Lizzie herself could find a cause. She was very happy, Lizzie said, no, there was nothing wrong with her marriage, nor with anything else. Work had been going well—she was a graphic designer—she loved the apartment in the Old Ribbon Factory, loved Lafferton, had had no shocks or illness.

“Every day I wake up it’s blacker. It’s like sliding down a pit.” She had stared at Cat hollow-eyed but there had been no tears.

Cat had prescribed an antidepressant and asked to see her weekly for the next six weeks to follow her progress.

Nothing had changed for over a month. The tablets had barely touched the surface of her misery. But on the fourth visit, Lizzie had presented with a badly bruised arm, and a dislocated finger where she had tried to stop herself falling. She had just lost her balance, she said.

“Has this happened before?”

“It keeps happening. I suppose it might be the tablets.”

“Hm. Possibly. They can cause mild dizziness but it usually passes within a few days.”

Cat had got her an appointment with the neurologist at Bevham General. That night she had talked to Chris.

“Brain tumour,” he had said at once. “The MRI will show more clearly.”

“Yes. Could be very deep.”

“Parkinson’s?”

“That crossed my mind.”

“Or maybe the two things are unconnected … look at the depression and the lack of balance separately.”

They had gone on to talk of something else, but the following morning Chris had crossed the corridor from his own consulting room to Cat’s.

“Lizzie Jameson …”

“Idea?”

“How was her gait?”

“Unsteady.”

“I just looked up variant CJD.”

Cat had stared at him. “It’s very rare,” she’d said finally.

“Yes. I’ve never seen it.”

“Nor have I.”

“But it checks out.”

After her last patient left Cat had put in a call to the Bevham neurologist.

Max Jameson had been widowed five years before meeting Lizzie. His first wife had died of breast cancer. There had been no children.

“I was mad,” he had said to Cat. “I was crazy. I wanted to be dead. I was dead, I was the walking dead. It was just a question of getting through the days and wondering why I bothered.”

Friends had invited him to things but he would never turn up. “I wasn’t going to go to this dinner party, only someone was detailed to fetch me—they practically had to haul me out physically. When I walked into that room I was thinking of a way I could walk right out again, find some excuse to turn round and run. Then I saw Lizzie standing by the fireplace … actually I saw two Lizzies—she was in front of a mirror.”

“So you didn’t turn and run.”

He had smiled at her, his face blazing up with sudden recollected joy. Then he remembered what Cat was now trying to tell him. “Lizzie has mad cow disease?”

“That’s a hideous term. I won’t use it. Variant CJD.”

“Oh, don’t hide behind words. Jesus Christ.”

There was no way of discovering how long the disease had been lying dormant in her.

“And it comes from eating meat?”

“Infected beef, yes, but when, we can have no idea. Years ago probably.”

“What will happen?” Max had stood up and leaned across her desk. “Plain words. What Will Happen? How and When? I need to know this.”

“Yes,” Cat had said, “you do.” And had told him.

The illness had run its terrible course very quickly. From depression to ataxia, with other mental symptoms that were harder for Max to bear—violent mood swings, increasing aggression, paranoia and suspicion, panic attacks and then hours of sustained fear. Lizzie had fallen over, lost her sense of taste and smell, become incontinent, been repeatedly sick. Max had stayed with her, nursed and cared for her, twenty-four hours a day. Her mother had come from Somerset twice but was not able to stay in the loft flat because of a recent hip replacement. Max’s mother had flown from Canada, taken one look at the situation and flown back home. He was on his own. “It’s fine,” Max said, “I don’t need anyone. It’s fine.”

Cat went out of the apartment and down the strange, brick-lined stairwell, which still had the feel of a factory entrance, to the street, where she could get a signal on her phone and leave Max to be quiet with Lizzie.

The Lafferton hospice, Imogen House, had a bed, and Cat made the necessary arrangements. The street was empty. At the end of it, there was the curious blackness which indicated the presence of water, even though there was nothing of the canal to be seen.

The clock chimed on the cathedral tower, a short distance away.

“Oh God, You make it very difficult sometimes,”Cat said aloud. But then prayed a fierce prayer, for the man in the apartment above, and the woman being taken away from it, to die.

Five

The bleep of a mobile interrupted the orderly calm of the cathedral chapter meeting.

The Dean paused. “If that’s important, do take it outside and answer it.”

The Reverend Jane Fitzroy flushed scarlet. She had arrived in Lafferton a week earlier and this was her first full chapter meeting.

“No, it can wait. I do apologise.”

She pressed the off button and the Dean moved the agenda smoothly forwards.

It was over an hour later before she could check the caller display. The last number was her mother’s, but when she rang back the answerphone was on.

“Mum, sorry, I was in a chapter meeting. Hope you’re OK. Call me when you get this.”

She spent the next couple of hours at Imogen House, to which she was now Chaplain, as well as being the Cathedral Liaison Officer at Bevham General hospital. The work would take her out into the community but bring her back to her base at the cathedral, where she would take a full share in the worship and ministry.

At the moment, the most important part of her job was to get to know people, and let them size her up in turn, to listen and learn. It was an absorbing afternoon, at the end of which she sat with a man a few weeks off his hundredth birthday and determined, as he said, “to go for the telegram.” He was like a bird, a fledgling of skin and bone, tiny in the bed, his skin the colour of a tallow candle, but his eyes bright.

“I’ll get there, young Reverend,” Wilfred Armer said, squeezing Jane’s hand. “I’ll be blowing out all those candles, you’ll see.”

Jane doubted if he would live through the next twenty-four hours. He wanted her to stay with him, to listen as he wheezed out story after story about his boyhood, of fishing in Lafferton’s canal and swimming in the river.

As she left the building, she switched on her mobile again. It beeped a message. “Jane?” Magda Fitzroy’s voice sounded distant and strange. “Are you there? Jane?”

She pressed “call.” There was no reply and this time the answerphone did not come on. She sat under a tree, wondering what to do. There was only one of her mother’s Hampstead neighbours whose number Jane knew and he was in America for three months. The house on the other side belonged to a foreign businessman who seemed never to be there. The police? The hospitals? She hesitated because it seemed too dramatic to involve them when she was not even sure if anything was wrong.

The clinic. That number was on her phone. Other numbers might be somewhere among her things which were still in boxes in the garden cottage of the Precentor’s house.

A boy bounced past her on a bicycle doing wheelies over the cobbles. Jane smiled at him. He did not respond but when he had gone by, turned and stared over his shoulder. She was used to it. Here she was, a girl, wearing jeans, and a dog collar. People were still surprised.

“Heathside Clinic.”

“It’s Jane Fitzroy Is my mother there by any chance?”

Magda Fitzroy still saw a few patients at her former workplace, though she had officially retired the year before and was now working with a fellow child psychiatrist on an academic textbook. She missed the clinic, Jane knew, missed the people and her own role there.

“Sorry to keep you. No one’s seen Dr Fitzroy today, but she wasn’t expected. She hasn’t any appointments here at all this week.”

Jane tried her mother’s number several times during the course of the next hour. Nothing. Still no reply and still no answer machine.

Then she went across to the deanery. Geoffrey Peach was out and she left a message. By the time she was away from Lafferton heading towards the motorway it was early afternoon.

The London traffic was dense and she sat on Haverstock Hill for twenty minutes without moving. From time to time, she dialled her mother’s number. There was never a reply and she turned the corner into Heath Place wishing she had called the police after all.

As she drew up outside the Georgian cottage she saw that the front door was ajar.

For a second Jane thought the hall seemed as usual; then she realised that the lamp usually on the walnut table was lying broken on the floor. The table itself had gone.

“Mother?”

Magda spent much of her time in the study overlooking the garden. It was a room Jane loved, with its purple walls and squashy, plum-covered sofa, her mother’s papers and books flowing from desk to chairs to floor. The room had a particular smell, partly because the windows were almost always open, even in winter, so that the garden scents drifted in, and also because her mother sometimes smoked small cigars, whose smoke had melded into the fabric of the room over the years.

The study had been taken apart. The walls had been stripped of their pictures, the shelves of every piece of old china, and both the desk and a small table had had the drawers pulled out and overturned. There was an unmistakable smell of urine.

It was only as Jane stood looking round in shock, trying to take everything in, that she heard a slight sound from the kitchen.

Magda was lying on the floor beside the stove. One leg was buckled beneath her and there was dried blood on her head, matted into her hair and crusted down the side of her face. She was grey, her mouth pinched in.

Jane knelt and took her hand. It was cold and her mother’s pulse was weak, but she was conscious.

“Jane …?”

“How long have you been here? Who did this to you? Oh God, you rang me and I didn’t realise.”

“I, I think … this morning? Someone rang the doorbell and … just … I couldn’t manage to get up again to the phone … I … thought you might …”

“Darling, I’m going to call the ambulance and the police. I’ll get a blanket but I won’t move you, they’d better do that … hold on a moment.”

Every room that she glanced into as she ran upstairs had been ransacked and overturned. She felt sick.

“This will keep you warm. They’ll be here soon.”

“I am not going to hospital—”

But Jane was already calling the emergency services.

“I’ll die if I go to hospital.”

“Much more likely to die if you don’t.”

Jane sat on the floor and took her mother’s hand. She was a tall, strong woman, with grey hair usually coiled up into an idiosyncratic bun. Now, it was down and anyhow; her features, so full of character, so well defined, with the beaky nose and high cheekbones and forehead, seemed to have sunk in, so that she looked closer to eighty than the sixty-eight she was. In a few hours, old age and vulnerability had come upon her, changing her terribly.

“Are you in pain?”

“It’s … hard to tell … I feel numb …”

“What kind of man was it? How did it happen for goodness’ sake?”

“Two … youths … I heard a car … It’s difficult to remember.”

“Don’t worry. I’m just angry with myself that I didn’t come sooner.”

It was only then that the old look crossed her mother’s face, the one which Jane had come to know so well over the past few years. Magda’s eyes fell, briefly, on her collar and there it was, even now, after everything that had happened—the look of scorn and of disbelief.