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to curry favour, but simply to care for Mamma as it has occurred to Ally that no-one else does. To offer her a little comfort, a few minutes’ solace in a life from which joy was cast out many years ago.

The first night, Ally made a mutton hash. Returning from the clinic too late to make a stew, recalling that Mamma finds the smell of meat grilled or fried objectionable and recalling also Aunt Mary’s cook’s view that while one must trust one’s butcher only a fool buys mince, she bought end of neck. A cheap cut, safe from the imputation of extravagance, but including rather too much connective tissue to be appetising when rapidly cooked. A training in dissection, Ally thought, carrying the seeping paper package through the rainy evening in her string bag, must have uses beyond the operating theatre, although it turned out that Mamma’s kitchen knives were too blunt for any kind of surgery. She ended up pulling filaments of iridescent tendon out of the red muscle with her fingernails, surrounded by a litter of bloodied and discarded knives. But the dish ought to meet Mamma’s requirements: Mamma considers highly-seasoned foods to be an indulgence of the palate, but regards the purchase of more delicate meats as profligate. The smell of onions, she says, permeates the house, and she tolerates enough such odours in the course of her work to be spared them at home. Ally set some potatoes to boil when she cleaned the knives and the board, and then chopped all together and fried it with a little fresh butter. She cleaned some of the silver and set the table. An hour later, Mamma tasted a mouthful and grimaced; had Alethea imagined she was cooking for a family of miners? Quite apart from the excessive quantity, such greasy concoctions are indigestible and wholly unsuitable for two women in middle life, engaged really in the lightest of work. Alethea having lavished her money and Mamma’s fuel, Mamma would attempt to eat it, but please, Alethea, a little more thought next time. It is no wonder, Ally thought, that Papa has given up, that he has left Mamma to her adulterous passion for self-denial, but even so he should not have done so. Promises were made, to love and to honour. If years ago Papa had lit fires in the drawing room instead of in his studio, if he had brought home eggs and cream and ham instead of seeking out restaurants with his friends while Mamma and May and Ally shrove themselves on bean broth and rice pudding, perhaps Mamma could have been different. Perhaps they could all remember May differently, if Papa, if someone, had shown Mamma how to be kind.

The noise of rainfall is drowned by the rush of feet and voices in the atrium. Now, at least, there will be no more time to think until the end of the day. Although then she will need to find something else for Mamma’s supper. It is like a game they play, a guessing game, where Mamma must already know the answer to the riddle and teaches Ally by withholding it. What dish is quick to prepare, wholesome and cheap, not rich or greasy, unseasoned and mild to the palate? What garb is neat and respectable, durable and easy to wash, suggestive of professional competence but in no way extravagant or showy? What demeanour shows both respect and self-respect, strength of character and humility—Miss Eastman is at the door, with the first patient, and the beginning of a sequence of problems Ally is trained to address

She is listening to the crepitations in yet another child’s chest when Miss Eastman hurries in. She bends to her stethoscope. A student here would go a long time without hearing the chest sounds considered normal elsewhere in the country. The mother watches from across the room, afraid, uncomprehending. Ally offered to let her listen herself but she doesn’t want to touch the instrument. Doesn’t want to be here.

‘Doctor?’

Ally holds up her hand. Coarse rales. A low fever. The child is emaciated, his skin patched with ringworm. Pus in one eye. He needs meat and fruit and sponge cakes made with fresh eggs, a warm bath, new clothes and weeks of careful nursing in a clean, dry room. For any real chance of reaching his fifth birthday, he needs, in fact, to be a lot less poor.

‘Doctor? You’re needed.’

No, she thinks, a revolution is needed. Bring Lord Salisbury in here and let him tell me to my face, to the face of this child’s mother, that the deserving poor have every opportunity to improve their lot.

‘One moment.’ What to tell the mother? He’s going to die. You’re going to lose another child, because you’re poor, and there’s nothing you can do about it, because you’re poor. Sorry.

Miss Eastman stands tall. ‘No. Now, Doctor. In the waiting room.’

The girl’s been in labour three days. Her father and his friends have carried her through the streets on a door and the howls of her like something not human. She’s quiet enough now, but even through the ragged blanket over her distended body Ally can see the contractions grip and ripple. The girl moans, the low bovine noise of the second stage. Several waiting children peer.

‘Take her through, please.’

While they lift the door, Ally hurries to scrub her hands. The forceps in her bag, she’s thinking, are clean but not sterile. May have to suffice. How long has the girl been pushing? Is the child still alive? Miss Eastman helps the men move the patient onto the table.

‘Thank you,’ says Miss Eastman. ‘Thank you for bringing her. We will do all we can.’

So she, too, has assessed the situation. There is another moan. As the men leave, Miss Eastman pulls back the blanket and pauses.

‘I’m, Miss Eastman, the nurse, and here is Dr. Moberley. We’re going to help you. We need to have a look at you now, see how

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