Louisa is a disrupter. An incendiary device for which there is no extinguisher; an inciter, a fomenter, an inadvertent subverter of all my self restraint. She has wreaked carnage upon my resolve, turned a blow torch onto my self control and expunged any lingering ideals of abstinence from my mind as thoroughly as one would debride a festering wound.

And now, as I sit at my desk, in the quiet of my flat, the only sound the rhythmical and reassuring ticking of my clock collection, I stare at the notes I have written on the page in front of me as they blur, and merge, and disappear. It's become an all too familiar feeling, an edginess, a disquiet, a constant gnawing presence; Louisa, under my skin. Once again, I find myself attempting to negotiate with a newly emerged inner demon; a freshly materialised, alarmingly carnal side of my nature; a fantasising, hankering monomaniac that I only manage to keep under control through sheer force of will.

I have fought valiantly but to no avail. I have attempted to rationalise, I've applied reason and logic to my situation; and I have even permitted the jeering voices of discouragement and self deprecation to loudly have their say, but it has all been completely futile. So now, I need to call it what it is. Lust, an all-consuming yearning that threatens to squeeze the breath from my body, a need so great that I doubt the depth of even my reserves of self control will hold me in check for much longer.

As embarrassed as I was to admit it, I now acknowledge that it is a physical desire that eats away at me now too, often manifesting itself rather disturbingly as an actual bodily ache. During waking hours it ebbs and flows; a constant companion, as inherent now to me as rain is to winter; varying in intensity but always there or never far away. Mercifully, my work is all-consuming, and the intense professional focus required of me makes it relatively easy to keep any dissolute thoughts at bay. But, in repose, in those moments where I attempt to quieten my thoughts, or relax my mind, the craving creeps in, enshrouding me in a dense, smothering, insidious fog.

I've distracted myself by devoting all my spare energy to arranging Saturday's excursion; focusing on what happens in the private viewing rooms of the Tate Gallery and, only slightly reluctantly, pursuing the opportunities that have been offered to me by my fortuitous contact. I've only allowed myself to think about the time Louisa and I spend together in public; after the gallery I've decided on a short walk to Pimlico, then supper at a restaurant recommended by the nutritional and weight loss adviser to the Obesity Clinic, a small, lean, fastidious man with similar principles to my own. While the timetable requires Louisa and I to eat later than I would usually choose, there seems no reasonable alternative, and so I am prepared to be flexible. The upshot is that I've applied all the organisational skill I have at my disposal and I believe I have factored in many of the things she has previously mentioned might bring her happiness. I am confident that the occasion will be seamlessly coordinated, informative and edifying, and I don't think I have missed any factor that might contribute further to Louisa's enjoyment. After that, however, is just too uncertain to contemplate.

Though I was initially somewhat tentative and, as always, ready to turn tail and run at the slightest hint of trouble, my confidence has grown in tiny increments to the point where not only am I satisfied with the formulated plan for the upcoming Saturday, I am now even anticipating the event with a degree of optimism. Making people happy does not come naturally to me but, fortunately, when I mentioned Louisa's Cornish origins, and love of the sea, to Fitzroy St. John-Reynard, my contact at the Tate, he responded positively and enthusiastically, and I was cautiously encouraged. In our subsequent conversations, he had suggested several artists whose names were unfamiliar to me, but whose works were in the gallery's collection, though undisplayed. In the end, I had left it to he and his team to curate that which he thought we should see; my only stipulation being, knowing Louisa's partiality, the inclusion of any available Alfred Wallis works.

From the moment I collect her from her flat at half past five, her experience of the ninety or so gallery viewing minutes, whether we walk from there or take a taxi to the restaurant, which table we sit at, everything up until to the point at which we conclude our meal, even the options and routes for returning Louisa to her flat at the conclusion of the evening, I am confident that I have planned and under control. But it's after that that now sees me sitting here in such a heightened stare of nervous awareness. Beyond the illuminated galleries, the well-lit bustling streets and the restaurant with its attentive waiting staff and observant patrons. In the murky shadows of her gloomy flat, or the dense heavy blackness of her tiny bedroom, without the pressure of a waiting taxi or the proximity of intrusive flatmates, what will happen then?

I'm still mildly anxious when I telephone on Wednesday and, once again, I'm relieved when Louisa answers. Though her tone seems quiet and subdued, her words hint at enthusiasm and she repeatedly mentions how she too is, in fact, greatly looking forward to the evening. Once more, I am surprised by how invigorated I feel by merely hearing her voice and how oddly reassuring it is to just to hear her say my name. It's a strange, inexplicable thing, this need I have for her. In my professional realm today, I was unequivocal in advising a non surgical treatment for a rare ruptured ovarian artery aneurysm and, later, confidently leading a surgical team that performed a right hepatic lobectomy for hepatoblastoma on a three year old boy. Yet here I am, rendered powerless and vulnerable by a spirited young woman who seems either amused or unimpressed by almost everything I say or do.

And so I find my quiet evenings at home now consumed by thoughts of her. It's worse than usual tonight, having spoken to her and now counting the days until I can see her again. I have so much reading to do in order to stay current but the Journal of Vascular Surgery sits unopened by my side. I shower and climb into bed, wrestling my thoughts back to medicine, back to its reassuring calm and irrefutable logic, back to the security of procedure and science. But more and more frequently, as I sleep and my conscious mind relinquishes it's control, my body is wracked by dreams of Louisa, so sensual and exquisite that they stay with me when first I awake, enveloping me in a strange, ethereal, trance-like state that has me in its grip for some time. Now, in the morning, as I enter the bathroom, I am almost too ashamed to look at myself in the mirror as I blushingly recall each salacious detail.

I barely know myself; suddenly my chosen path in life, while it was never completely comfortable, was always somehow manageable. Now it has become exhausting, debilitating, and rendered seemingly unsustainable by Louisa, the disrupter and I'm only grateful that long days and heavy caseloads make the rest of my week fly by. Suddenly, it's Saturday afternoon and I'm checking my spreadsheet in case, irrationally, I have missed or forgotten any tiny detail. As I sat in the barber's chair earlier this morning, reluctantly facing my own scowling image, I wondered coolly about the risk I was taking, at how enormous the change in my life might be and, in the unlikely event of Louisa deciding upon on some sort of commitment to me, just how prepared I was for that. But my brain seems reluctant to think logically and rationally and, though, I feel vaguely foolish, I can't even find the strength to chastise myself for my relatively buoyant state of mind. Suddenly, life has possibilities that I had long ago abandoned any hope of.

Despite the fact that I realise that there is already too much of me exposed beyond the ramparts, my face reveals an almost childlike, clear-eyed hope, an expression more sanguine than I've ever seen before. The anticipation stays with me and, as I shave before dressing, it's transformative and the figure that stares back at me seems to be more impulsive than restrained, more willing to risk this plunge into uncertainty than to retreat from the edge of the precipice and, though hesitantly, finally prepared to place his trust tentatively in another human being. I choose my attire carefully, a dark blue suit and a previously unworn tie that I had rejected as a ridiculous impulse purchase but which now seemed to have the required contemporary feel appropriate for escorting a Liberal Arts student to a gallery exhibition. My selection of cuff links is lacking an avant-garde element and I stare at them in disappointment, finally making my selection based on the style least likely to become awkwardly ensnared in Louisa's hair.

The journey to her flat is becoming very familiar; the cabbie attempts conversation but I ignore his particular line of mindless drivel and, as I notice him looking at me in the rear view mirror, desperate for affirmation, I glare at him dismissively and, mercifully, he takes the hint. Outside of my professional capacity, I have never cared about anything as much as I do about making this evening a success. Everything is outside my realm of comfort, nothing about pursuing Louisa comes naturally to me. Each action feels so torturously inadequate, every emotion exhausting and yet I am driven on by an inexplicable need to be with her. We pull up outside her flat, and I ask the taxi to wait. I smooth my suit coat, check my tie and knock heavily on the front door, once again careful to avoid stepping on the putrid doormat.

As I stand there, adjusting my cuffs and breathing deeply, I'm aware of the wailing and thumping of some sort of loud modern music emanating from within the flat. Louisa always takes care to warn me if and when her housemates will be home and tonight is no different. I am expecting an audience and I have adopted the cool, focused presence of a key note speaker at a specialist conference. Confident, authoritative and resolute, I will endure whatever interaction occurs, and I ensure that my expression is one of aloof disinterest as the door suddenly opens before me.

A girl I don't recognise ushers me in. As I step inside and onto the hideous carpet, as well as the familiar musty odour of the room, my nose is assailed by the smell of something else. Acetone perhaps and some sort of volatile organic compound; Ethyl acetate perhaps. I scowl as I am forced to inhale and, as I look around me, I notice that there are two others seated on the couch. Somewhat uncomfortably, I realise that they are both staring at me in what looks like shock.

"Good evening." I hear myself saying and, even as I attempt politeness, I think that perhaps my greeting came out of my mouth like a low growl.

The girl who opened the door also stares at me for a moment. Her gaze is quite appraising but I am equal to it, returning it in an equally haughty measure.

"Hello Martin." She says slowly. "We have met before. I'm Libby."

"Yes." I say, nodding at her as the memory of our previous encounter comes back to me vaguely. It wasn't perhaps my finest moment, as I recall.

"Umm, how are you?" I add, not because I'm interested but for some reason I feel I should at least improve upon our first meeting. I believe she and Louisa are close friends and so I am determined to be polite.

She wanders across to a stereo system and turns down the volume, before turning back in my direction, and smiling at me, somewhat cautiously.

"I'm well, thank you." She says and I hear a slight relaxing of her tone. She gestures at the two people seated on the couch who I can now see are engaged in painting their toenails in what appears to be the colour of inflamed mucous membranes; lumps of what appear to be cotton wool stuffed perplexingly between their toes. They, too, are both young and blonde and therefore, to me, all three are virtually indistinguishable from each other, a problem I foresee, should I ever be forced again to have to greet them by name.

"This is Holly, and this is Toni." She says simply and, internally, I groan.

Holl-y, Ton-i, Libb-y. Not only do they all look the same but they all have similar, sing-song sounding names as well. It's a hopeless endeavour and I give up, nodding at each of them, disinterestedly. The shorter one glances away quickly, apparently focused solely on the application of known carcinogens to the highly absorbent surfaces of her body, but the flatmate next to her continues to stare at me for some time.

"Lovely to meet you, Martin." She says, not taking her eyes off me for a second as she slowly places the lid back on the tiny bottle in her hand, slipping it on to the low table in front of her. "We've all been dying to meet you."

I glance anxiously down the hall, willing Louisa to emerge but there is only silence, and no perceptible movement to be heard from her bedroom door. When I look back, she is still staring at me and, as I glance at her in discomfort, she narrows her eyes and a knowing smile forms, replacing the patently false and fabricated one she bestowed on me seconds earlier.

"Mmm, yes." I reply gruffly. It's not uncommon for me to take an instant dislike to people and that's exactly how I am responding to whatever this one is called.

"And where are you taking Louisa this evening, Martin?" She says, and her voice has a slightly predatory tone that makes me uneasy.

I glance back at her haughtily. I have no wish to discuss anything with her, no desire for pleasantries or conversation of any sort. I just want Louisa to hurry up so that we can leave.

"Louisa said you're off to the Tate." The standing girl says, pleasantly.

"The Tate!" The predatory one exclaims and I realise that every time she speaks, I like her less. "Trying to drum some culture into our sweet little country cousin, Martin? Perhaps if..."

"I'll just see where Louisa is for you." The standing girl interrupts hastily, and I'm thankful as she rushes from the room, leaving me to contemplate the wall above the sullen toe nail painter; studiously avoiding the rapacious gaze of the other horrid termagant, with her unblinking, heavily made-up eyes and her marauding, mirthless smile. I feel my face forming into an intense and disapproving frown. It's bad enough that Louisa has to live in a rundown, malodorous place like this but to share it with people such as the two harpies seated in front of me, is beyond the pale. I turn my back on both of them and edge toward the door, so frustrated by Louisa's personal circumstances that I don't even notice as she finally emerges from her room, and walks up behind me.

I hear her say my name softly, and I feel the lightest of touches as she lays her hand gently against my arm. Instantly, I experience that strange and indefinable surge of warmth again and I turn; greeted by her endearingly hesitant smile and, once more, rendered helpless by my own physical and emotional response to her closeness.

She looks even more beautiful than ever, sophisticated and somehow different; Her hair is up, constructed into a beguiling sort of top knot, and she is wearing a short, sleeveless dress, with a high neck and a very alluring cut-away front, as if the maker had removed a circle of fabric with the express purpose of distracting me for the entire course of the evening. I realise that I am staring at her but I can't help it. A tonic for the eyes, my Auntie Joan used to say when she picked me up from the railway station and, for the first time in my life, I know what she meant.

"Louisa." Is all I can say, softly and deceptively calmly, conscious of the many pairs of eyes upon me at this moment. "Umm, the taxi is waiting. We should..."

"Yes." She says, and I gesture for her to go first. She pauses as I open the door and, as she walks past me, I notice that she is wearing boots that come up to her knees. Not her normal, army combat style, the heels do however seem reasonably practical should we decide to walk anywhere. Averting my eyes from the tantalising glimpse of thigh on offer as she walks toward the taxi, I glance back at the standing girl and I can't help but notice the thoughtful expression on her face. Without saying anything, I close the door silently behind me and, with relief, stride across the pavement and climb into the back seat of the minicab that will take us to the Tate.

After a short journey, we enter via the door that takes us to the Members Room, and we are met by an earnest, bespectacled man who shakes my hand effusively. He is wearing a cardigan and a bow tie which causes me to ponder how old he might be and I conclude that, while he is somewhere between Louisa and me in age, he must for some reason be determined to dress like an pre-war Oxford scholar or a minor character in an Evelyn Waugh novel. Glancing down at his shoes, I notice the backs are scuffed and the stitching is coming away at the heels. Seemingly, working in the arts sector doesn't pay enough or perhaps his personal standards of presentation are merely shoddy, either way, when I combine it with his level of attentiveness to Louisa, as we walk up the wide corridor, I don't like him much At all.

He explains that Fitzroy St. John-Reynard has been unfortunately delayed and that he will attempt to join us as soon as he is able. In the meantime, the young man who tells us his name is Miles, will be our guide and as I watch Louisa listening to him with that eager intensity she has, so determined to be delighted by everything and everyone, I can't help but growl in response. She flashes me a surprised look, scowling slightly at me with a deeply questioning expression and I find myself straightening my shoulders and glancing back at her, my face a mask of neutrality.

We are shown into a room of exquisite proportions; featuring magnificent coved ceilings, large arched windows and a finely constructed parquet floor. I hear Louisa exclaim with pleasure as we enter and she grabs my arm enthusiastically.

One wall is lined with well spaced easels, displaying a range of larger paintings, and there are several works hung on the gallery wall, smaller in size and many quite ornately framed. On a table in the corner, there is a large silver ice bucket, a selection of champagne flutes and a large cheese platter.

"Fitzroy said that you were a very important VIP, Mr Ellingham." The young man says with a nervous titter and, to my embarrassment, Louisa turns and beams at me with delight.

He walks over to the table and removes a bottle of what appears to be champagne from within the copious bowl of ice.

"You and your lovely lady friend here, of course, are our esteemed guests and if there is anything we can do, you must just ask."

I cringe. I don't want any of this waffle and I'm still in the throes of wincing internally at his reference to Louisa being my 'lady friend'. It's just too hackneyed and excruciating for words and I'm struggling to maintain the facade of politeness I've adopted for Louisa's sake.

"Mmm, yes. Perhaps we could, umm, start?" I say and I know I sound impatient, but I don't care. The man is a lumbering imbecile with the presentation skills of a maundering, astigmatic gnome.

Louisa glances at me again but this time I don't meet her gaze because I'm transfixed by his ineffectual attempts to remove the stopper from the bottle. As he has wrestled it into a tight grip under his arm, he has shaken it so much in doing so that I fear he will take the window out, aiming as he is, directly at the floor to ceiling arch beside him.

"Here!" I bark hastily. "Perhaps you'd better let me do that while you, ummm, give the talk."

He looks at me in surprise but, as I hold out my hand demandingly and glare at him, he passes the bottle to me. Veuve Cliquot, I notice as I cautiously unwind the wire capping, and gently ease the stopper from neck.

"I didn't think you drank champagne?" Louisa asks, and she sounds genuinely surprised.

"I don't, but that doesn't mean I don't know how to correctly open a bottle!" I reply, frowning at her as the cork comes away with a rather satisfying pop. I believe the score is now one up to me.

I fill a glass for her and pass the bottle back to the worn shoe man, who has retrieved another glass and smiles at me hopefully.

"Help yourself." I growl and, as Louisa takes an appreciative sip, I watch in disbelief as a large proportion of his flute overflows and spills onto the floor. Perfect, I think to myself, now we have a very expensive slipping hazard. The man is an imbecile.

Mercifully, we only have to listen for a few minutes to his haltingly delivered eulogy, touching on the importance of St. Ives, and the subsequent painting schools that developed around the location throughout the nineteenth and twentieth centuries, before St. John-Reynard slips in through the door and greets me warmly.

"Martin!" He says jovially, taking my hand and shaking it firmly. "Welcome, welcome, welcome. So delighted that you could be our guest tonight!"

He turns to Louisa and she smiles at him beatifically, transferring her glass into her left hand so he can grasp her right, squeezing it gently in both of his. She has a way of instantly putting people at their ease and, though in general I feel smiling to be an overused, overvalued expression, I never fail to be broadsided by hers. I can tell that he warms to her instantly, with barely a word spoken between them and I feel a strange sense of something proprietary about her, a disconcerting feeling of possessiveness. For god's sake, Ellingham, I reprimand myself, he must be sixty five if he's a day. While they exchange pleasantries, and he asks her about Cornwall, I feel at a loss and, with a surge of nervous energy, I reach for the half empty bottle of champagne and generously refill her glass, noting with pleasure the young fool downing his drink and slipping away through the enormous door.

So we follow Fitzroy about the room and his status as a senior manager is patently obvious in the manner of his presentation. His knowledge of his subject commands respect and I find myself drawn into his critiques to rather a remarkable degree. More importantly, I stand at Louisa's shoulder and I can feel the thrum of delight that she exudes. Her enthusiasm for all things Cornwall is really rather touching, even if it is completely beyond my understanding, and I'm rewarded for my efforts when she clasps my hand with an intense fervour that reveals her exhilaration, turning to me frequently and smiling radiantly.

Her delight at the two Alfred Wallis works is palpable, and she tells our host about her purchase of the print from this very gallery, which now hangs on her bedroom wall. She speaks breathlessly, her accent becoming thicker as her excitement grows and, just by looking at the gentle and benevolent smile on his face, I can see that he finds her utterly charming.

As we move from easel to easel, Louisa, of course, loves everything we are shown with a fervour bordering on ecstasy but, to me, most seem rather mawkish. Tuke's works, frankly, are a bit off putting, and the Turner oil seems busy and dated though I am sure it is technically brilliant. The relevance of the Napoleonic blockade to the fisherman of St Mawes was, however, historically interesting and added the extra dimension to the viewing that I'd hoped the personal attentions of the curator would contribute. Of course, I could see the sadness in Louisa's face as she listened; watching as she bit hard on her lip and empathised so wholeheartedly with people who lived one hundred and fifty years ago and with whom she had merely the most tenuous of connections. Such was her sadness at the plight of the dumped pilchards, and the ruddy-faced Cornishmen who had caught them, that she clung to my arm with both hands as we shuffled the few short yards to the next exhibit and I felt the need to touch her shoulder reassuringly.

She turns and smiles at me and, thankfully, 'Moonlit Shore' by some chap called Julius Olsson makes Louisa gasp loudly with pleasure and, while I do admit that the capturing of the light is cleverly executed, we finally stand in front of 'Beach at Dusk, St. Ives Harbour' by someone called William Evelyn Osborn, and I like it enough that I step backwards to get a better perspective. I find the composition surprisingly satisfying and I feel a need to jot his name down in my notebook, because perhaps he warrants further investigation as an artist of interest.

Fitzroy pauses thoughtfully.

"You might have something to say about poor old Will Osborn." He says ruefully, glancing at me, before he turns and smiles at Louisa. "I'm sure Martin would have sorted him out beautifully."

He grasps his lapels and stares at the painting on the easel.

"Suffered from what was thought to be an excruciating toothache. Poor sod was found dead at forty eight years old, suspected accidental overdose on pain medication."

I clear my throat.

"Trigeminal neuralgia I assume? Ummm, yes, it was common for it to be mistaken for dental issues. Extremely painful and, sadly, usually not helped in the slightest by the analgesics available back then."

Louisa looks at me, downcast, and I'm not sure what else to say. The man's been dead nearly ninety years and I can't think of anything pertinent that might assuage her distress. A miserable way to die, nothing I can do about it, yet still her distress disturbs me. I cough unhappily.

"And, umm, I wouldn't have treated him, as it happens, ahh, should he have been around today and, ahh, been referred to a specialist. That is to say, umm, he would be seen by a neurologist, mmm. Possibly an interventional radiologist..." My voice trails off awkwardly. I didn't come here to talk about work and I'm annoyed that we seem to have deviated into an area I'm so very reluctant to discuss.

"The poor man." Louisa says simply, lost in thought.

"Yes." I add quickly, glancing at my watch." And, now, if we could just keep moving. We've still got a bit to get through and time is running out. Trigeminal neuralgia or not, we've got a restaurant booking at eight."

I notice the look that Louisa gives me, and the slightly awkward shuffle that Fitzroy takes on as we move on toward the smaller artworks on the wall, but I see no point in dwelling on pointless conjecture so I ignore both of them. Things just don't get done if you allow yourself to be waylaid by absurd supposition. It might be grist for the mill in the Arts community but my time is precious, and I have a schedule to keep to.