I sat stiffly in the uncomfortable seat that currently served as my consulting room chair. I was still using Dr. Dibbs' furniture. Given that I'd only be in Portwenn for another few weeks, it hadn't made sense to bring back my own things, which remained in a storage warehouse on the outskirts of London awaiting my arrival.

Next week's endarterctomy on Chris Parsons would be the first step in reestablishing my surgical career. The world of vascular surgery was extremely small; news of my return to surgery would spread like wildfire. For that reason alone, ensuring the surgery was not only successful but executed flawlessly was an absolute imperative. And, of course, nothing was more important than making sure I provided Parsons the absolute best care possible.

My laptop was playing the audio CD sent to me by that juvenile psychiatrist Edith had convinced me to see. He'd been an imp but, I had to admit, the CD had been more useful than expected in helping overcome my hemophobia. Things had gone well of late. I'd not reacted to the bleeding scalp injury from the workman who'd fallen off the ladder or Morwenna's bleeding foot or even the patient with the bloody nose. Although I'd blanched at the sight of Aunt Ruth's bloody hand, I'd managed to cover that one small slip.

Still, I knew that those incidents were nothing compared to the omnipresent blood I'd experience in my first full surgical procedure in several years, an operation I'd be performing in a few days on my closest colleague. I couldn't fail.

On the desk in front of me was a pig liver I'd purchased from the butcher. I would listen to the CD, mentally walk myself through the procedure and, at the appropriate moments, visualize the liver as the neck of Chris Parsons. Parsons probably would have laughed had he seen me. Or, maybe not.

I closed my eyes. The monotonous but eager young voice of Dr. Marcel Milligan droned on, reassuring me that I was in control of all around me.

"Imagine you are standing in the operating theatre, controlling the area where you are standing . . . Your domain . . . Standing in your scrubs. Your patient is prepped, and the field sterile . . ."

I imagined myself in surgical garb striding purposefully toward the table. The patient was laid out under sterile blue sheets, only the head and neck exposed. In theatre were the scrub nurse, the circulating nurse, the anesthetist, and the junior surgeon who would assist me. Given that I'd never operated in the Truro hospital before, they were unknown to me – merely sets of eyes above their surgical masks. Gleaming stainless steel instruments were laid out in meticulous rows, awaiting my use. The room was cool. The monitors beeped and hissed at appropriate intervals. It was all as it should be.

I took a calm, cleansing breath.

I'd done this procedure more than a thousand times. As Parsons had said, I could almost do it in my sleep. Start with a vertical incision along the anterior margin of the sternocleidomastoid . . . dissect through the carotid sheath . . . clamp the artery to reveal the obstruction . . .

"You are in charge, in control." The voice of Dr. Milligan urged me on.

Yes, I was.

The circulating nurse approached with a gown and gloves. She wrapped the gown around me and tied it in back. I slipped each hand into waiting gloves, size XL as always, and wiggled my fingers to ensure the gloves fit tightly and were comfortable. I was in control, in command. The others in the room were simply awaiting my next move.

"You are ready. You walk over to the table and make eye contact with the anesthetist," the tape continued and I wondered just how many times Dr. Milligan had actually been in an operating theatre.

"He's ready for you, Mister Ellingham," the anesthetist said from behind his surgical mask.

"It is simply a patient. A person you will cure through your surgical skill. A body." Dr. Milligan's comments mimicked my approach to all my surgeries. . . until that one fateful day.

A patient. A body. A disease for me to cure. Nothing more than that.

"You walk towards the patient and pick up a scalpel. You prepare to begin the operation . . ."

I looked down at the surgical field. Because I would be working on the neck, there was no way to avoid seeing the patient's face.

It was Chris Parsons, eyes closed in anesthesia-induced sleep. He looked so peaceful, content in the belief that my surgical skill would save him.

Focus, Martin, I told myself. I nodded to my team. "Let's begin," I said with more confidence than I felt.

"Your skill is all that you need. You are in control. Focus on what you need to do. Pick up the scalpel."

"Scalpel." I held out my hand.

And watched as Parsons' face morphed into that of the elderly woman, my patient of five years ago.

"No!" I gripped the scalpel as tightly as I could. It was today and Parsons was my patient. I could do this.

"Visualize every sense. You are in control."

It's only a patient, I told myself. Make the incision. I closed my eyes. I saw Emily clinging to Chris, the elderly woman's son and husband clinging to her. They were counting on me. They trusted me.

"Mister Ellingham?"

I breathed. There was a sound coming from the computer. I was . . . in . . . control.

I made the incision into the neck – into the pig liver in the steel basin resting on my desk. Blood poured out.

Blood. The pig's blood. Chris Parsons' blood.

Oh God. Bile rose from my stomach to my throat. I blinked rapidly, trying to focus on whatever Dr. what's-his-name was saying. Blood. Bloody surgery, Parsons had called it. It was simple, so simple. I could do this.

"Mister Ellingham? Are you all right?"

I couldn't quit now. Chris . . . and Emily were counting on me. I looked back down at the incision I'd made. My assistant had brought out the cautery. The smell . . . the blood, the cauterized flesh . . .

"Focus only on the your surgical technique . . ."

I swept the laptop off the desk along with a collection of tongue depressors, pens, and paper. It all landed on the floor with a dull thud, and it seemed that maybe the annoying Dr. Milligan was finally silenced. I jumped up from the desk and dashed to the sink, heaving my lunch and bile until there was nothing left to come up.

Spent, I rinsed and wiped my mouth and stood over the sink, sucking in deep breaths and wincing at the smell of my own vomit.

"Martin?"

I snapped around to see Louisa standing at the door to the consulting room. Why was she here? How much had she seen?

"Martin? I stopped by to . . . I heard a crash." Her eyes flicked to the mess on the floor. "What happened?" she asked, giving me a worried look.

"Get out!"

"Martin?"

"I said to get out." I took a few steps forward and slammed the door in her face. Behind me, Dr. Milligan was still talking.

"You are in control . . .