I'd taken the clock from the box and laid it gently and carefully on the table before me. It was a smallish, square Tudric clock, made for Liberty Co; the hammered pewter surface black, and almost tarnished beyond recognition. When the dealer had first shown it to me it, knowing my interest in The Arts and Crafts period, it had immediately caught my eye but I had feigned disinterest. I'd looked on, nonchalantly, as he had brought out yet another unremarkable oak Napoleon, then an ornate Victorian Gingerbread Mantle with a badly damaged case, and lastly, a rather nice and slightly tempting Four Glass Edwardian. I'd given them each a cursory glance but, in truth, I had already made my mind up. As was becoming my habit in every part of my life, I did my utmost to give the impression of cool dispassionate indifference when faced with something I really wanted for my own.

However, in this case, I had the upper hand; the clock, though still ornamental, was worth a lot less unless one had the skill and patience to restore it to functioning order. So I had negotiated a fair purchase price and brought it home, where it had sat now, untouched, for many months. Until now, when I'd found myself in desperate need of distraction, and I had sought it out. I'd got as far as removing the bezel and glass when, while contemplating the hands, everything around me became blurred and indistinct. After realising that I had spent a good proportion of the evening, staring at nothing and lost in my own thoughts, I had abandoned the idea and, resignedly, prepared for bed.

Monday evening saw no improvement to my state of disquiet. I'd had a busy day and, as well as striding briskly to the hospital in the morning, I'd taken advantage of the pleasant early evening weather to add a longish deviation through the park to my energetic walk home. I hadn't felt like any supper and instead had focused my energy on ironing my clean washing, and polishing all of my shoes. When there was nothing left to launder, I found myself wandering the flat, pulling books from my shelves simply to replace them unopened. Only when I discovered myself checking my pantry contents for Best-by dates did it seem that I needed to acknowledge the cause of my debilitating and constant unease.

It is an uncomfortable truth to face. I am not by nature a risk taker and every part of my rational mind is urging caution. As I stand under the pulsating shower, it seems that I am in constant and exhausting negotiation with myself; the improbability of any reciprocation of my feelings for her illuminated by the blinding flash of thousands of warning lights. I adjust the water temperature upwards but it doesn't help. I can't free myself of the grip I am in.

Even newly laundered sheets and freshly ironed pyjamas bring me no satisfaction and, as I lie in bed, desperate for sleep, I alternate between dissecting every nuance, pathetically searching for the slightest hint of encouragement, or attempting to be the firm voice of reason against an increasingly intense physical need. I have no intuition to call upon, and little experience. All I have is an all-consuming yearning that threatens to squeeze the breath from my body. I sleep fitfully and awake feeling shattered.

Tuesday, mercifully, is chaotic, and by the time I get back to the flat, it is once again too late to eat. I am physically and mentally exhausted, and optimistic that an early night is warranted and will be effective. I desperately need to sleep. The new BMJ has arrived and I am especially keen to read some newly published research into the selective use of patch angioplasty after carotid endarterectomies. I shower and, where I once found the sensation of the water cascading over my neck and shoulders relaxing, tonight it does nothing for the tremendous tension I feel.

As I stand on the mat, vigorously rubbing the towel across my wet hair, I look up at my own reflection and experience a moment of lucidity. With all the negative internal noise I have been subject to, I have become illogical and incapacitated by fear. Of course, I fled from Louisa because I needed to escape the developing intensity between us. She hadn't rejected me or mocked my efforts. In fact, she had been just as she always was; sweet, grateful and spontaneous. It is my personal failings that have caused my current state of unease, not hers.

Momentarily invigorated, it dawns on me that, because she was clearly unwell, I do have the perfect justification for telephoning and enquiring about her current state of health. I secure my towel around my waist and go in search of my wallet, not daring to pause and think, lest the self-ridicule becomes once again deafening. I glance at one of the many clocks that adorn my flat and I notice with relief that it's only just after eight o'clock, definitely still an acceptable time to call her; completely within the realm of good manners. Fishing the slip of paper from the zippered compartment, I weigh the edge down with the edge of the lamp base, pick up the receiver, and dial.

As I wait for the connection to go through, my own situation suddenly feels ludicrous. Thank god she can't see me now, standing foolishly in my office; half naked, damp hair standing on end, the shadow of the day's beard growth still darkening my jaw. I run my hand nervously across my chin as I hear the click and my stomach lurches in anticipation. I remind myself that all I have to do is ask how she is feeling, and I am completely capable of that; I ask that same question many many times each day.

Suddenly, I feel a surge of disappointment as I hear the mocking chirrup of the engaged tone and I slam the receiver down, more heavily than I intended to. I return to my bedroom and get ready for bed, folding the towel neatly over the heated rail and hanging up the bath mat. Now at least somewhat more modestly attired, I steel myself to try again, only to have the same aggravating result. Groaning with annoyance, I give up. I secure the flat, turn the lights off and make my way to bed, feeling disgruntled and thwarted in equal measure.

I switch on the bedside lamp and, just as I am turning back the bedclothes, I remember the BMJ. I'm feeling so put out by the farce the evening has turned into that I can't even recall where I left it but, in all probability, it's in my office. Indeed, I locate the errant magazine in my brief case and I retrieve it but, of course, once I'm in there, I notice that I've haven't placed Louisa's phone number back securely in my wallet. I'm just in the process of doing that very thing, deep in thought, when I nearly jump out of my skin. The telephone rings shrilly and insistently right behind me and, merely seeking to silence it, I snatch at the receiver angrily.

"Ellingham!" I bark.

There is a pause, a low chuckle, and then I hear a familiar voice.

"Hello to you too, Mart."

"Chris." I reply slightly less tersely, as my heart rate returns to normal. "To what do I owe the honour?"

"Honestly, mate, that's quite a salutation. You even scared me!" He says pleasantly, and laughs again. "Don't tell me you've let the accolades go to your head Mister Ellingham."

"You caught me at a bad time." I growl

"Certainly sounds like it!" He chuckles. "Anyway, how are things? Still terrifying everyone at St. Mary's I hear...I was a bit surprised to hear that you hadn't moved on to fresh pastures. I'd heard rumours..."

"Which you should know better than to listen to, Chris Parsons." I interrupted. "Is that why you are phoning me? To discuss mindless hospital gossip?"

"No." Chris replied, ever jovial. "I'm in town for a few days at the end of the week. Administration induction. Bit of a meet and greet. Wondered if you'd have time to catch up?"

I groaned.

"Sounds like you followed through then...not sure if congratulations are in order but, umm, well done." I said, as genuinely as I could manage. "I hope you find it, ummm, as rewarding as you hope it to be."

Chris laughed. "Yes, well, we've been through this, Mart, but I appreciate the sentiments. Anyway, what about lunch one day? When are you free?"

I looked around me.

"Umm, just a moment, I need my diary. It's, umm, it's busy at the moment." I said, reaching out an arm toward my briefcase which was on its side on my desk. I tucked the receiver between my ear and my shoulder, and popped the catches. As I did so I heard a distinct click, followed by the drone of the dial tone. I retrieved my diary and turned around to see that I had disconnected the call by allowing the receiver cord to trail over the top of the cradle and had inadvertently hit the infernal button. I hadn't intended to cut him off and I hoped that, of course he'd realise it. As I put the diary down on the desk, and opened the drawer to locate a biro, I automatically hit redial to call him back, lowering myself down into the chair and absently flipping through the week's already congested pages.

As I looked at my commitments, I realised that the weekdays were already impossibly full but the weekend was a possibility. Unusually, I was free on Saturday and on call from three o'clock on Sunday so perhaps that was a possibility. After several rings, I began to feel surprised that he hadn't answered yet and I was about to hang up when I finally heard the click of the call being picked up.

"Sorry about that." I say hastily before adding, somewhat flippantly "Tempting as it was, I didn't intentionally hang up on you."

I waited for him to reply in his usual good-humoured way but I was met with total silence. I could hear a faint rustling in the background but there was no response.

"Hello?" I say impatiently.

"Martin?" A voice says tentatively and I gasp, suddenly overcome with confusion.

"Umm, Louisa?" I hear myself splutter.

There is a nervous laugh.

"What are you doing?" She said. "Are you prank calling me now?"

I feel the most mortifying flood of embarrassment radiate throughout my whole body. My face burns and my throat is instantly dry and abraded. Of all the humiliating scenarios I could have imagined, mindlessly hitting redial and accidentally telephoning her, was not one of them. I open my mouth to speak, more out of hope than conviction.

"No, I, ummm...there was...that is to say...I didn't expect...ummm...I...I...I just wondered...I wondered how you were."

"That's funny, cos I was thinking about you too. I mean, calling you. You know, because, umm, because I was just thinking..." She pauses for a moment and I hear the anxiety in her voice. "I wasn't sure that I thanked you for, you know...thanked you for everything. And I've been feeling a bit bad about that actually..."

"No, ummm, you did. Thank me I mean. And, you weren't well. Are you feeling better now?"

"Oh yes!" She says effusively. "I'm fine now! Thank you."

"Right, good." I say, feeling as if I am floundering. "And, umm, your new job? You've started it? Yes?"

"Yes!" She says and I hear the excitement in her voice. "And, you know, so far so good."

"Ummm, when did you start?"

"Today..." Louisa replies a little self-consciously, and I hear her laugh.

"Oh, I see. Well, that's good then, isn't it? That it went well, I mean." I reply, conscious that my contribution to the conversation is verging on the pathetic.

There is a pause and I hear her clear her throat.

"Umm, actually, Martin, it's funny that you rang because I...I was going to call you." She says and she hesitates momentarily. "I know you mentioned only having Sundays off, didn't you, but, umm, one of my pupils, I mean, one of the kids I'm tutoring is...lives in Kensington and, well, I have three hours booked in with them on a Saturday morning. So, umm, I thought, on the off chance you were free, I could...we could...you know, maybe have a cup of coffee afterwards? I mean, if you can't that's fine too. I just thought..."

"No!" I hear myself say almost too quickly. "I mean, that would be good."

"Really?" She says and she almost sounds excited but then I can't be absolutely sure.

"Yes." I say, happily drawing a bold line across the whole day in my diary. "How about lunch? What time suits you?"

"That sounds nice." She says, and I'm in a slight daze as we make our arrangements to meet up.

After she hangs up, I can't quite believe the ridiculous sensation of relief I'm feeling as I again switch off all the lights and make my way, somewhat elatedly, to bed. Some minutes later I hear the telephone ring again but, by now, I'm ensconced in the soft comfort of my sheets, revelling in the unusual sensation of anticipation which has overtaken me, and I'm happy to let the call go to the answer phone. Muttering an insincere apology aloud to Chris Parsons, within a very short time, I fall deeply and exhaustedly to sleep.

By the time Saturday arrives, I am greatly looking forward to lunch. Unfortunately, I had to postpone my catch up with Chris Parsons but it couldn't be helped. He had also wanted to meet up today but I put him off with a vague and non-committal message on his answerphone on Wednesday, and we haven't managed to speak since. I manage to schedule a last minute haircut on Friday afternoon and, late on Saturday morning, I surprise myself with a slight indecision when choosing my attire for the day. Standing before my wardrobe, I hesitate before choosing a dark pinstripe, and a plain white shirt. I have a new red tie, as yet unworn, which seems to be the obvious choice.

I do take a little extra care in the knot, standing in front of the mirror, glowering at myself and trying desperately not to let my mind be overcome with negative thoughts. It was Louisa's idea to meet for lunch and I'm not taking any risk by agreeing to join her. That mocking voice can jeer at me all it likes, I'm determined to ignore it. I walk briskly down the stairs and make the short journey to the restaurant on foot. It is another pleasantly sunny day and, by the time I get to the restaurant, a few minutes early, I am almost buoyant. The waiter shows me to the table and I chose the seat facing the door. I'm pleased that I have a moment to collect myself before Louisa arrives. I need it.

Sometime later, the door is flung open and she rushes in, eyes sparkling, flashing me an apologetic smile and making her way towards me.

For a split second I feel my internal organs dissolve and I clamber to my feet, breathing heavily and reaching for a table napkin so I can wipe the perspiration from my palms.

"Hello Martin," She says, holding my gaze for a moment before removing her jacket and tossing it onto the back of her chair. As she sits down it is all I can do to look coolly over the top of her head as I recover from the impact her arrival has on me.

"Louisa." I say with remarkable calmness as I remind myself not to stare. It is already warm outside, and she is flushed and glowing. "How are you?"

I should have pulled out her chair for her but my feet feel like they are stuck in cement. She flops playfully into the seat with her particular air of joyous excitement.

"I'm much better, thanks. It must have been that omelette that did the trick."

I recognise the teasing smile that plays around the edges of her lips.

"I didn't realise you were such an accomplished chef." She says, and her eyes twinkle merrily.

I lower myself back into my seat.

"Ridiculous, it was just an omelette." I counter gruffly, and for some reason I feel very self-conscious.

She smiles again as she turns and struggles to hang her bag on the curved back of the seat. Her hair is up in a simple ponytail and it suits her. The lighting in the room seems to make it look even glossier than ever, so much so that I'm mesmerised as it shifts and shimmers with each movement of her head. In god's name, Ellingham, what is wrong with you, I think to myself and remind myself to breathe.

She turns back to face me, catching me mid stare, and I feel myself blush.

"You're just being modest." She says, holding my gaze. "It was delicious."

Yet another smile. Different from the last, so many permutations, each with its own meaning, so much so that they are almost a language in themselves.

I swallow hard. Say something, you idiot, a desperate voice in my head barks at me.

"I suspect, considering the state of your kitchen, you haven't much to compare it to." I say matter-of-factly.

She stares at me, and her eyes narrow but she says nothing and I realise that, in my attempt to deflect her praise, I sounded as if I were criticising.

"You've never lived in a share flat, have you Martin?"

"No, ummm, I didn't mean..." I said and my voice trails off helplessly as I mentally kick myself. All I can do now is focus on flipping open a menu and passing it to her.

"Are you, ahhh, how hungry are you? The seafood chowder is usually excellent."

She glances down, clasping her hands together under her chin. Somehow, Louisa makes even perusing a menu seem like a joyful undertaking.

"It sounds lovely but, to be honest, I'm just wondering if it might just be a bit hot actually." She says casually, thoughtfully turning the pages over.

She settles on a Chicken Caesar Salad. At least the eggs are an iron source I tell myself, though I'd like to see her eat something more substantial. Having seen the contents of her refrigerator, I believe my concern is justified. The waiter arrives and Louisa is cheerfully insistent with him when she requests no anchovies. It seems an important detail and I commit it to memory.

Glancing at me, her expression shifts. Another smile, more insolent this time and, with a defiant gleam in her eyes, she orders a glass of wine.

As I open my mouth to speak, she gives a tiny shake of head so, reluctantly, I swallow my words and, then, so typically, I cannot think of anything else to say. There is an awkward silence and I feel a moment of panic. Suddenly this has all been an appalling idea and I am about to be exposed as the dour and taciturn wet blanket I know myself to be. To distract myself, I inspect the cutlery for cleanliness. Although I have always found this bistro to have exemplary hygiene, it never hurts to monitor if standards are being maintained. As I hold up the knife, twisting and turning its blade in the light, the waiter returns with Louisa's wine.

"Is everything alright, sir?" He asks, a hint of concern in his voice.

"Umm, yes, fine." I reply as nonchalantly as I can, and slowly replace the knife, symmetrically, on the table.

"Thank you," Louisa says to him and, as she smiles up at him sweetly, I realise how completely unprepared I am to cope with the rapid undercurrent of my emotions. I feel like I am in a foreign country; not speaking the language, holding no currency, mystified by the customs and traditions.

She gazes at me quizzically and, when I meet her stare, she holds up her glass.

"I don't know about you, Martin, but I feel like a toast is in order. What should we drink to? Any ideas?"

I look up at her cautiously. The more I search for something to say, the more tongue-tied I become.

"Umm, I don't know. Do we need a toast? I mean, umm, you're going to drink it anyway."

She stares back at me, confused. I can see that I have not made myself clear so I attempt to clarify.

"Such an idiotic proposal, in my opinion, drinking to ones health." I add. "And rather ironic, considering one can barely do anything more deleterious to ones liver."

She lets out a sound that sounds like a suppressed groan and I notice that she has lowered her eyes and appears to be attempting to regather her thoughts. When she looks up at me again, I can tell that my firmly offered opinion has made her uncomfortable, and I feel I must explain myself.

"Louisa, only last night I was reading an article about Transjugular intrahepatic portosystemic shunts. Hepatic cirrhosis is not something I'd wish on anyone."

I can't help but notice her chest rise and fall as she draws her breath in deeply, and exhales in a long heavy sigh.

"Yes, Martin, I understand. But it's only one glass." She looks at me a little imploringly and involuntarily I hold my breath, unable to look away. I'm still transfixed when, suddenly, I give a reflexive start. Looking down, I see that she has slid her hand across the table and the tip of her index finger is resting on the knuckle of my nervously clenched fist.

"Besides, I've been looking forward to this all week." I hear her say quietly, and I swallow hard, unable to look up.

Is this what it is like for everyone, I wonder, or is my inability to express even the simplest of thoughts just another symptom of my own social ineptitude? People everywhere seem to have no problem communicating with the opposite sex, indeed the terrifying rate that the human species is multiplying is surely proof of this, yet here I am, either grimly admonishing or pathetically inarticulate.

She delicately traces my knuckles with her fingertip and, despite how much I want to take her hand in mine, I am paralysed. I stare at her fingers, so slim and elegant when placed alongside my own, and wrack my brain for something to say. Although it's enough for me just to sit here, silently like this, I know it's never enough for other people. I've been condemned for it my whole life.

I clear my throat.

"Umm, I don't suppose you have your examination results back yet?" I ask hesitatingly.

"No, not yet." She says, and her mouth twists into a smile. "Though it would be nice, actually, after all that work, you know, to toast success."

"Mmm. Yes."

"What about you, Martin? Or is it too soon for you too? I suppose it's only been a month, hasn't it?"

I hesitate before replying. I detest talking about myself. In my experience, nothing good ever comes from it and, professionally, I very much prefer to let my work speak for itself.

But Louisa is staring at me expectantly, wide eyed and so very lovely, and I know her well enough to know that my silence will have piqued her curiosity.

"Mmmmm, actually, the confirmations came in yesterday's post." I reply casually, after a short pause.

She lets out an incredulous laugh and fixes me with that hypnotic stare; the one I am so ridiculously susceptible to, like an enfeebled snake before a very determined mongoose.

"Aaaand?"

"Ummm, yes." I don't know what else to say.

"Martin!" She exclaims jubilantly ."That's brilliant news! Congratulations! Oh, wow, amazing, well done!"

I look down and watch as she curls her hand around mine, and gives it an enthusiastic squeeze. In my mind, the results were always unequivocal but, surprisingly, I don't mind her excitement.

"What happens now? Are you having some sort of posh presentation?" She asks, and her eyes are sparkling.

"What? Noooo. I've just requested they post the certificate out to me." I assure her, horrified at the thought.

"Oh right." She replies slowly, with a slight knotting of her brows, and I can tell she wants to say something but, instead, she bites her lip and after a few seconds her softer, more joyous expression returns.

To be honest, I'm totally unused to sharing anything of a personal nature, and even less used to receiving such an apparently delighted response, that I'll admit to feeling a little overwhelmed. But, as a moment in time, as I sit with her hand covering mine, savouring her rather gratifying reaction to my news, I feel oddly content. I'm almost disappointed when the waiter arrives and I now need both my hands to eat my lunch.

After a few moments, she makes another effort at conversation and I find myself drawn into a comfortable discussion about the museums and galleries she would like to visit. Unfortunately, my favourites are housed within the Royal College of Surgeons and are not open to the Public and so I suggest the Museum of Anaesthesia, which is both free and is General Admission but Louisa's reaction is amused ambivalence at best as I notice the corners of her mouth flicker into a kind smile.

I try again.

"Ummm, while it might not be of any interest to you, obviously, the Clock Museum, at the Guildhall has always fascinated me. And, ahh, it's been quite some time since I visited last but I have always found something new and interesting at the Science Museum." I tell her.

The doubtful look on her face disappears.

"And the Museum of Childhood at the V & A apparently." She says with a wry smile. "So I can see what I missed out on."

I glance up at her but there's no hint of self pity in her expression. I don't know what to say but she seems to know that I understand, holding my gaze long enough that reminds us both of what transpired all those years ago. Neither of us want to be defined by our misfortune to be born to people who never should have brought a child into the world. Louisa's belief that, despite everything, her father did love her, and her obvious attachment to the watch he gave her is our significant difference. While I clearly had every financial advantage, the only people I ever felt love from, for those few short years, were Joan and Phil and, as a consequence I want nothing as a reminder of my coldly indifferent parents.

I'm reluctant to contribute my own experience to the conversation but it seems that my perspective, thankfully, isn't what she is asking for. She starts to tell me about one of the pupils she has begun tutoring and, as she speaks, it's clear she's verbalising rather a deep seated concern.

"It's sort of giving me a different perspective on privilege, actually, because these are kids that want for nothing financially but, you know what, they are neglected. I can't quite explain, but it's just this really odd situation where the parents have really high expectations of their children but, conversely, such a low emotional connection."

She pauses, empty fork in the air, and gazes at me as she apparently considers what is to her an obviously disturbing scenario.

"During the term, you know, some of these kids are in after school care til nine o'clock at night. There's au pairs running them around, and in the holidays there's tutors like me. It's like the job of parenting has been totally abandoned to others. And, as soon as they are old enough, and if they can pass the entry exam, they'll be off to boarding school before they're eight years old. They're just babies, and...and it just breaks my heart."

I stare at my meal, feeling more than a little uncomfortable. I know I am expected to say something but I am almost mute.

"Mmm. I see." I say softly, and without conviction.

"We've been studying attachment theory and, you know, specifically related disorders, in psych," She says and her voice takes on an earnest tone "And in these kids, you know, some of the symptoms are definitely there."

I pause.

"Louisa, what you describe just sounds like a normal upbringing to me. It would have been exactly like that for many of the boys I was at school with."

She frowns at me.

"What? What are you saying? That it's acceptable to let other people bring up your kids? Neglect them emotionally. That's ok?" Her tone takes on a slightly confrontational tone and I am immediately cautious.

"No, I'm not saying it's right. I'm sure your concern for these children is entirely warranted. But I am uncomfortable about the bandying about of such emotive and potentially damaging psychological terminology. I am aware of the propensity to give every form of behaviour a label but, to me, it's often a lot of claptrap and, worse still, it becomes a convenient excuse for continued poor behaviour into adulthood."

She stares at me and, because her face can't help but reflect her thoughts at any particular moment, her eyes begin to flash and she gives a defiant toss of her head.

But I am unflinching and, before she can launch into the tirade that I can see she is preparing for, I place my knife and fork down carefully, and speak again, in as calm a voice as I possess.

"Louisa, ummm, please understand...I was in the care of a long procession of nannies, sent away to boarding school at seven and, umm, other than the several summers I spent in Cornwall as a very small boy, I remained at school for most of the holidays. In reality, I credit all the extra hours of study I was able to undertake as the reason I have recently become the youngest ever vascular fellow at the RCS. If I'd been told from the age of ten that there was something wrong with me, and that I should probably be medicated, might I have taken a different path?"

As I spoke, I watched her face fall, but I'd continued, despite noticing her expression turn to one of appalled shock. She stares back at me for a moment, biting down on her lip thoughtfully, frowning sadly with what I now realise is genuine concern. I stare helplessly back at her lovely face and I realise that experiencing her empathy feels like stepping out of the bitter icy shade and instead basking in a warm shaft of sunlight.

"Oh Martin, I'm so sorry. I had no idea." She says eventually and reaches out, again covering my hand with hers. This time, I don't flinch. Suddenly emboldened, I intertwine my fingers through hers and clasp her hand tightly in mine. Such a simple gesture and yet it feels so incredibly significant to me, and so deeply reassuring, despite her softness and delicacy. I glance down at our locked fingers and I wonder if this is as momentous as it seems. I feel her thumb gently caressing my palm and the sensation causes a flood of something warm and comforting to flow through my limbs.

Thankfully, Louisa doesn't seem to expect me to say anything, seemingly content to finish her salad, one-handed, and in what I believe to be a companionable silence. Amazingly, I don't care if the waiter sees us joined together thus. I'm not willing to relinquish this feeling for anyone, not prepared to release my grip or tear my gaze away from her beautiful face at all, and so I ignore him as I sense him approaching. It's not until I hear a loud cough that I look up, in irritation, and directly in to the face of a grinning Chris Parsons.