The doors close slowly and we face each other, alone together in the stuffy confines of the lift. I'd held the door open, allowing her to catch up to me, and enter first, before standing opposite her, maximising all of the distance between us that this dreary enclosed space would allow. I'd been in the thick of a mountain of outpatient reports, undertaking the tedious process of dictating the G.P letters into the tiny microphone, when her call had come through and, to be honest, the unexpected nature of the whole business had alarmed me rather markedly. Despite her reassurances that, personally, she was fine, I could immediately sense by the slight shakiness in her voice that she was not being entirely honest with me and so I had instantly assumed crisis management mode and flown down the stairs to locate her.

It's rather unusual for Louisa to admit she needs my help and I pause for a moment to collect myself before I burst through the swinging doors and into the invariably busy waiting room. While I am driven by rather a desperate urgency to ameliorate this situation for her, I am only too aware that she does have quite firm views on what I am, and am not, allowed to do to assist her, generally. I'm also acutely conscious that, in life, my field of expertise is narrow indeed; I have very few natural instincts, and even less aptitude, for relationships, and I live with the constant underlying fear that I will never be enough for Louisa. But, right now, just for a moment, she is in my domain, a world I understand completely; a territory where I can easily hold my own; where nothing seems foreign or mysterious to me and where I have worked exceptionally hard to make a place for myself, and to earn the respect of my colleagues. As I stride toward the admissions desk, I know that, within the boundaries of patient confidentiality and hospital protocols, I will move whatever mountains I need to in order to resolve this situation to her satisfaction. Whatever my own enormous limitations are elsewhere, I have the opportunity to make her happy, even temporarily, and I fully intend to make the most of it.

However, as usual, when I'd seen her again, it was like an uppercut to the jaw, and I must fight with every shred of strength I possess not to merely stand and gape at her like a besotted fool. On Saturday night she was the most exquisite thing I'd ever seen, sophisticated and elegant in a way that had me utterly in her thrall. Today, however the bohemian student has returned, the free-spirit, and I'm surprised at myself, at how appealing I find the element of rebellion she exudes; casual, defiant and individualistic in a way I almost feel slightly envious of. She reminds me of the first time we renewed our acquaintance as adults, at my aunt's birthday lunch, when Louisa had seemed so insouciant, with enough of the young, impudent teenager still on display that I instantly recognised her, and so beautiful and vivacious and warm that I'd been instantly and hopelessly attracted to her.

As I glance at her now, as the lift lumbers and creaks toward my floor, I already feel my resolve diminishing; her eyes are huge and sad, giving her an air of impossible vulnerability and my fingers twitch as I clutch my hands firmly and desperately behind my back. My instinct is to console her but I know that if I were to touch her, or to lay a hand on any part of her, if I were to feel the curves of her body, clad as tightly as they are in black, accentuated and highlighted for me in some sort of nonchalant yet profoundly effective torment, I know that my self control would be challenged. Worse than unhelpful, that sort of weakness, any sort of lascivious behaviour within a professional environment would see me disgusted with myself, appalled at my own lack of restraint, and absolutely horrified at the thought that I may have taken advantage of her current susceptibility. I swallow hard, gazing at her, until I'm mortified to see her lip tremble and I reach into my pocket, hastily, and retrieve a clean handkerchief. I'm momentarily stricken, fearful of so many things, primarily that she might cry, secondly that she might be seen to cry by someone other than me and, more especially, that my ineptitude around weeping women, my complete and utter inability to console or reassure, will be horribly exposed.

"Can you tell me what has happened to this...err..child, Louisa?" I say, in desperation, probably too sharply if the look she gives me is any indication. "Everything you know please, calmly and factually..."

She stares at me for a moment, her expression strangely disapproving, as if my attempt to get to the bottom of things is somehow the wrong course of action.

"Hello, Martin!" She interrupts, rather pointedly, and I frown back at her, somewhat perplexed.

If I'm not mistaken, we exchanged greetings on the telephone, not more than five minutes ago yet now I seem to be mistaken in my assumption that solving the problem at hand is the absolute priority; perplexed as to why she called me to assist her, if that were not the case. I can't help but feel somewhat frustrated, if I am honest; I have absconded from yet another extremely busy, rather demanding day, without hesitation, dropping everything to come to her aid, and yet she prioritises a rather ridiculous insistence on what she considers good manners over fixing a problem that is obviously distressing her. I avert my eyes lest she recognise my irritation, in case my disdain for pointless pleasantries becomes obvious. I glance back at her, impatiently, but she meets my gaze and holds it, as usual, with fierce determination, her eyes swimming with tears, and immediately I sigh inwardly as I reluctantly reconsider my stance.

"Mmm, yes, of course." I mutter briskly, before inexplicably I feel myself relenting and I add gently: "Ummm, hello."

I'm instantly rewarded with a softening of her expression, and the vaguest hint of a smile. She blinks at me, eyelashes dark and heavy with tears, and I collapse inwardly.

"But, if you want me to help you, Louisa, you will need to explain to me what the problem is." I say carefully, feeling like I am feeling my way through a minefield, blindfolded.

Before she can answer, the doors open as we reach my floor and I bustle her along the short corridor to my office, closing the door behind me. A few of the clerical staff had glanced up at us as we passed by, but I had studiously ignored them, fully aware after my meeting with Chris Parsons yesterday that I have become the favourite subject for the usual mindless gossips, my appearance with Louisa on Saturday night currently apparently spreading at warp speed along the hospital grapevine. I'm also aware that, by bringing Louisa up here, I am now, inevitably, adding an enormous fuel load to an already blazing inferno but, surprisingly, other than a mild annoyance that so many staff have nothing better to do with their time than speculate idly on the lives of others, at this moment I don't honestly care what anyone says or thinks.

I usher her into a seat, and she declines my offer of a glass of water but I pour her one anyway and lower myself into my chair, opposite her. I try not to stare as she removes her jacket and tosses it onto the floor beside her, squeezing my eyes closed momentarily , forcing myself to concentrate before folding my hands on the table in front of me, signalling that she should begin her explanation. As she speaks, breathlessly one moment, rather more composed the next, I make a few notes, clarifying any inconsistencies or important details with her, all the time maintaining my outward appearance of cool dispassion as I contemplate the specifics of that which she has told me.

"And you say that the boy has recently had a cold?" I ask her.

"She...I mean the housekeeper...said that was all that was wrong with him...that he just had a cold, but I don't particularly recall him being ill last week." She says with apparent despair. "And she...she wasn't even there last week, it was a completely different woman...this one, the horrid one, she's the third housekeeper since I started tutoring Piers..."

"Did you mention the cold to the Admissions team?"

She nods and reaches down, pulling my handkerchief from the front pocket of her jeans, dabbing at her eyes and gazing ruefully at me. The arbitrary care provided to this child has clearly upset her greatly and, knowing how she is, I suppose I am not really surprised. For a moment, I'm distracted, unsure if I should mention to her just how many different women came and went in the course of my childhood; nannies, housekeepers, maids, each as wildly divergent in their ability and enthusiasm to care for me as any group of people could be. The best of them, the the kinder and more capable, invariably lasted the shortest time but no one seemed to ever have the slightest concern about the effect this constant change, this transience and insecurity, might ever have had on me. I'm aware that people, my parents especially, just didn't concern themselves about things like that, it was just how it was done and that was that; children should be seen and not heard; frankly not even seen that often if Margaret Ellingham had anything to do with it.

But, as I watch Louisa's face contort with worry, I see her obvious despair at the plight of this small boy; the depth of her empathy for his situation and her brave refusal to be turned away by the harpy who was allegedly responsible for his care, just for a split second I wonder how things might have been different for me at the age of seven if I'd had someone as caring and determined as Louisa prepared to stand up for me. I feel a surge of something inside me, an admiration perhaps, a gratitude that, despite her own appalling childhood, she still has the capacity to care about the needs of others, and I feel strangely moved. Haltingly, I reach over and tentatively place my hand over hers.

"I'm going to place a call and see what I can find out." I tell her, as gently as I can, squeezing her hand lightly before relinquishing my hold and reaching for the telephone.

She nods at me hopefully, and I recognise the expression because I see it all the time. Patients who have no choice but to place their trust in me; the most desperate of cases, the poorest of prognoses, as Louisa does now, they place their faith in me to save their limbs or, often, their lives. But, as I glance across at her, it feels even more important that I don't let her down, that I don't disappoint her. I look up the extension for the paediatrics consultant and, dial, conscious of how Louisa gazes at me, nervously tugging at her ponytail and biting on her lip. Fortunately, the phone-call is not only answered but by a registrar that I am on reasonable professional terms with, having worked with his team a month ago on a series of congenital vascular anomalies. I'd actually enjoyed the process, finding the paediatrics team to be, on the whole, inquisitive and conscientious, and, even better, happy to leave the temper tantrums to their patients.

I briefly explain the situation and ask for an update on the boy; Piers Stanley I call him confidently, as I glance down at the name I have scrawled across the bottom of my notepad. Succinctly, the registrar confirms that the child has been admitted to the general ward and has undergone the usual tests. I ask him a few more questions and his answers confirm that we are both on the same page as far as a potential diagnosis goes; they've picked up on the viral link too and I make a mental note to commend Louisa on her observations; if only some of the junior doctors I've worked with had the same attention to detail, I think to myself as I direct a surreptitious glance in her direction. The concerned air she exhibits, her sadness at the circumstances, has not diminished and, as I look at her again, I feel an urge to reassure her, to stroke her cheek, to tuck her famously unruly and determined strands of escaping hair behind her ears, to feel the spare elegance of her neck so soft and warm against my fingertips, but I keep a firm hold on myself. It would be only too easy to give in to my own selfish needs when what Louisa desperately requires is medical reassurance; facts, details, a prognosis, and, hopefully, news of a care plan for the boy's eventual recovery.

I press my colleague further, and listen as he details the tests they have run; approving the urgency with which they have already undertaken a lumbar puncture and an MRI scan.

"Bilateral lesions?" I ask him, making a note of the findings in my notebook as Louisa leans further across the desk, now chewing nervously on her thumbnail. "Lymphocytic Pleocytosis? Yes. I see. Of course."

He provides me with a few further details and, just as I am about to terminate the discussion, I hear Louisa loudly whisper my name.

"Martin!" She gasps, sounding almost in desperation. "His mum and dad..?"

I nod at her in acknowledgement, putting down my pen and clearing my throat as I listen to him deviate into a tedious and unrelated anecdote; informing me just how intensely annoyed he is about having funds he'd considered as earmarked in the budget, for an extra paediatric ICU bed, diverted elsewhere. I vaguely recall him bending my ear over this in a yet another previous meeting, as if it were of any possible interest to me at all. As much I suppose I sympathise with his intense endeavours, and his religious attendance of every planning and budgetary meeting he could force himself in to, at this point in time, I simply could not care less.

"These things happen." I tell him, keen to obtain the information I require and then rapidly bring the conversation to an end. "Umm, I'm sure you did your best...yes...yes...I appreciate that...and, umm, may I just confirm...the boy's next-of-kin, have they been notified, do you know? It seems there might be some difficulty in locating them..."

Louisa gasps and I'm horrified to hear her utter a strangled, desperate sob. I glance over at her as she buries her face in her hands and slumps forward onto the desk, and for a moment, as I listen to the update on the whereabouts of the parents, I stare at her in utter confusion.

"Aah, I appreciate that and, ahh, yes, we will be along shortly. I'm sorry, I must go. Yes. Certainly. I will. And, umm, thank you." I hear myself telling him as I drop the handset into the cradle and leap to my feet. In two strides, I am beside her but then I find myself loitering hesitantly, confused and uncertain. Hesitantly I reach out and place the tips of fingers lightly on her cervical spine.

"Louisa?"

"Martin..." She replies indistinctly, and her shoulders shake helplessly as sobs again."I...just...can't...believe..it.."

I slide my hand up over her trapezius muscle and I realise, after a moment, that I have been standing in silence, unconsciously massaging her shoulder.

"Neither can I, frankly." I growl disapprovingly. "They're at Old Trafford, watching a test match apparently. Can't get back before tomorrow."

She throws her head up and turns to look up at me, her expression utterly wretched.

"Their son is dead and they can't get back from Manchester until tomorrow?" She says, in disbelief, shaking her head slowly from side to side, her eyes wide and glassy.

I stare back at her, momentarily confused.

"Dead? Who said he was dead?"

"I thought you said, didn't you...umm? Didn't you just say?"

"Noooo!" I tell her emphatically, as she dabs at her tears with my by-now rather bedraggled looking handkerchief. "I mean, he's still a very sick little boy but he has an excellent chance of recovery. In no small part due to your prompt actions, Louisa, so, umm, well-done."

"So, what did he say then? What's happened?" She cries imploringly, twisting around in her chair, sideways, as a hopeful smile transforms her face. "I mean the doctor that's treating him. What did he say?"

"Yes, of course, ummm..." I say slowly as I wrack my brain, unsuccessfully, for the child's name. "It's a condition called ADEM, which is an acronym actually, for acute disseminated encephalomyelitis. Nasty condition but, usually, umm, completely treatable."

"ADEM? I don't think I've ever heard of it."

"No, not surprising, really, because it is quite rare. Umm, you may be familiar with the more common condition Multiple Sclerosis, yes?"

She nods at me, half-heartedly, wiping at her eyes as she speaks. "Sort of."

"It's similar in that they are both inflammatory conditions affecting the brain and spinal cord. With ADEM, it often follows on from a minor infection such as a cold, which was why your information about him possibly having had an earlier viral infection was important."

She flashes me a reluctant smile, sweetly self-conscious, and I notice the brightness has returned to her eyes.

"For some reason, and no one is entirely sure why, the immune system becomes mis-programmed, if you will, and the body's immune cells attack the healthy myelin, which is fatty protective coating that covers the nerves..."

"So, what's going to happen to him? Will he have it forever, Martin, like multiple sclerosis?"

"Umm, no, ADEM is more a disorder of childhood and, with prompt treatment, it can often be resolved quickly. In the boy's case he'll be on intravenous methylprednisolone for four to five days and, hopefully, his appalling parents will arrive just in time to see his remarkable recovery."

She gazes up at me silently and gives a tired shrug of her shoulders. I've witnessed veritable legions of weeping and wailing people since I started my medical career. Somewhat fortunately, I've probably dealt face-to-face with fewer than average but I've still seen enough at close hand to describe in detail the contorted, tear-stained faces, the blotchy skin, the puffy, red eyes, and the waxy, moist nostrils exuding copious streams of nasal mucus. But not Louisa. Her beauty merely seems more fragile, her skin paler and her eyes a deeper, darker, more intense green. A smattering of pale tiny freckles appear across her nose, giving her an even greater appearance of vulnerability. I take a small step toward her, cradling her jaw in my hand, in my own feeble attempt to reassure her. I notice with relief that her smile is more forthcoming, and she reaches up to place her hand over mine.

"Thank you." She says quietly and she gazes up at me so intently, I can't look away.

"Umm, that's absolutely fine." I tell her quickly, and I feel my heart quicken. "And, ahh, a good result in the scheme of things. Absolutely not ideal but certainly preferable to meningococcal disease, which is an appalling infection. So, ahhh, are you feeling somewhat relieved? I hope so. You should be."

"Yes." She replies, sighing heavily and gently leaning in so her head rests against me, her cheek on my hip, smiling up at me, as if she is suddenly overcome with exhaustion.

For a moment I am content just to stand there, stroking her hair, rather experimentally and hesitantly, as I wait for her to digest everything that I have told her.

"How do you deal with this sort of thing all the time?" She says thoughtfully, after a moment, her brow knotting as she gazes up at me.

How can I possibly explain it to her? What do I tell her? That the process one undergoes in surgical residency is completely transformative? That the training involves taking from you everything you have to give, and more? That residency itself is so arduous, so exhausting and yet so completely consuming, that you find yourself engrossed and engulfed to the point where all life is expunged from within you? And then, gradually, you are rebuilt, conformed as a new person, one whom is able to endure death, and dying, and make incredibly difficult decisions as calmly and easily as most people decide what to have for lunch.

I glide my hand gently down her neck again. I love the way her skin feels, the softness, the gentle warmth, it's somehow so tranquillising; elegant and feminine yet so very very strong.

"It's my job." I tell her simply, pausing thoughtfully for a moment before I slide my fingers gently under the neck of her t-shirt, massaging her shoulder lightly as if I'm somehow now trying to reassure her of my own well-being.

"That's nice." She says, after a moment, and I feel her hand lightly on the inside of my knee, as she trails her fingers up and down absently. The room seems peaceful, more like the quiet secluded corner of a library than the administration area of a crowded busy hospital, despite the all the dull background noise, the telephones, and the drone of distant conversation. And then I remember where I am and, now, suddenly, none of this seems like such a good idea, in fact I would go so far to say that it's actually become terribly unwise, as I clear my throat and step away quickly, desperately fighting the feeling of impropriety that has begun to rather awkwardly suggest itself, mortified lest someone barge in through the door and discover us.

"Louisa, umm, why don't we pop over to the children's ward and you can see...ahh...the boy for yourself? The paediatric registrar told me I was welcome to bring you across...if you want to, of course..."

She smiles at me, and I detect an improvement in her mood, a certain levity, a sparkle in her eye, more colour in her cheeks. I retrieve her jacket from the floor, glancing at her with just enough obvious disapproval that she grins as she takes it from me, slinging it over her shoulder and snatching her backpack from where she hung it on the chair. I hold the door open for her and, as stand there, I'm aware that there seem to be rather more milling staff members loitering around the admin cubicles than there usually would be. Some I recognise, some I don't and certainly there are no members of my team, no one that I could legitimately question about why on earth they were here. I do what I always do, lifting my chin and gazing at them, as coldly and dismissively as I am able, until they avert their stares or slink away. But, of course, Louisa, who doesn't miss anything, notices them all too and she does what comes so naturally to her, bestowing on them all the most beatific of smiles, dazzling them into silence as she runs the gamut of their undisguised interest.

I'd expressed my frustration to Chris Parsons yesterday, every since I'd become aware of the growing level of chatter that seemed to follow me around on Monday and Tuesday. I would never give anyone the satisfaction of reacting or responding but it had aggravated me somewhat, to be clearly the subject of such infantile speculation. Of course Chris had guffawed with laughter and stared at me incredulously when I'd mentioned it.

"You have the reputation of devoting your life to medicine, existing outside these four walls as some sort of eremitic monk, and then you turn up to your first social outing ever, and you have Louisa on your arm. Honestly, Mart, what do you expect people to do?"

"I expect them to mind their own business!" I replied mulishly, before stubbornly and rather churlishly pointing out that bringing Louisa with me was, in fact, his idea.

"Yes, and it was a good one!" He replied vehemently, as he cackled with laughter and loosened his tie. "Because, now, everyone knows the great Martin Ellingham is, in fact, human. Flesh and blood, like the rest of us!"

I'd glared at him and said nothing. I couldn't possibly expect someone who'd spent his life as an extrovert, bubbling over with social skills and a desire to get to know absolutely everyone he ever met, especially the half of the population that were a female, to understand my need for privacy. Perhaps he was correct, and people were just surprised, maybe they were generally without malice, probably they were merely curious about her and, as a scenario he seemed convinced of, if they'd been actual attendees at the function, they were probably rather jealous. I did try to elucidate rather forcefully on the discomfort I felt at the idea of Louisa being regarded as an accessory, some sort of decorative, two-dimensional adornment, but he hadn't seemed to grasp what I was trying to say. Good luck to anyone who attempted to treat her as such, I'd thought to myself as Chris had prattled on regardless. Hopefully, as he had speculated, by Friday I would be old news and the focus of everyone's interest would drift elsewhere, leaving me, mercifully, in peace.