Dr Paul Martin sat in front of the unlit fire, the family around him. Joe had gone to the barn shortly after lunch and found the boy splayed on the ground, in a large pool of blood from his head. He had screamed and panicked, before carrying Jamie to the sofa. Try as they might, they could not rouse him. As they sent Hoss for the doctor, they thought their charge may be dead. They felt for a pulse. It was very, very slow and weak, but it was there.

"Oh, God, Dad," cried Joe. Ben started. He had never called him that before. "What shall we do? What will we tell Matthew? It's all my fault!"

"It's not, Joe, it's not."

"It is! We should have intervened earlier. I got you to ignore him, I thought he was a spoiled brat having a tantrum." He gazed at his cousin. "Who knows, perhaps he was. But it was more than that. Something was terribly wrong. No-one could endure the hunger he must have felt unless there was. And it's my fault."

"Joseph, now stop this! It's not your fault and even if it was, you can't worry about it now. Our job, our only job is to get him well again. We must concentrate."

"I'm sorry. You're right."

Ben stroked his head as he had done when he was a child. "Joe, it's as much my fault as yours. I didn't have to listen to you. I thought his body would force him to eat, too. I had no idea Jamie was sick. Truly troubled."

"Would it have made any difference if you had? I mean, on Monday?"

"I don't know," said Ben after a pause. "I still think I was right. Jamie needed correction. But if I'd known..." He shook his head. "I don't know."

Dr Martin had examined him carefully. "Jamie's in a poor state, I'm afraid. Clear signs of starvation." Ben groaned. Put into words it sounded as if he had neglected the child and nothing had been further from the truth. "His heart rate is extremely fast, but his pulse very slow. His breathing is shallow. His feet are swollen and his skin is loose, pale, dry. He's shivering constantly. His hair's so brittle it's falling out."

Ben tried not to weep. Even Joe and Hoss were stunned.

"I've prescribed some medicine and you must give it to him every two hours, day and night. He must expend absolutely no energy, he needs all he can get. The head injury is bad, but not fatal. He's split the scalp which is why it's bleeding so much. I won't know for some time but I've checked his eyes which show no trauma. You must tell me of any nausea or headaches or eye strain. I must say, these injuries are unpredictable, sometimes the full damage isn't known until much later."

"But what can we do, Paul?" asked Hoss.

"I need to know everything there is to know about him. I have an idea but I want to test it first."

He listened dutifully, posing the occasional question, and as he listened he began noting the conversation in a notebook. It was a long time before they had finished. He sat in thought for a little while.

"Ben, you know The Lancet, don't you?"

"Yes, it's a medical journal."

"I get it sent from England and it arrives always two months behind time. I like to keep my hand in. A most interesting article earlier this year. There was an address by the Queen's physician in Oxford describing a new condition. Well, it's not new, it's very old. Apepsia Hysterica. But so far it's only affected women."

"Apops – what, what?" Hoss frowned.

"Apepsia Hysterica. A person deliberately starves herself."

"What an earth for?"

"There are so many theories, Ben. I have my own, although I have never met a sufferer before. I have never heard of it affecting boys. Personally I think it's a matter of control. Tell me, how does Jamie get on with his father?"

"Badly. Matthew has little input in Jamie's upbringing. He went to school after school. His mother died when he was born and I suspect Matthew blames Jamie for it."

"Ah! And does the boy have any friends, any other family?"

"I don't think so."

"And you say his behavior was appalling? That you had to chastise him?"

"He was an obnoxious little brat."

"He's not much better now," said Joe, "although in a different way."

Paul proffered his glass. "May I have another of your excellent sherries, Ben?"

"Of course."

"I'll get it for you, Doc," said Hoss.

"Well, Ben, I have never treated this. Although I have studied hysteria - "

"You think he's hysterical?"

"In its medical sense hysteria does not necessarily denote wild, frenzied behavior. It covers a wide range of symptoms. This is a new field, we're only just starting to understand it. I'm just a humble country doctor, it's outside my area of expertise. But I could give you my theories as a friend."

"Please do. We need all the help we can get. I don't know about the boys, but I have no idea what the heck's going on with him."

"It's simple, Pa," said Joe. "He's cracked."

"That's not very helpful, Little Joe."

Joe lowered his eyes. "Sorry, Doc."

"But that's certainly the way he goes on, Paul," said Hoss. "Like he's not right in the head."

"The boy's in a fair amount of distress - "

"I'm not surprised as he's starved himself for a week!"

"That's a symptom, Ben, not a cause. You've told me a bit about him, what's happened since he's been here, his background, his interactions with you. I think Jamie has an issue with control. He's desperately unhappy, his relationship with his father is extremely bad, he has no mother, you say he's more or less been brought up by strangers...In fact, he thinks he killed his mother." Paul fixed his eyes on Hoss and Joe. "Could you imagine what that feels like? I mean, if you truly, truly believed it?"

"No, sir," said Hoss.

Joe shook his head. "No, Paul, I can't."

"Neither can I."

Ben sighed and flopped into his chair. "The terrible day when Elizabeth died. You didn't know her, Paul. I loved her so much. I took Adam in my arms and I swore nothing would happen to him. He was a part of her, a part of me, she had laid down her life for him, had died bringing him into the world. For that sacrifice I knew I would treasure him all the more for it."

"But Matthew didn't feel the same way?"

"No."

"This is only my opinion. Jamie's hostility, rudeness, his defiance...these are the only things that have held him together over the years. It's what got him through. Your punishing him damaged that, took away that last vestige of control."

"So you're saying it's my fault?"

"No. It's not a question of fault."

"I did no more to him than I would've done to my own children."

"Your four are different. They were brought up in a loving home. They've had love as well as discipline. As far I can tell, Jamie never had that love."

"It does sound like you're blaming Pa," said Joe, slightly annoyed. "You didn't see Jamie. I've never met such a horrid brat. He broke my calf's leg. Every..."

"Joe, I said it's not a question of blame. From what you said, Jamie needed correction. Your father had no idea what would happen. He saw a child out of control and took action, it was the natural thing to do. I'd have probably done the same. But...these problems go back a long way. Probably from the day he was born."

He paused, drained his glass; Hoss immediately refilled it.

"It's a good thing I have no more rounds today. I shall be falling out of my trap. I've never had three sherries before."

"Don't worry, Doc."

"Well, it'll have to be my last one! Ben, Jamie's lashing out the only way he knows how. He can no longer act out so he brought his anger inward. By hurting himself he knew he'd hurt you. That blackness inside him is like an aching hole. He's much more angry with himself than he is with you."

"Could've fooled me!"

"He seems to hate Little Joe more than any of us," said Hoss.

"Yes, it's strange, that. I don't know why. But, Joe, you've never been slow in saying what you think. You say you laughed when he was punished?"

"We both did," said Hoss.

"He was finally getting what he deserved!" Joe scoffed.

"You're closest to him in age. If anyone'd be his ally, it would be you. I don't know, I'm guessing, but that might be why."

Joe groaned. "So it's my fault as well as Pa's?"

"I keep telling you, it's not a question of fault."

"So it's a question of control?" Ben said. "What do we do about it?"

"Obviously, the first thing, he must eat. You'll have to force him, if necessary. It'll be messy and hard. But he's very weak. He may have dizziness and headaches from his injury. Liquid food. Broth, soup, nothing too thick. Plenty of fluids. Just a few mouthfuls every couple of hours. In a couple of days keep increasing the amount. It may be a few days before he can have solids. You've got to realize he will resist you. He will do everything in his power to thwart you. You see, I don't think he wants to recover. I think he wants to die."

There was a terrible silence.

"A boy of that age?" Ben asked. "A boy with his whole life in front of him? He wants to die?"

"And all over a spanking!" Hoss cried. He did not know whether to laugh or cry.

"It was the straw that broke the camel's back. My friends, please understand, I may be wrong in all this. I read the modern research. There are studies in London and Paris, various physicians doing sterling work. But it's guesswork. I have never treated this. I deal with broken limbs, falls, digging out bullets. I do not treat ailments of the brain. Or the soul."

"Well, you are much better placed than we are, Paul," said Ben. "We're still not much the wiser but at least we have an idea now."

"He must not get out of bed. He's come around now and Hop Sing is with him. He's extremely frail. But keep the feeding up. Broth, not too thick, and plenty of water. Slowly make the broth thicker as time goes by. Your cook is excellent, he'll know what to do. I shall be in tomorrow. Don't leave him alone."

After he had left they did not know what to say to each other.

Joe broke the silence. "What have we gotten ourselves into?"

"Well, it doesn't matter what we've got into, Joseph. We owe him a duty of care. I swore to Matthew I'd look after him. As long as he's under my roof he's my responsibility, as much as my own child would be. I have no intention of handing him a dead son when he returns. Joseph, go and sit with him, and tell Hop Sing to make some broth."