I close my eyes, trying to imagine the picture from textbooks, as I’ve never seen this in real life. ‘If I ask you to lie down, does the appearance change?’

‘Good call. It does. What else?’

‘Um . . . how old are you, Mr Plum?’

‘I’m sixty-one.’

I diagnose varicoceles and suggest that radiotherapy is likely to be the best treatment if confirmed.

Kerry nods. ‘Is that all?’ She looks at me steadily.

I close my eyes. What else could it be, at this age? Cancer? I try to picture the vessels and tracts and imagine what else might be lurking. ‘I think we’d also want to get him tests to rule out invasive renal cell carcinoma . . .?’ My voice rises uncertainly.

She closes the book and drops it onto the carpet. ‘You’ve passed.’

‘Thanks to you. You’re going to be the top of the class once you get to medical school.’

Her smile tightens and for the first time, I notice black rings around her eyes. What am I not seeing? For diagnoses, we have these endless mnemonics – from DR GERM for abdominal exams to SOCRATES for evaluating pain.

If only there was one to diagnose the problem in an ailing relationship.

‘Tim?’

When I look up at Kerry, the blush the wine had given her cheeks seems to have disappeared.

‘I need to tell you something,’ she says. ‘A decision I’ve made.’

Is it about Joel? Was that unsettled feeling I had something I should have analysed further?

‘Yes?’

‘I’m going to defer my med school application for the year. Well, I already have. It’s nothing to worry about. I just think that with all the uncertainty around which deanery you’re going to, it might be easier for the three of us if we have an extra year to get ourselves organized, save up a bit of spare cash.’

I stare at her. Of all the things I was expecting her to say, it wasn’t this. ‘But you worked like crazy to get your A levels so you could start this September. I don’t get it.’

She stands up. ‘It makes perfect sense to me. Anyway, there’s no point arguing. It’s done. Another year is neither here nor there, really, is it?’

As she leaves the room, I am certain I am missing something. Maybe it relates to Joel, and his card, and whatever secrets it contained. Or could she have lost her nerve about medicine? No. Not Kerry. What I do know is that if Kerry’s decided not to tell me, I have no chance of working out what it is.

But if it was definitely over between us, she would have said so. I have to cling to that.

Chapter 40: Kerry

8 March 2005