Her speech is slurred. I think she’s drunk, but it could be gas or spice or whatever else she might use to make life on the streets tolerable.

Though that doesn’t mean she’s not dying. Sometimes patients suss it out long before medics do. And rough sleepers die at twenty-five times the rate of the rest of us.

‘Let’s try to get you sorted. You told the triage nurse you had pain in your tummy and back so let’s start there. Why don’t you lie down so I can examine you.’

She gives me a warning look when I try to lift up the layers of clothing, and does it herself instead. The smell gets stronger, even though I’m still breathing through my mouth. I can almost taste its zoo-like pungency. Her skin, what I can see of it, is deep brown from dirt.

Do I recognize her because I’ve seen her in A & E before? There’s not much on her notes, but she’s probably come in under a false name. Plenty do, to try to get hold of opioids.

As I palpate, she cringes. ‘Tell me where it hurts most if you can . . .’

But she doesn’t seem to be able to articulate it. ‘Have you been bleeding when you go to the toilet? Or from your vagina?’

‘No.’

She’s still chatting to me, but I stop hearing her because I feel something pulsing under my fingers and my heart beats faster.

I try to find other possible explanations, because I want to be wrong. But my gut tells me we’ve found what we’re looking for.

I pull the curtain to one side to call out to my colleagues. ‘I think this one needs to go to resus ASAP. Query ruptured AAA. We need a CT and can we bleep the on-call vascular consultant NOW.’

There’s a grim satisfaction in her smile. ‘I am dying, aren’t I?’

Most patients with a ruptured abdominal aortic aneurysm die after surgery. ‘We need to get you a scan now, but if this is what I think it is, you’ll need an emergency operation. It is very serious, I’m afraid. Is there someone we can call?’

She reaches for my hand. ‘No. You’ll stay with me, though, won’t you, Kerry?’

I freeze. I was right. We’ve met before. She knows me.

‘I can’t promise that, but you will be looked after, Miss Allsop.’ I look at her notes, for her first name, because the surname feels too distant for someone who is facing death alone. Zoë.

And now I know who she is.

When they take her off for her CT, I stay behind the cubicle curtains, to give myself a minute to work out what to do.

Zoë is Joel’s ex. Leo’s mother. If she wanted me to call Joel, she would have asked.