He did his best to persuade her to stay. Offered to change. To spend more time with her. Asked what he could do to make amends. But to no avail. He even suggested she stay for the sake of the children. But he was too late on that count. They had flown and now so had Kate. It never occurred to him that she might have found someone else.

There was no denying that her leaving affected his work. It was not that he became unreliable, just more irritable. Less tolerant of those underneath him when they mislaid a prescription or muddled up an appointment. From being courteous and unflappable he had become irascible and tetchy; quick to snap and dismissive of patients he considered were wasting his time.

Those around him tried to make allowances, convinced themselves that it was a temporary blip and that soon he would be back to normal. But Randall Cummings, the senior partner in the practice, felt obliged to have a word with him. Things seemed to be improving, until one day, out of nowhere, Cummings said that it would probably be best for everybody if Christopher left the practice. Made a new start. Turned over a new leaf.

Others in the practice were surprised not only at the senior partner’s precipitate action, but also at Christopher’s tacit acceptance of the decision. The irritability had gone now, to be replaced with a distancing, almost a withdrawal. There was no farewell party. He just slipped quietly away. Preoccupied. Troubled.

Having devoted himself to medicine for the better part of his life he began to wonder if it had all been worthwhile. What difference had he made? Where was that missionary zeal now? That raw energy that drove him on in his early days as a GP; the days when he felt on top of the job despite the tiredness, the travelling and the endless ministering to the sick. Now he just seemed to be drowning in a sea of forms and regulations. That and loneliness. Not the sort of thing you want to admit to anybody. Loneliness–the unmentionable disease. He tried not to wallow in it. But it had grown ever more enveloping since Kate’s departure.

He could feel no bitterness towards her. Just profound sadness at his own myopic self-absorption which had forced her to leave–the long hours, the putting of patients’ interests first, the weekends on call, the Christmas dinners interrupted. It had been all his fault. It must have been. What other reason could she have had? Kate seemed apologetic when she left. Apologetic but determined. And she had not kept in touch; that surprised him, and then he began to wonder if she had someone else to care about. Someone of whom her children would not approve.