“Uhn . . . uhn . . . uhn . . . ”

Even with the hospital running prescription upgrades over its Wi-Fi, Karen Meads can’t yet speak, or raise her left hand.

The stench of the hospital, of alcoholic hand gel, chemical bleach, terrible tea and flaking skin turned to dust in dull air is a toxin, a tonic, a shock that flings Harmony back to the bed and the darkness in London, a sensory assault that she could dance in.

In the grand scheme of things, you still have to make choices.

She sat down, alone at home as her mother tried to walk again, and did some maths.

Living in Karen’s home, with a steady income from her job in the shop, paying back her credit cards and with her body running only the absolute basics of the immune packages, she had at the end of every month £18.19 to spare.

But if she didn’t go down the pub, and was careful with what she bought at the shops, that could be nearly £50.

And if she was very careful indeed, and got a promotion to the shop in Virginia Water, she might even be able to pay the credit card back by 2041, at a cost of only £102,865.

These numbers – these ideas – had seemed terrifying to her, once upon a time. She had run away from them, too frightened to even give them a name.

The recommended treatment course for Karen, to get her out of hospital and self-sufficient, was £670 a month, and that was even without some of the upgrades that the occupational therapist felt would speed up her mother’s recovery.

Karen’s pension didn’t cover it, and neither did Harmony’s pay. Not unless Harmony had been willing to make a lot of sacrifices, a lot of choices which would have been, as Karen put it, not living your life.

You have to live your life, she’d say. You have to make these choices.

The hospital released Karen after a month and a half, and the local church organised a cupcake bake to help raise money to refit her home.

This is Harmony, thirty-one years old.

She is

Only herself.

Normal.

A woman who knows herself, neither fat nor thin. She quite likes her wrists, though she can’t get her thumb and little finger round them yet in a loop. She has practised her smile in front of the mirror, and thinks it is wise.

She sits by her mother’s bed, as Roman, the chipper young man from Lithuania with the gelled-back hair, spoon-feeds Karen cold porridge through her drooping, dull lips. Karen doesn’t speak, as Roman scrapes a line of dribbled, half-chewed food off her chin. Sometimes she makes little grunting noises, and seems to recognise Harmony. Sometimes her right hand clenches and opens, as if looking for a sensation that isn’t there, but you can hardly see the dent where her ring once was, and if Karen has noticed the absence, she doesn’t have the language to express it.