Tancredi felt the old fear returning and reached for his nose. His anxiety was compounded by the fact that he didn’t understand what they were doing. Tamany gazed down the hill.

‘Don’t worry,’ he said, ‘they’re just sick.’

Emboldened, Tancredi decided to confront them.

‘Why are you disturbing the peace of Sanitalis?’ he shouted. ‘This is a place of long-term thinking, dedicated to medicine.’

The army shuffled. A patient emerged from the ranks, swathed top to toe in bandages with only a slit for his mouth.

‘I’m the Chief Patient,’ he croaked, jerking his head in every direction, unable to see Tancredi. ‘What you say is nonsense.’

He lurched a few paces forward.

‘This is a place of madness. Long-term thinking is unknown in the health profession. Sanitalis is out of control. It’s creating a monster which will wreck the planet.’

Tancredi was incredulous – the health profession, committed to good works, creating a monster? What was he talking about?

‘Who are you? What do you want?’

‘We’re the sick who wish to die,’ replied the Chief Patient, ‘but medicine on Sanitalis requires human life to be extended indefinitely, regardless of cost.

I’m one hundred and fifty-nine years old. There are millions of us undergoing continuous surgery to prolong our lives.’

He started to unfurl his bandages to prove the point.

‘The only original part of my body is my backside. Everything else has been replaced at least once. I’d been in hospital for thirty years before I escaped to join the Revolution for Death. Half the population are attached to life-support machines, incapable of doing anything for themselves. Behold the future of medicine!’

Tancredi was perplexed. Wasn’t sustaining life a worthy cause? He was about to reply when Tamany tugged at his sleeve, and pointed to what appeared to be a giant speaker on wheels coming up the far side of the hill. It was accompanied by an army of unarmed middle-aged men, dressed in brown jackets with plastic identity tags which twinkled in the sunlight. They were in no rush; Tancredi could hear the strain of civilised conversation. Behind him the maimed patients wailed and moaned.

‘I don’t know what’s going on,’ Tancredi said to Tamany nervously. ‘We’d better get out of the way.’

The patient army quickly deployed at the crest of the hill. As it beheld the opposing force, a banshee cry went up. The brown combatants reacted with indifference, turned their backs and continued their conversations. Some broke out flasks of tea, which they poured into plastic cups before adding milk and sugar with pedantic precision. A few attempted to drink from teaspoons with insistent pecking motions like busy woodpeckers.

This enraged the patients, and a roar of anger issued from their ranks. Tancredi expected the brown army to react, but its only point of activity was a technician busying himself at the base of the giant speaker at the front of their assembly.

The patient army stumbled forward on the battlefield. A rainstorm of scalpels and other sharp objects flew overhead, but fell short of the target of their hatred. Tancredi rushed Tamany towards the cover of a tree. He held the child behind him and peered out from around its trunk.