His next patient wasn’t until three, and Gessen welcomed the thought of spending a few hours alone in his private quarters. An underground passage connecting the stone manor house to his cosy chalet allowed him to come and go without being observed by the patients, though there were fewer than usual these days. Equipped to treat twelve full-time residents, the clinic was down to five. The first time since launching his ambitious enterprise nearly a dozen years ago that he’d had so few patients in his care. No wonder his accountant was nervous. Gessen rarely thought about the money side of things, but he couldn’t ignore the fact that he would soon be operating at a loss.

Inside his chalet, cleverly screened from the other buildings by a copse of trees, light poured in through the large windows. Fernanda, the corgi and beagle mix he’d rescued from a kill shelter in Spain, wagged her tail in greeting, then rushed across the room to fetch a well-chewed orange ball and drop it at Gessen’s feet. He tossed the ball and smiled as she raced to catch it. She could do this for hours, and after a long day of attending to the needs of others, the joy in the eyes of this little dog, saved from a miserable death, never failed to brighten his mood.

He stroked Fernanda’s silky ears and let her out into the fenced garden to lie in the sun. Placed squarely in the middle of the kitchen table, the accountant’s report was like a reproach. The three-pronged warning loud and clear: admit more patients, raise fees, or cut operating costs. Only the first was an attractive option.

Next to one item, a quarterly donation to a charity in Warsaw, his accountant had scribbled a remark in red ink. Is this necessary? Consider dropping it. Ever the diplomat, what his accountant meant was: axe this immediately and save yourself a boatload of money. But Gessen had no intention of changing a thing. Not even when the world’s financial markets were toppling like dominoes. Sending money to the Varem Heym Foundation was non-negotiable.

He closed the report and looked out through the sliding glass door to the terrace, neatly framed by a hedge of Japanese hawthorn. He dropped into a chair and studied the line of jagged peaks to the east. In certain lights they resembled the massive teeth of a Jurassic reptile.

Perched high above a forested valley in the Bernese Oberland, the former retreat of an eccentric 1920s industrialist who’d lost everything in the crash had been transformed into the clinic’s main building. A folly of turrets and parapets, acres of parquet, and a soaring tower with a bird’s-eye view of the grounds. Surrounded by quintessentially Swiss chalets for the patients and staff, the whole set-up might have been plucked straight from a fairy tale.