It had been a routine night shift. Jude had been called down multiple times to the casualty department. Three women in their eighties, one woman in her nineties. Three had fallen. One had been brought in unconscious. Two were severely confused. The wards had been quiet. Not literally quiet. A patient with dementia was calling for her mother over and over again. A male patient woke up repeatedly and shouted something unintelligible in a frenzied tone and went back to sleep and then woke up again and shouted the same fearful words. Jude had talked to the duty nurse about his medication but decided to leave it as it was.

Years before she’d had a placement in an A & E department at a hospital in south London. Friends of hers who had done that job said they enjoyed the adrenaline, the sense of not knowing what you would be doing in five minutes’ time. Jude had never felt that. She didn’t feel much adrenaline in treating the drunken fights, the drunken accidents, the drunken car crashes. You would fix them and send them away. Or you couldn’t fix them and you would send them on to someone who could fix them. And sometimes, horribly, there were the mangled dead or the dying and she never got used to that.

When she chose geriatrics, her friends seemed surprised. Didn’t she find it depressing? No, she didn’t. She did the things other doctors did, making diagnoses, prescribing drugs, ordering tests. But she also felt like a doctor from an earlier age, when sometimes all one could do was to sit with a patient, hold their hand, talk to them, listen to them, attend. Behind everything, the mask of old age, they were as funny and complicated and fucked up as everyone else. Every time she was able to send a patient home, a little better than when they came in, without pain perhaps, able to walk unaided, it felt like a victory.

She looked at her phone. The 94-year-old woman should be having her X-ray. Jude made a mental note to check up on her before she left. Then she got cross with herself and made a real note. Mental notes were useless.

She looked at the board on the wall next to the nurses’ station. Nothing she hadn’t dealt with. She walked across to the nurse behind the desk and asked if anyone had called from A & E.

The nurse shook her head. “They’re terrible down there. They never get back to you. They never return calls.” She tapped her finger on the desk. “But then as soon as they want something.”

“I know,” said Jude. “Tell me about it.”

These shared complaints about the inefficiency and the arrogance of other departments—that was how they bonded.

“Someone called for you,” said the nurse.

“Did you take their number?”

“No, I mean called. Came here. Asked to see you.”

“Which department?”