I pull up the patient’s chart on my computer. She’s a fifty-two-year-old woman who came to me five months ago complaining of dizziness and shortness of breath, neither of which were surprising given she was at least forty pounds overweight. Unlike many of my colleagues, I don’t see obesity as a moral failing. But as a heart surgeon I know there’s no such thing as fat but fit either. Healthy obesity is a myth propagated by a laudable body positivity culture that’s unfortunately missing the point: fitness is the body’s ability – and specifically the ability of lean tissue, or muscle – to take in and use oxygen. Which means it’s really all about your heart and lungs. You may get away with those extra rolls around your waist at thirty, but by fifty, your heart is exhausted from all the extra work it has to do.

The first time this patient came to me, I told her to come back when she’d lost three stone. She cried, and complained to the hospital she’d been ‘fat-shamed’. And then she went home and lost the weight.

I tell my patient that I’m proud of her, and ask my secretary to schedule her surgery. She’s my last appointment of the day: for once I’m only running a few minutes late. I’ll be home in time to have dinner with Tom and the children.

‘Liz,’ I say, putting my head around the door to my waiting room, ‘what date was that board meeting with the trustees again?’

‘The eleventh,’ she says. ‘And there’s someone here to see you, Ms Lennox. She doesn’t have an appointment. I told her you were busy, but she insisted she’d wait—’

‘It won’t take long,’ Harper says, rising to her feet.

I’m not even slightly surprised to see the woman at my hospital. She clearly has issues with boundaries, as she proved when she gatecrashed my gala.

‘Thanks, Liz,’ I tell my secretary. ‘You can go home now. I’ve got this.’

Harper follows me into my office. I shut the door, and take my seat behind my desk. She has no choice but to sit opposite me in one of my patients’ chairs: deliberately lower, so the occupant has no choice but to look up to me. It has nothing to do with ego: it’s an effective psychological trick, because a patient who respects their surgeon is more likely to do as they say pre- and post-op and thus achieve a better surgical outcome.

I’ve been waiting for this shoe to drop since we told the Conways the sale was off. She’ll have gone to Tom first, and he’ll have given her tea and sympathy and there’ll be other houses. It was only a matter of time before she came to me.

‘I assume this is about the house,’ I say.