He doesn’t wait for an answer. I watch him as he storms out of the kitchen, slopping coffee from his mug onto the pale wood floor as he goes. Automatically I pick up a sponge and mop the spills before they stain.

Tom may refuse to face it, but I can’t hide from the truth any longer. Whatever small seed of darkness there is in me has rioted uncontrollably in my son like Japanese knotweed.

I’m torn between protecting him and protecting the world from him.

And I’m coming to the dreadful realisation I can’t do both.

chapter 28

millie

There’s only one place I feel safe. In control. One place where I know who I am: where being who I am is a good thing, not a bad one.

The patient on my table is in his mid-sixties, a Catholic priest who was more afraid of dying when we met for his consult than one would expect, given his calling. An arterial switch operation is complex, but it’s a surgery I’ve done many times. I don’t expect any complications.

I start to cut. The familiar procedure is as soothing as a meditation: first expose the aorta and pulmonary arteries, and perform multiple cardiovascular cannulations in order to initiate a cardiopulmonary bypass. Transect the arteries and resect them together with a small patch of aorta. Implant the coronary arteries to the neo-aorta, formerly the main pulmonary artery, and switch the transected great vessels. Then shift the proximal transected pulmonary trunk posterior to the branch pulmonary arteries, and patch the proximal transected aorta at the site of coronary artery explantation. Finally, repair the atrial septal defect via a right atrial incision.

I work swiftly, and we finish ahead of schedule. Changing into a clean pair of scrubs, I head back up to the ICU to check on my patient.

‘Let me know if his condition changes,’ I tell my registrar.

For the rest of the day, I cut and sew, break ribs, stop and restart hearts, my powers undiminished. Whatever my failings as a mother, I am still God in my operating room.

It’s almost nightfall by the time I leave the hospital. Tomorrow will be another long day, starting with a heart transplant on a young athlete with heart failure brought on by dilated cardiomyopathy. A viral infection, probably, though the cause is uncertain. I can do nothing about the monster at home, but here I save lives. Here, I am a good person.

A shadow looms out of the darkness as I cross the car park.

‘Jesus Christ, Harper,’ I exclaim.

‘You didn’t answer my texts,’ she says.

I unlock my car and toss my bag onto the passenger seat. ‘You can’t keep coming to my place of work like this,’ I say.

‘It’s been almost a week,’ she says. ‘You told me you’d handle it.’