What was left of Queenie’s hair was thin and white like a seedhead in a hedgerow; puffed over her scalp, and pulled sideways, as if she’d been caught in a violent wind. He could see the papery thin skin of her skull. Her neck was bandaged.

Queenie Hennessy looked like someone else. Like someone he had never met. A ghost. A shell. He glanced behind him for Sister Philomena, but the doorway was empty. She had gone.

He could drop the presents and go. Maybe with a card. The idea of writing seemed by far the best idea; he could say something comforting. A burst of energy shot through him. He was about to retreat when Queenie’s head began a slow and steady journey from the window, and he was struck still again, watching. First came the left eye, then the nose, then the right side of her cheek, until she was facing him, and they met for the first time in twenty years. Harold’s breath stopped.

Her head was all wrong. It was two heads in one, the second growing out of the first. It began somewhere above her cheekbone and protruded over the jaw. It was so big, this growth, this second face without features, it looked as if it would erupt through her skin at any moment. It had forced the right eye to close and was tugging it towards her ear. The lower half of her mouth was jammed sideways and sliding towards her jaw. It was inhuman. She lifted her claw fingers, as if to hide, but there was no not seeing. Harold groaned.

The noise was out of him before he was aware of making it. Her hand groped for something she didn’t find.

He wished he could pretend it wasn’t horrible to look at. But he couldn’t. His mouth opened and two words shuffled out. “Hello, Queenie.” Over six hundred miles, and that was all he could come up with.

She said nothing.

“It’s Harold,” he said. “Harold Fry.” He was aware he was nodding, and shaping the words with exaggeration, and directing them not at her disfigured face but at her claw hand. “We worked together a long time ago. Do you remember?”

He snatched one more glance at the gargantuan tumour. It was a shining bulbous mass of thread-like veins and bruising, as if it hurt the skin to contain it. Queenie’s one open eye blinked at him. From the other slid a trail of something wet towards her pillow.

“Did you get my letter?”

The look was naked, like an animal trapped inside a box.

“My postcards?”

Am I dying? said her marble eye. Will it hurt?