‘That doesn’t really surprise me. It’s a difficult concept to explain if you’re not in the business. John was as much a counsellor here as he was a physician. It’s like that, working in palliative care. We don’t heal. We guide. But it doesn’t really matter how comfortable you make a terminal patient; the end result is always the same. The trick is to help them find peace before the end.

‘In the West we have a pretty messed up relationship with death,’ she continued. ‘We spend our lives trying not to think about it, yet at the same time we hold out hope that when the time finally does come, we’ll somehow be at peace with it. Our philosophy seems to be, We’ll deal with it when it happens. But that’s rarely the case. More often than not, when people are close to the end, they talk about a sort of … void.’

‘A void?’

Holly nodded and looked down at her fingers, as if they were alien entities.

‘There’s a lot of sadness in this place, Kate, but there’s a lot more anger, a lot more guilt. As Medical Director, I no longer get to do much practical medicine, but I still spend a lot of time talking to our patients. To the ones well enough to talk, anyway. Sometimes we talk about the weather or music they like or who’s winning the cricket. Then sometimes they say things like, God feels very far away from this place or What did I do to deserve this? They talk about a lack of peace. That’s spiritual distress.’

Kate remained silent and waited for her to continue.

‘When you’ve been in the business long enough you get pretty good at diagnosing it. Sometimes you can see it just by looking in someone’s face. Their eyes turn a couple of shades darker. Usually it’s something you see in your patients, but every now and then, you see it in your staff.’

‘Are you saying John was in spiritual distress?’

‘I’m saying that seven months ago, I noticed his eyes turn a couple of shades darker.’

‘What happened seven months ago?’

Holly offered a small robotic shrug and whispered, almost to herself, ‘The dam swelled.’

‘I don’t understand.’

‘Working in this sort of environment is emotionally taxing,’ Holly said. ‘So, we practise something here called leaves on a stream. It’s a quick form of self-therapy designed to disentangle yourself from negative thoughts. The idea is to visualise a stream, take each negative thought and place it on a leaf, put the leaf in the stream and let it drift away. But there’s only so many leaves you can place in that stream before it forms a dam.’

‘And that’s what happened with John? He was … stressed?’