James awoke with a start. His foot jerked out, squeaking against linoleum. As he straightened himself in his seat, he noticed a large woman eyeing him suspiciously from the top of a magazine. Smiling uncertainly at her scrutiny, the frowning woman shook her head in bemusement. It was only after she had returned to her reading that he realised he had no idea where he was.

The room was small and lit by artificial light. Two other people sat beside the large woman, glumly perusing a collection of dog-eared magazines heaped on a coffee table. It appeared that they were all waiting for something, but what?

Closing his eyes, he drew his hands across his face, raising a sound like raked gravel from the stubble covering his jaw. Another memory returned to his mind that seemed far more vivid than the recollection of where he was now sitting. He saw again the young boy walking beside the two old men into the mountains. Their bright yellow robes flashed across his mind like blinding flares, accompanied by a single word which repeated itself again and again like a mantra. It was a curious word that didn’t make any sense, yet there it was, rolling around inside his head like a restless marble.

‘Perrin, Perrin, Perrin…’

His lips moved silently around the word, until his voice finally made it whole.

‘Perrin!’

It was barely a whisper in his throat, but he realised with mounting horror that he was prepared to scream it from the top of his lungs. Gripped by a sudden and overwhelming sense of loss, he took a deep breath and opened his mouth wide…

‘Mr Gelding? Mr James Gelding?’

James jumped as a hand alighted upon his shoulder. Opening his eyes, he saw a middle-aged nurse smiling down from above, her face like the wide, dazed mask of a Buddha statue. Of course! This was the hospital! How could he have forgotten?

‘Having a little shut-eye were we Mr Gelding?’

‘Yes, I suppose I must have been,’ he replied, getting unsteadily to his feet. ‘I’m sorry about that.’

As the nurse led him out of the waiting room and down a short corridor, James frowned. Already the strange dream was beginning to fade from his memory, but it was unnerving that it had affected him so deeply. If the nurse hadn’t come at that very moment, would he have really screamed that odd word out aloud?

Now that he thought about it, he realised he had already forgotten what the word had been. It had sounded like peanut or parrot… or had it been perret?

Shaking his head with bemusement, he followed the nurse onto a small ward where two comatose patients occupied a row of otherwise empty beds. The nurse gestured to a seat and James sat whilst she drew a small machine on caster wheels towards her.

‘I’m just going to take your blood pressure,’ the nurse said, taking a flesh-coloured armband and sliding it dutifully up his arm.

She flicked a switch and the machine buzzed and clicked into life, causing the armband to slowly inflate around his arm. Soon, he could feel his heartbeat tapping out a steady rhythm against his bicep. It was unnerving to feel its beat so steady and sure, when the rest of his body felt as though it were about to unravel.

‘That was a big sigh,’ the nurse said, deflating the band before removing it like the shed skin of some recently deceased animal.

‘My mother used to always say that,’ James heard himself reply.

‘Bless,’ the nurse said, smiling mechanically. ‘Well, Doctor Smithson will call you into the consultation room when he is ready, so just sit tight until then.’

And then she was gone, leaving him sitting alone on the empty ward.

He slumped back against the chair and gazed up at the sign hanging from the ceiling, “Neurophysiology”. Before today he hadn’t known the word existed, let alone what it meant. But now, that one word hovering above his head meant a great deal. It lay like a leaden weight upon the gnawing pain inside his head, the numbness prickling through the left side of his body; the arm, the leg, the half of his face that no longer felt his own. The impending consultation seemed not only to be unnecessary, but ultimately futile. He didn’t need the professional opinion of a doctor to tell him what he already knew…

He was dying.

A door opened and a tall, thin man in a white coat poked his head out like a shy cuckoo emerging from its clock.

‘Mr Gelding?’ he said, his eyes reluctantly alighting upon the ward’s sole occupant. ‘Would you like to come inside?’

Without waiting for a reply, the man’s head disappeared back out of sight.

‘Would I like to come inside?’ James mumbled as he got unsteadily to his feet. ‘No, not especially.’

Smiling mirthlessly, he made his way towards the pool of sterile light filtering onto the gloomy ward. As usual, the numbness in his left side made him walk strangely, as though unseen hands were trying to pull him off course, and when he reached the door he had to pause to steady himself. Wringing his sweaty hands, he held his numb tongue against the roof of his mouth and with another deep sigh entered the room.

The office was small and sparsely furnished. A row of metal filing cabinets lined one wall and a huge wooden desk sat in the middle of the room, blocking the way forward like a crude barricade against intruders. A potted plant that had seen better days sat forlornly in one corner, its waxy leaves coated in a thick layer of dust. The doctor had already taken his seat on the other side of the desk and was busily thumbing through a collection of papers when the sound of the closing door made him glance up.

‘Please, take a seat Mr Gelding,’ the doctor said, gesturing to an empty chair safely separated from him by the wide expanse of mahogany.

For a few moments, the doctor returned his attention to his papers, his eyes anchored to the pages as though determined not to stray beyond them.

‘Now,’ he said, at last bringing his eyes to meet his patient’s. ‘Last week, as you know, a number of scans were performed upon your brain and the cervical portion of your spinal cord.’

James nodded, suddenly feeling uncomfortable that he had yet to speak a single word to the other man.

The doctor stood, and drawing a number of transparent sheets from a brown envelope walked over to a light box attached to the wall. Flicking a switch, he promptly tucked the sheets inside its top edge where they hung like a series of macabre prints in a photographer’s studio.

‘As we previously discussed, our concern was that you might be experiencing the early signifiers of Multiple Sclerosis,’ the doctor continued, looking hesitantly between the illuminated images of his brain and the head that contained it. ‘I am terribly sorry Mr Gelding, but I have some bad news for you.’

James had been prepared for these very words ever since the doctor had first suggested the MRI scans two weeks before. Hearing them now was like watching a long awaited train finally pull into its station. The scans would reveal the blight of lesions spread across his brain and spinal cord, signifying the indiscriminate death of nerve cells due to the autoimmune disease he had read so much about. He knew the salient points of the diagnosis by heart; he knew that it was a disease for which there was no cure, a death that would be slow and degrading as his nervous system slowly crumbled around him.

James took a deep breath and tried to meet the doctor’s eyes with what little bravery he could muster.

‘Mr Gelding, I’m afraid you have cancer.’

Something inside James’ stomach flipped, sending waves of cold to every inch of his body. He looked back up at the glowing transparencies and watched in mute horror as the doctor’s finger traced the outline of a dark smudge buried within the cauliflower swirls of his brain.

‘It is difficult to see on this image,’ the doctor continued, ‘but you actually have two separate tumours.

‘The primary tumour is situated within the Frontal Lobe, the portion of your brain that is located beneath here,’ the doctor said, placing a slender finger above his own forehead. ‘And the secondary tumour is situated within the Parietal Lobe,’ his finger traced a path backwards until it hovered over the North Pole of his balding head.

‘It is likely that this is the tumour responsible for the weakness you have been experiencing on the left side of your body,’ the doctor said, finally removing the finger from his head, ‘and, of course, the migraines,’ he added, sitting back behind his desk.

‘I’m afraid, Mr Gelding, that there is only one option available, and that is surgery to remove both tumours. However, I have to warn you now that the larger of the two tumours will be extremely dangerous to extract, and I cannot rule out the possibility of some damage to the surrounding tissue… even if the operation is a success.’ The doctor shifted in his chair, his eyes slightly glazed as though defensive shutters had been drawn up inside them.

‘However, the prognosis, should you choose not to proceed with the operation, would be a remaining lifespan measured in months.’

The doctor laced his fingers together above the shiny surface of the desk and took a deep breath.

‘Mr Gelding, I feel that I should be perfectly candid with you at this stage. There is no way of knowing for certain until a biopsy is completed upon the extracted material, but judging from the positions of the two tumours, I am reasonably confident that the two are linked. Therefore, we have to consider the possibility that we are dealing with a particularly aggressive form of cancer. Even if the tumours are successfully removed, there is no guarantee that new cancers will not have already been seeded elsewhere in the brain.’

The doctor paused, as though suddenly floundering with the lack of medical terms he might use to fill the silence. After a short while, he resorted to the emotionless platitudes of which he was so well versed, ‘I’m so terribly sorry, Mr Gelding.’

***

Minutes later, James was back on the other side of the door. He couldn’t remember what the doctor had said following the bad news, only dwelling upon the two words he had offered by way of reply: ‘That’s ok.’ It was strange how these two words now sounded so much like an apology, as though he had felt responsible for the obvious discomfort Doctor Smithson had just waded through.

The nurse with the benevolent smile suddenly appeared at his side and promptly led him back through the labyrinth of hospital corridors, her hand resting upon his arm as though he were a lost child.

‘Your appointment for the operation will be posted out to you in the next few days,’ she said, eventually depositing him inside the busy hospital foyer.

For the first time, the woman’s smile vanished and was immediately replaced by a disconcerting parody of sympathy.

‘If you should need to talk to anyone about what is happening, please do not hesitate to call this number.’

She handed him a small pamphlet with a number printed along the bottom. ‘You are not alone in this,’ she added, gently patting his arm.

And then he was alone once more, standing outside the hospital, the paper pamphlet clenched in a tight white fist. The sun slipped out from behind the clouds and for a moment he stood blinking against its sudden brightness. A warm breeze carried the beginnings of summer, the smell of cut grass, the faint perfume of flowers bordering the nearby car park.

Before he knew what he was doing, he was already walking; his unthinking legs carrying the burden of his body like a dead weight. As he blundered across the car park and onto the pavement beyond, Doctor Smithson’s words returned to him from the sterile interior of the consultation room. The doctor had concluded their one-sided conversation by telling him that the egg-sized tumour had very likely been sitting there inside his head for the past twelve months.

Twelve months!

With the unmistakable tone of accusation in his voice, the doctor had asked why he had waited so long before seeking help. But James had only shaken his head, unable to tell the pitiful truth that he had been too scared to know what was wrong.

James sighed, but it didn’t make him feel any better. A scream would have been more appropriate but as he walked out of the hospital grounds, he realised he lacked the courage for such an outburst. Instead, his thoughts drifted back through the months he had unknowingly shared with the tumour; the months leading up to this dreadful discovery.

He saw again her face, smiling at him within a warm embrace; her dancing green eyes, the freckles dusting the bridge of her nose. Her soft words of assurance had always been enough to quieten his endless worry… but never for long.

The bittersweet memory of his ex-girlfriend vanished, and was immediately replaced by a more recent recollection. She held him once more, but this time her radiant smile was gone. With her anguished eyes seeking his, she had told him that she had had enough. That it was over between them.

That had been two months ago.

Obviously, she had grown tired of his endless worrying, his depression, his apathy…

Who wouldn’t?

The love they had once shared hadn’t ended. Rather, it had been slowly bled dry for all it was worth. Without knowing it, he had personally strangled that love, throttling it, stifling it, until its weak arms could no longer surround them both.

These involuntary recollections dredged another painful memory to the surface of his mind, where it flooded him again with self-pity and despair.

It had been a dull, overcast morning when he had said goodbye to her for the last time. Her tears had returned as they stood together on her doorstep, but this time they were fewer, as though the pain of parting was already being tempered by the relief of never having to see him again. He had walked through the streets in a daze until he had reached the old wooden bus shelter on the edge of town. It had been a lonely wait for the last bus he would ever catch from it, and as he had watched the steady stream of traffic pass along the grey street, it had given him ample time to consider what he had lost, what he would never have again. In those moments, the numbness in the left side of his body had seemed to swell until he had wondered if he might not be fading from existence altogether.

James frowned as the hospital receded into the distance behind him like a grey ship on the horizon. The runaway train of his thoughts had dislodged another fragment of memory from that painful parting in early spring. It was strange that he hadn’t thought about him until now, but somehow in the fog of his all-consuming depression he had forgotten all about the man who had smiled…

That morning, it had seemed strange to see another person out walking when everyone else preferred to hide within the cloistered privacy of their cars. So when he had first seen the man striding down the hill towards him, he had assumed he was homeless; his beard was long and unkempt and he wore a large canvas rucksack with a bedroll tied to its top. But it hadn’t been until the man had drawn nearer that he had realised his mistake. For despite the dirty clothes and unkempt appearance, the man’s stride had been confident and purposeful, his bearing proud and noble like a prince masquerading in rags.

In that moment, as though reflected in the mirror of the man’s nobility, James had truly seen himself for the first time. And what he saw had made him turn his eyes to the ground in shame. With blinding clarity, he had seen the taint of his life receding into the past like a baleful ribbon. The man he had become was the sum of countless denials and lost opportunities; a hopeless wretch now left alone and bereaved at the side of the road. The tears he had been unable to shed in the presence of his girlfriend had then fallen freely, until his entire body had been wracked with sobs of despair.

It had been some time before James had been able to look up, his chest still hitching and shuddering like a child recovering from a hysterical fit. He had expected to find the strange man dwindling into the distance behind him, but with a jolt, he had found him on the opposite side of the road, watching him intently; the endless traffic ruffling his long, greying hair like the brambles in the hedge behind him. James had been about to turn away in embarrassment, when something miraculous had happened.

The man had smiled.

The man’s smile had moved him deeply at the time, cast out amongst the flicker of racing traffic like sunlight breaking between dark clouds. It was a knowing smile, a kind smile, and within its radiant benevolence, James’ misery and loss had evaporated like rainwater baked off a pavement.

But it hadn’t lasted for long.

With the sudden hiss of airbrakes, the wide expanse of gleaming metal belonging to the country bus had interceded, severing the connection as abruptly as scissors through a phone line.

Caught in a moment of indecision, James had clambered aboard just as the doors were closing. But as the bus had jerked back into traffic, he had stumbled up the staircase to peer out of its top windows. There, he had got his last glimpse of the smiling man as he climbed a wooden stile and set off across the open fields beyond…

James stopped walking.

Turning, he gazed at the hospital now all but lost on the horizon. The main building was hidden behind a line of trees, but the tall chimney of its incinerator rose into the sky like a taunting finger.

It wasn’t until this very moment, faced with the news of his illness and reminded of the crushing loss of his girlfriend that he finally understood what the man had been doing that day. The modern world, with its endless cars and concrete, its innumerable disappointments and rejections, its absolute certainties and irrefutable diagnosis’; that man, who had given him the simple gift of his smile, had been leaving it all behind…

Looking now across the road, James noticed an old stone wall and without hesitation ambled towards it, thrusting out a trembling hand to slow an approaching car. The car’s horn blared into the air like an angry scream, but James kept his eyes locked upon the far side of the road like a floundering swimmer desperately making for shore. Reaching the wall, he awkwardly hoisted himself over it, landing in a tangle of brambles which tugged painfully through his clothes. Unmindful of their tiny knives, he drew a deep breath, and pushed through.

Hampered by his numb leg, he blundered out onto an abandoned car park, hemmed in by weeds and nettles. Oily stains still marked the cracked concrete where cars once held sway, but otherwise it was deserted. It gave him a grim satisfaction to see this slice of modernity in the process of reclamation, but still it wasn’t enough. Undaunted, he pushed on through a stand of blackberry bushes, their thorns adding to the scrapes already traced in crimson across his bare arms.

A shimmering sea of green filled his vision as thorns tugged and plucked at his clothes. The air was pungent with the fragrance of sap and ripening fruit, the insistent hum of insects thriving in the undergrowth. The melodic song of a blackbird was like a call of welcome; a joyous congratulation for his imminent escape.

A tentative smile was creeping onto his lips when his foot suddenly caught in the undergrowth. His hands acted before he could stop them and grasped the leaves around him, the hidden thorns readily biting into his flesh. With a cry, he released his hold and tumbled down through the green. A sea of discarded beer cans broke his fall, the sound jarring against the buzzing and chirping fecundity that surrounded him. It pained him to have the real world so violently mashed back into his senses, but he struggled on, crawling along a gully similarly choked with the off-casts of the modern world.

When at last he crested the muddy bank of the ditch, the gutted remains of a small building barred his way. The crumbling redbrick walls were covered with ancient graffiti, like hieroglyphic warnings from another time. But still he lumbered on, scrambling up a heap of rubble that lay across his path.

Cresting its tottering summit, he slid down the other side, his shaking legs finally bringing him to a halt as stones rattled around him. A tall chain-link fence loomed across the abandoned lot like a dark net thrown across the sky. Its top was crested by a rusted tangle of barbed wire, where fragments of decaying plastic bags fluttered forlornly in the breeze.

As insubstantial as this barrier appeared, it was a wall to him all the same. His legs carried him forward until his body leaned into its creaking embrace. With a shuddering gasp, he lowered his head into his hands and quietly wept.