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Authors: Patrick Gale

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Self-sufficient in their pseudo-marriage, her parents were the sort of people who had colleagues rather than friends. They often left their clothes off around the house and garden, at least at weekends. They had no naturist friends and neither did Laura, apart from the small gang with whom she joined up at Summerglades, which meant that any entertaining involved the selection of clothes and a sense of the family making an effort to pass for normal. The strain this involved inevitably meant that colleagues or school friends were rarely invited twice.

Laura grew to be self-contained. An early school report pronounced
Lara keeps her own counsel
. (She was Lara then, named for the passionately divided heroine of
Pasternak’s celebrated novel, but grew so sick of having ‘Lara’s Theme’ sung at her in school that she acquired a U at the first opportunity.) She maintained a wall of privacy about her family life as impenetrable as her parents’ escallonia hedges. But she also fell into an early habit of keeping her own life private from her parents and to this day there was much about her that her mother didn’t know. She never thought of this as secrecy but as dignity: the maintenance of a kind of order. Now that they were living in close proximity again she took pains to respect her mother’s privacy whenever practicable and trusted that the courtesy was mutual.

As to the effect of her parents’ naturism on her love life, it had left her happy in her skin, dauntingly unselfconscious about removing her clothes. It had also robbed naked flesh of any power to excite her. For her, eroticism was found at the body’s periphery: in clothes, in scents, in the sound of a man’s voice. She made love, Graydon the banker told her, like a blind woman.

There was a death announced in the old girls’ magazine which had passed her mother by and which demanded tribute. She fell to writing a belated condolence letter while Laura cleared the breakfast things away and loaded the dishwasher.

‘Do you want a hand getting dressed later?’ she asked.

‘I’ll be fine,’ Mummy said, frowning at her writing pad.

FILTER COFFEE

Ben took another mouthful of the staffroom’s filter coffee and winced. Stewing quietly on its hotplate all morning had done nothing for its complex flavours. He moved over to the sink to pour the rest away then stepped outside onto the fire escape for a few lungfuls of relatively fresh air before guilt tugged him back inside and to his next patient.

Butterfield’s original 1863 County Hospital, a first cousin to the Natural History and Pitt Rivers museums, might have been placed high on a hill for the health benefits of uncontaminated breezes but it also lay pointedly outside the old city limits, on land once set aside for life’s undesirables: prisoners, plague pits, the dead and the infectious. In what felt like a hangover from Edwardian practice, the centre for genito-urinary medicine, known invariably as the GUM clinic, was housed in a grim redbrick house quite separate from the main hospital
campus. It lay on a stretch of the Romsey Road where the pavement was oppressively narrow, and was hemmed in by a full graveyard, heavy traffic and the jail.

As he climbed the hill to work, Ben had soon learnt to spot the freshly released prisoners on their way to the train and coach stations since they tended to be carrying their few personal possessions in tell-tale transparent plastic bags. Building plots in the city centre had grown so scarce, property prices so absurdly high, that there was talk of the prison being converted to luxury flats; the oldest part was a listed building, after all, and granted grim immortality as the spot where Hardy’s Tess was hanged for murder. Yet it was hard to imagine the citizens of such a prosperous place consenting to the erection of a new prison anywhere that wasn’t out of sight and preferably with a reassuringly remote postcode.

Like a Victorian school, the GUM clinic fell into male and female halves, each with its own waiting room and with the staffrooms as a shared territory in between. Although he had briefly visited a female clinic during his houseman years, when he was closely chaperoned, patients preferred to be seen by doctors and nurses of their own gender and the preference was echoed among the staff. Ben wasn’t sure – he was a poor judge – but he believed most of his male GUM nurses were gay and gathered, from unguarded comments in the common room and loos, that some of them assumed he was too.

Back at his desk, he glanced at the next pseudonym listed on his computer then opened his consulting room
door and looked at the group of men dotted around the waiting area.

‘Bruno?’

A thin, dark-haired man stood up and made a faint, waist-height gesture with his hand. He was dressed as if for a job interview.

‘Hello,’ Ben told him. ‘This way.’ He shut the door behind them. ‘Take a seat,’ he said and sat himself, as trained, beside his desk not behind it. ‘It’s your first time here, I think.’

‘Yes.’ He was about Bobby’s age, possibly younger.

‘Well, as the receptionist will have explained, your being here and whatever we do for you remains entirely confidential. So don’t worry that anything you tell me will get back to your employer or doctor or anyone else. What can I do for you?’

‘I’ve developed a…a discharge.’

‘Yes?’ Ben hoped he was looking encouraging.

‘In front.’

‘Right. And discomfort with it?’

‘It hurts when I piss.’

‘And when did this start?’

‘Two, no, three days ago.’

‘And when did you last have sex?’

It was always
have sex
not
make love
because the less emotive phrase encouraged candour. He had colleagues who preferred
fuck,
but when he said it it felt artificially coarse.

‘At the weekend,’ the man told him. ‘At a conference.’

‘Was this a regular partner?’

‘No. A girl, another delegate.’ Ben met the man’s eye encouragingly then cast a practised glance down at his wedding ring. ‘My partner doesn’t know.’

Ben paused in his note-taking. ‘And have you not had sex with her since the weekend – with your regular partner?’

‘It’s a he. Er, no. I mean, we’ve shared a bed obviously, because we live together, and hugged a bit but we haven’t…’

‘Made love,’ Ben supplied, because these small touches of mischief made the work bearable.

‘No,’ the man said and flushed.

‘Right. Well, good. That’s one less problem you have to deal with! And when you do have sex with him, do you wear condoms?’

‘No.’

‘Why not?’

The man reddened even more. ‘We’re faithful. As a rule.’

‘Of course you are. And when you have sex, or make love, do you have anal intercourse?’

‘Usually.’

‘Do you penetrate him?’

‘No. No. He fucks me usually.’

‘I see. Right then, Bruno, we’d better give you a thorough checking-over. If you’d like to step in here.’

There were tiny treatment rooms to either side, to which the nurses had independent access. Ben showed
Bruno into one then asked him to remove his suit and to lower his pants. He donned a pair of latex gloves and examined his penis and scrotum, gently pulling back the foreskin to check for paraphimosis and looking into the meatus to note the discharge, which was still fairly watery. He also checked for lice or scabies, or any lumps or warts. Luckily Bruno was not one of the patients – straight or gay – who became uncontrollably excited at the touch of latex or by the mere act of being examined. Ben had never quite decided how to deal with these. Obviously a polite show of indifference was called for, since anything else might prove disastrous, yet a complete lack of acknowledgement always seemed a little discourteous. Once one prodigiously well endowed patient divined his dilemma and had overcome his own embarrassment sufficiently to say,

‘You could always applaud.’

As was usually the case among GUM patients, Bruno smelled strongly of soap. The countless dinner-table grillings Ben had faced about his work over the years tended to involve an assumption that his patients were unclean, and he always felt honour bound to explain that shame or a compensatory sense of decorum meant that most of them arrived for their appointments scrupulously, and recently, washed, often sporting slightly inflamed patches from where they had just been rubbing and scrubbing.

Men at dinner parties and, less often, women wanted to know if the penises he encountered were ever spectacu
larly large or grotesquely small and he could honestly reassure them that most, funnily enough, were average, neither pitiful nor frightening. But occasionally he liked to shame the prurient by pointing out that men with extremely small endowments were far less likely to show up in a clinic for sexually transmitted disease since people were far less likely to sleep with them and a horror of ridicule was, in any case, quite likely to have put them off sex.

Ben then had Bruno lie on his side on the couch and draw up his knees so that he could check internally for any abnormalities. On withdrawing his finger he glanced down to check for blood traces before discarding the gloves.

‘Right, Bruno. Don’t worry. Nothing sinister. Stay as you are and a nurse will come in next to take a quick swab front and back and in your mouth and to take some blood. He’ll knock first so as not to startle you. He’ll also want you to give a urine sample – you’ll be left on your own to do that, don’t worry. We’ll be checking for your urinary PCR – looking for traces of viral or bacterial activity. And the smears will let us do a pus cell count under a microscope. We’ll check you for hepatitis A and B as a matter of routine but would you like an HIV test while we’re at it? I need your legal permission for that.’

Bruno had sat up on the edge of the couch and preserved his modesty with his shirt tails. ‘You mean like for AIDS?’

Ben nodded. ‘Uh-huh.’

‘No thanks.’

‘Certain?’

‘Definitely.’

‘Right you are. And finally if, as seems likely, you have picked up an infection we’ll obviously be able to treat you but we need to do all we can to stop the infection spreading. Is there any way you could contact or enable us to contact the girl at the conference? We could do it anonymously.’

‘No,’ Bruno said, worried. ‘No way. Sorry but, well, I don’t even know her name or who she works for.’

‘Shame. Maybe she’ll come in on the other floor under her own steam. So. When the nurse is through with you you’ll need to wait back in the waiting area until your results are ready. Or make an appointment to come back but it’s best we treat you today, obviously.’

‘Will it be long?’

‘Half an hour, if you’re lucky. See you later, then.’

An earlier patient’s test results had come through while he was with Bruno. He returned to the waiting area and called for Tim. Two men stood.

‘Sorry,’ Ben added. ‘Tim 1972.’

From nine-thirty until shortly before he broke for lunch, Ben examined thirty penises and eight back passages. Six of the back passages were gay, one was ‘bi-curious’ and the last was straight but so convinced
something had happened
on a camping trip, despite medical appearances to the contrary, that Ben referred its owner for counselling.

All the men who consulted him were carrying one of the usual venereal infections, apart from one of the two who had been sent in for an all-clear before their new girlfriends would sleep with them. And these, depressingly, were the only ones all morning to request tests for HIV.

People attending the GUM clinics presented a human Venn diagram that varied little from day to day except in its occasional startling particulars. One of that morning’s patients had gone down on a woman with such zeal he had managed to pick up a pubic lice infection in his eyebrows. Another had neglected his gonorrhoea for so long that the pus he was producing actually was the green of everyone’s worst imaginings rather than the usual mundane off-white.

Genito-urinary medicine was probably the medical field with the least variety in the presenting cases and the most patients convinced that their case was especially shameful or revolting. It was the dullest, medically, but one of the richest in psychological interest. This was not his specialism of choice – his favoured area was the treatment of patients with HIV, but clinics for the two still tended to be administratively, if not physically, linked, both to save money and because, in terms of preventative medicine, they had ground in common.

As a medical student it was virology that captivated him and he nursed dreams of devoting a career to research in the field, finding a cure to something elusive or at least the genetic key that would pave the way to
such a breakthrough. His houseman year was spent at what was then St Stephen’s Hospital in Chelsea and he found himself assigned to the Thomas Macaulay Ward just as the first wave of London’s AIDS cases was being admitted. The shock of patients having to be treated for a syndrome for which there were then few hard and fast treatments on a ward which had to be kept locked yet even so was plagued by journalists trying to bluff their way in and photographers aiming telephoto lenses from fire escapes in search of a ghoulish scoop woke him from the long sleep of medical study and he was startled by a clinical vocation. Not even HIV research – however well paid and glamorous by comparison – could beat the fulfilment he found in battling to prolong and then to save lives in medical territory that was still drawing up its own maps.

Chloë’s father was a heart specialist. Brutally uninquisitive, dismissive of the world beyond his operating theatres, he had never recovered from his disappointment that not one of his three children, all daughters, had proved studious enough or sufficiently scientific to follow him into medicine. Chloë was the hardest-working and had at least made it to Oxford, but he’d discounted French as
a girl’s subject
, at which she’d merely exclaimed, ‘Dad!’ and laughed. She won some favour with him, however, by delivering him a medical son-in-law. Though common decency prevented him saying so in public, he was disgusted at Ben’s wilfully steering his career into what he saw as a professional
dead end and at first his dismay was dutifully echoed by Chloë.

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