They had never truly lived, yet they watched the children play. The sky was iron grey and stretched forever. It had been a day of ceaseless rain, and smeared dust blurred the view framed by the cracked glass. Behind the grimy windows, the clocks had stopped long ago. None that passed by looked up. Had they chanced to do so, they may have seen a brief glint in the glass and thought it a reflection, if they thought of it at all. The children were singing. A simple song. A happy song. A song to be sung by happy children in warm and comfortable places. Places where love is taken for granted, the birthright of the fortunate.

‘The wheels on the bus go round and round
Round and round, round and round,
The wheels on the bus go round and round,
All day long!’

The song ended in a ripple of cheers and handclaps, and the laughter echoed briefly. The reflection flickered and faded. Empty windows gazed down at the lights of the kindergarten. As the toddlers played, they were silhouettes, glimpsed and changing. They were happy as only children can be before fears and sadness darken their world. The kindergarten was full of their shouts, and some still sang remembered lines of other songs. These rang across a drab, paved courtyard where weeds pushed through the spaces between the slabs. Directly opposite the kindergarten there stood a building, locked and neglected. Some of the windows were broken and faded curtains still hung on the ground floor. The doors had closed on a day when evening fell early, and no one had ever bothered to return. There were flower beds outside, long untended and now overgrown with a scattering of broken bricks. A drifting mound of litter, plastic cups and leaves, wrappers and broken glass, piled against the doors. The padlocks were rusted and the keys had long since been lost. Institutional green paint flaked from the walls, and signs pointed to paths long closed. It was a place that seemed to breathe neglect, but it was not deserted. At the edge of nightfall it was a darkened shipwreck, recognizable but serving no purpose. An enamelled metal sign still clung to the crumbling brickwork by what was once the main entrance. It was corroded by the years but still legible. It read:

THRESHER HOUSE

Both buildings had once been part of St Nicholas Hospital. The kindergarten was a splash of watercolour while Thresher House stood, slowly crumbling, seemingly brooding and long disused. It had not always been so. In the distant past, St Nicholas had been a cottage hospital, attending to the needs of the largely rural community that fringed the small town. It had been a collection of bleak and cheerless structures, the wards named after wild flowers. Perennial rain battered the windows, and the sad elderly coughed their lives away. Over the years, the town had grown and spread, seemingly haphazardly and in all directions. So it was with the hospital. It was named St Nicholas Hospital, and known to all as St Nicks. St Nicholas was the patron saint of children. The hospital had served the local people well for many decades. There were rambling corridors and long Nightingale wards. The populace gave birth, grew ill, recovered, sometimes died, and often their visitors sat anxiously in the League of Friends Canteen. Life, death and most places in between are found in hospitals, and records must be kept. What was now the East Side Kidz Kindergarten had once been a storehouse for some of these musty documents that chronicled illness and decline. Many were stamped DECEASED in fading maroon capitals, histories retained but rarely if ever required. Rows of pale folders, tattered labels and pathology results. The building was only known as Records. The bulk of the growing population’s records were kept in another anonymous section of Nick’s at the bottom of an echoing staircase, but Records continued for many years. It was presided over by a dwindling number of pale staff who rarely ventured into the main body of the hospital. They filed the notes of pain and death, the bowel chart and the cancer diagnoses, and occasionally a taciturn porter would arrive to take a poor soul’s notes to a ward or department, of which there was an increasing number as the population continued to grow. The clerical staff there were largely anonymous and easing toward retirement via this dreary medical backwater. Deep within the burgeoning levels of hospital bureaucracy, a decision had been taken that would end this sleepy and somewhat cheerless routine. After months of rumour and lethargic deliberation, all medical records were to be centralized, as the staff newsletter phrased it, ‘for increased accessibility.’ This would entail the closure of the Records building and the removal of those chronicles of despair that resided there. The folders were removed and boxed, and wheeled on creaking trolleys to the main records section. The spaces on the metal shelves continued to grow, spiders spun their webs, and the staff grew more apathetic. They lingered for several months and left with little regret. Records fell silent, save for the rain that drummed on the few windows like a child’s tantrum. The shelves stayed empty and gathered further dust. The calendars from local stationery companies hung at slight angles. Leave that would never be taken was noted in red marker. The coffee mugs remained, the staff not being sufficiently concerned to take them. The phones were disconnected. The institutional green paint, of which Nick’s seemed to have a bottomless supply, began to flake on the walls. There was very occasional maintenance. Records was still part of the hospital, but there were many other demands. There seemed to be no further use for it. Records lingered, and the years passed.

The area where Nick’s stood had become increasingly affluent and the suburbs had spread like spilled wine. Property values had grown to levels that would have seemed scarcely credible in the past, and with the increasing prosperity came couples and employment. Mortgages were negotiated, houses bought, and as time went by the children came. In one of the many administrative levels in the hospital, it occurred to an assets manager that Records, unused for years, could perhaps be leased for some unspecified purpose. There was no clinical use for it. Remarkably, it was still structurally intact and could be functional. It was advertised and for a few months there were occasional vague enquiries. Nothing tangible came of them. However, a local entrepreneur had seen what he referred to as ‘a gap in the market.’ It was a simple equation. To maintain the level of affluence most aspired to, both parents had to work. Mindful of that, the children had to be cared for. It was proposed that Records become a kindergarten. There followed a languid process of approval, but it was finally confirmed. Records was to become East Side Kidz Kindergarten, ‘where play is learning and learning is play.’ Given the passing years and neglect, a great deal of work had to be done to render Records fit for its new purpose. A large and smiling stick figure had been erected by the entrance. The eyes were black dots, the smile fixed. In Thresher House, on the opposite side of the courtyard, weeds continued to grow in the flowerbeds, and sometimes there were reflections on sunless days.

On a day in decades past, Thresher House had had another name. It had been Rowan House, continuing the practice of naming the wards and other treatment areas after trees – in the case of the surgical block – and the medical wards after flowers. Visitors were directed to Hawthorne, Alder, Chestnut and Alder, Bluebell, Primrose and Clover wards. Rowan House stood separate from the scattered buildings of St Nicholas Hospital. Five steps led into an entrance area of burnished floor and hard wooden chairs. A corridor led away from Reception and there were rooms to either side. A glass topped table bore copies of old magazines, and occasionally a telephone rang in the distance. It was late afternoon. The gardens seemed washed in pale watercolour. A young woman walked along the path that led to Rowan House, her steps growing slower as she approached. She pressed down a shining brass handle, and stepped into Reception. The only other person present was an older lady who smelled of lavender. She mentioned an appointment, and pointed to the chairs. The younger woman sat down. Ten minutes went by. A telephone rang. The secretary answered. The doctor was ready. They passed several doors. They paused. A polished brass sign on the door read CONSULTANT. The secretary tapped gently on the door, and permission to enter boomed from within. The younger of the women stepped inside and closed the heavy door behind her.

The floor was carpeted, and her steps made little sound as she approached a heavy wooden desk of polished ebony. Dust swirled in the sunlight that slanted into the office. In the distance, she thought she could hear a lift descending. There was a silence. Behind the desk was a man. He was staring intently at some notes in a manila folder. He closed it, and raised his head to look at the woman. The sunlight glinted off steel framed spectacles. His face was shadowed. She was still standing. He gestured to a chair in front of the desk, impatience in the gesture, a man who had many demands on his time.

He introduced himself, curt and to the point – that is how he would have described himself, had any ever troubled to ask. He was Dominic Thresher, Consultant in Obstetrics. A lavishly embossed and framed certificate, prominently displayed, confirmed this to the casual onlooker and the troubled patient. Behind him stood a bookcase of varnished oak. It contained rows of medical textbooks, the sheer volume adding testimony to his stature. He spoke for the first time.

‘I think you know who I am. Why did you want to see me?’

The woman felt embarrassed, hesitant and, absurdly, ashamed. Her face reddened. She explained. Unmarried, she had become pregnant. She had heard very bad rumour, often whispered, of the ways of the people who carried out abortions for the desperate. Stories of injecting air, of toxic preparations to induce labour, of scraping, alcohol, of infection and death. She had been terrified and could not bring herself to seek their services. It was said that there were doctors who could help, though it would be very expensive and on grounds of the strictest confidentiality. A name had been mentioned. With considerable discretion, an appointment was arranged. To keep it, she had made her way to Rowan House on this autumn afternoon. It was a story Thresher had heard many times before, and he listened as the woman drew to a close. Among the junior medical staff, Thresher was known for his significant pauses, especially on the rounds when his patients were reviewed. He waited. She told him she was twenty-one or twenty-two weeks into her pregnancy. She could not be sure.

‘Young women in your position rarely are,’ he commented. Another long pause. Again, the sound of a distant lift coming to a halt. The silence became oppressive. The ruminations of a great mind that was not to be interrupted by the mundane. He reached across the desk and took a gold fountain pen from a holder. Slowly and deliberately, he unscrewed the cap. Thresher drew a vellum notepad, and began to ask questions. The replies were wavering. He made brief notes, rarely interrupting and occasionally raising his head. The sunlight glinted off his spectacles. Finally, he replaced the cap. Long practiced, the interval before he spoke was designed to introduce an air of tension. He would dispense his knowledge in measured doses and these would establish her dependence. No one else could help – she had suggested as much – and he began to hold forth his views and his guidance. She nodded, anxious to convey agreement and gratitude for his time. Thresher completed a brief anecdote about a former professor who conducted rounds in a tartan dressing gown. He smiled. A fond memory. The woman, head slightly bowed, said nothing. Her hands were clammy, and they were clasped against her lap, not visible to Thresher. She felt movement. Kicking. Thresher had always prided himself on his no nonsense approach, at least that was how he would have described it to attentive medical students or to colleagues who, in his view, were of a similar eminence. This approach, he said, was infinitely preferable to the use of euphemism and half-truth employed by so many in the profession. He looked directly at the woman, and began to speak. He did not use her name. He fully understood the problem, and it was as well she had consulted him now. It was clear what was required, and time was of the essence. Yes, twenty weeks was rather late but not especially daunting to those of, in all modesty, a certain degree of experience in such matters. A certain proficiency would be required. She understood.

The woman listened, nodding agreement. Thresher opened a diary. The next day would be convenient, and he gave a time for her attendance at Rowan House. The secretary would give her the details, including the charges. The woman thanked him. There was a lull in their conversation, such as it was. She stood. He was making a note. The fountain pen scratched across the diary page. He waved towards the door. A dismissal. She pulled down the heavy brass handle and stepped into the corridor. She saw faded photographs of past Medical Superintendents on the walls. They were unsmiling. Inscribed plates described the dates of their tenure. In the distance, beyond the signs marked CLINICAL AREA – NO UNAUTHORIZED ENTRY – she again heard the lift, and the faint anaesthetic smell hung faintly in the air. Thresher had briefly referred to what he termed ‘the administrative formalities.’ These were completed with the secretary, who handed the woman an envelope and a reminder of the expected time for attendance.

‘Eight o’clock sharp and nil by mouth from midnight. Mr Thresher expects his patients to be punctual.’ Hearing this, the woman murmured polite understanding and due deference. Outside Rowan House, a growing breeze ruffled the branches as evening grew closer. The woman went home. It was a night of sombre dreams. Sometimes she felt movement. Summer had drifted into autumn. She could see the glimmer of the full moon through the thin curtains. As if in a tantrum, a spiteful wind seemed to be inflicting anger on anything that stood in its path. She rose from the bed and looked out at the deserted street. Moonlight seemed to dance and shift in the windows. The edges of the shadows blurred. The movement she felt seemed to increase as she watched. She returned to her fitful sleep. The slow night passed, and the wind was unrelenting. Morning crept sluggishly over the town, the light pale and reluctant. The woman had made her way to Rowan House. Damp leaves piled in the gutters. She stepped through an archway. It was surmounted by a crenelated row of reddened brickwork. She thought it looked like a castle from a mournful fairy tale, a princess imprisoned gazing wistfully into the distance. She went up the steps and entered the reception area. There was a smell of coffee and polish. The secretary looked up. Without greeting, she spoke the woman’s name and checked the time. She mentioned in passing that the woman was lucky Mr Thresher could make the time to see her. He saw all his private patients in Rowan House. It was much quieter than the main hospital. More private for his private patients, if you follow. The woman sat as instructed while the secretary lifted the telephone and made a brief call. The woman felt movement, and sounds seemed amplified in that room. She was staring at an oil painting. A beach swept by storms. Rain spattered the windows. Again, the sound of the distant lift, and footsteps from the polished corridor nearby. A nurse in pale blue theatre clothing entered Reception. She carried a clipboard, her manner brisk and formal. She called the woman’s name. There were no other patients in the room. The nurse turned. The woman followed. They went past the offices and the burnished signs on the doors, the photographs and the radiators. There was a lift at the end of the corridor. Next to it, a staircase which wound to the upper floors. The lift doors slid open, the nurse entered and gestured, a hint of impatience, for the woman to follow. The doors hissed shut. They emerged on the third floor. A narrow passageway opened into an area marked CLINICAL PERSONNEL ONLY. Her first impression was of brightness. The morning had been dull and overcast, and there had been a pale quality to the lamps in Reception and the corridors. There were large ceiling lights and gleaming trolleys. There were windows opposite. Blinds of the same institutional green were pulled down and secured. There were two beds. She heard sounds of running water, distant voices and a clattering of steel on steel. She felt a kick, or so she thought. The nurse pulled a latticed wooden screen around the bed and indicated a linen gown, neatly folded, on the bed. She would be back shortly, and tapped the clipboard to indicate why. As she changed, the woman did feel kicking. There was no question. Perhaps it was the light. Perhaps eyes that had never opened sensed the light. Nobody knew, not even Mr Thresher. Their conversation had been brief and intimidating. She did remember one phrase he had used, pausing in his note taking. In his conversations with his general surgical colleagues, many of whom were not noted for their modesty, the subject of surgical abortions sometimes arose. He likened the removal of an unwanted foetus to the excision of a malignant tumour, ‘initially unnoticed, but inevitably progressing to a point where the consequences of non-intervention are likely to verge on the catastrophic…’ He had ended this comment with a Latin quotation, smiling ruefully at her lack of comprehension. Thresher, she realised, had looked up. ‘Ablata causa, tollitur effectus…’

‘Shall I translate?’ It had not been a question. More an order, briskly placed. She had barely nodded, feeling increasingly overwhelmed.

Again, the celebrated pause. He translated. ‘It means “remove the cause and you remove the effect”. The surgeons, I find, do not have grounds to disagree with this conclusion,’ he had continued, a point proven.

‘And neither do you, or – may I assume – you would not be in the position you find yourself in.’ She had not been able to summon an answer. The recollection faded as the nurse entered. A checklist was completed. A sullen orderly arrived with a trolley. He moved the screens to one side. He smelled of cigarette smoke and had not shaved. He gestured that she should get on the trolley, which he lowered to the level of the bed. The trolley plastic felt cold under the sheet that covered it, and the nurse placed a thin blanket over the woman.

‘Got the notes?’ The nurse handed over a clipboard and envelope. They went down the corridor. Brief glimpses of oil paintings, somehow out of place. She felt a jolt as they entered the lift. The nurse and the orderly had done this many times before. There were fragments of their conversation she overheard. She did not speak and was conscious of a growing apprehension. The lift went up one floor, and the orderly pulled back the lift doors with a crash that seemed to echo. In a small room that smelled of anaesthetic, the woman was handed over to the theatre staff. A masked nurse looked at the checklist and noted the signed consent form. An intravenous line was placed, and she felt a stinging in her arm. A tall man in faded hospital scrubs came in. He introduced himself as the anaesthetist. Questions were asked and answered. She saw him hook saline to the line and watched the drops. She would soon feel sleepy, he said, and he injected medication into the line. The lights had been bright but seemed to wane. As she drifted into unconsciousness, she heard – or thought she heard – Thresher’s voice. There was movement. As the overhead lamps seemed to dim, his voice seemed loud, amplified by the tiled walls and sterility of the operating theatre. Still she felt movement. There is a school of thought that proposes a foetus – at varying points in gestation – is aware of voice and tone. Again the kicking, felt at the edges of consciousness and the sound of metal. Thresher was addressing the technician and anaesthetist, an audience of two, as if they were eager students in the auditorium at St Nicholas. As with most of his conversation, the subject reflected his own expertise. He was returning to one of his favourite themes, the comparison of an unwanted foetus to a spiteful growing tumour. The theatre lights glowed, and there were reflections in the steel instruments, laid with precision on green cloth. Hearing is the final sense to disappear when anaesthesia is induced. She could hear various sounds in the background. She could also hear Thresher. His brusque manner generally was reflected in his speech, and he saw no reason to lower his voice. He was delivering a brief monologue on the virtues -indeed, necessity, of speed, experience and the use of both in conducting operations such as this. He used the phrase ‘induced foetal demise’ as if it hovered, in quotation marks, in the chill air of the theatre.

‘You have probably heard of this, he went on, ‘I, however, am not a believer.’ Again, the celebrated pause. The anaesthetist and the technician, both being familiar with Thresher’s oratory, knew it was better not to interrupt.

‘Why should we introduce potassium chloride, or – what is the other one? – digoxin? – to stop the foetal heart? We are introducing unnecessary components and complicating a relatively simple process. We have a problem to address, and I will address it. Simple. The unwanted foetus is comparable to a tumour – in some ways even worse – and there is no moral requirement to stop the foetal heart before I complete the surgery. I can assure you it will stop soon enough.’ His voice had grown louder, as if anticipating debate. None was forthcoming. Thresher’s voice was the last thing she heard. A faint kick was the last thing she felt. She could not hear as his booming voice continued. What mattered, he said, was speed and proficiency, tempered by long experience. He continued in this vein as if the others were presenting loud arguments to the contrary. Both were silent. Once again, he mentioned his surgical friends.

‘I rather doubt,’ he went on, repeating the phrase for emphasis, ‘I rather doubt any of their patients express concern over, what, transient survival of a tumour? When does a tumour become a tumour? I prefer to leave that particular debate to the philosophers, and get on with the job in hand. I have done this literally hundreds of times, and have often been begged to do so…’ Thresher checked his surgical gloves, and stepped towards the woman. Her legs were in supports. The operating theatre was brightly lit. The technician adjusted the lamps at a gesture from Thresher. His eloquence was finely honed, not least through frequent repetition and encouraged by the absence of dissenting voices. The technician and the anaesthetist murmured occasionally. Thresher took this as agreement. He resumed.

‘Our beloved hospital board recognize this, and so we can use this theatre – indeed this building – to accommodate this truth without any great ethical debates. Imagine if a general surgeon questioned the morality of, say, excision of a blockage in the small bowel. Is he asked about the ethics of removing it?

‘He is not, because he knows that if he does not use his skills, his patient will be vomiting faeces and die, sooner rather than later… and our neurosurgical friends, deep in the mysteries of the central nervous system – so they care to tell us – recognize a malignancy deep in the brain. They manage to overcome their philosophical musings and operate. Sometimes their patients are paralyzed, perhaps blind, literally speechless. “A life in endless twilight” as one of the neurosurgeons described it in something of an unguarded moment…’ Thresher smiled at the memory, a point proven. He made a comparison with his own speciality, inevitably favourable.

‘. . . We, however, are resolving a clear cut and easily identifiable problem. A woman has an unwanted pregnancy. She requests the removal. She has her reasons for this and rarely – if ever – are these our concern. We address the problem – we save her from the medieval attentions of the backstreets – and the next day she goes back to her life. We are not overwhelmed by the consequences and – I assume I speak for you both – nor are we especially troubled by any supernatural ramblings about when life begins.’ He waited. The technician brought the suction machine forward. It was of an older design, with red rubber tubing and two pressure dials. At a barely perceptible nod from Thresher, he turned it on. There was a sudden, rapid drumbeat that seemed to fill the room. It was a common sound in operating theatres. Somewhere, at an unmapped border, it was heard, muffled and strange, beyond interpretation. There was movement, slight and unseen. Thresher raised his voice, variations on the speed, skill and expertise parable he so often visited. He reached for a gleaming curette. He guided it forward. A steady hand was required. Blood spattered the glass jar and the note of the suction changed as flecks of tissue passed through the tubing. The theatre lighting was harsh. Again, the technician moved the lamp closer and increased the brightness. Through closed eyes, there was an awareness. Thresher put down the curette. He placed several gauze swabs, now bloodstained, in a steel container labelled CLINICAL WASTE. He picked up forceps. The intravenous fluid dripped slowly in the chamber. Thresher moved closer and applied pressure to the forceps, which were rubber tipped. He increased his grip and began to pull, describing this to the other occupants in the operating theatre. It was, as he had said earlier, relatively simple for those with a certain proficiency. There was a scream. It resounded in the theatre. Thresher did not hear it as he relaxed the pressure on the forceps. It was a shriek borne of pain and fear and a brief, dazzling light. The men could not hear it. Others did. The echoes of past agonies echoed around the sterile rooms and polished offices of Rowan House. Unheard, they would remain. There was a terrible loneliness in that place. It would not fade. Rather it would grow, as the years passed, into a bleak grief, a grief that knew no end, nor ever would.

The technician cleaned the equipment. He threw bloodied swabs in the clinical waste, next to Thresher’s discarded gloves and mask. The foetus, with its crushed skull, he placed in a separate container. As was the practice at that time, it would be cremated, without fuss or ceremony, in the hospital incinerator. The theatre was cleaned, the doors closed and locked, and the lights dimmed and then turned off. Until the next time. It was autumn. Evening fell early. In the upper windows of Rowan House, fleeting reflections seemed to dance. There was no moonlight, and years seemed to pass before dawn came. Next morning the woman left. She carried an envelope that contained an invoice. Many had come to Rowan House before her. More would follow. Thresher was known for his discretion in the circumstances in which so many women found themselves. It was costly, but infinitely preferable to the horrors that would come in the front parlours of the parasites that preyed on such women. There was no morality involved. Rowan House was his personal fiefdom. His personality had ensured that it was supplied and staffed as and when he required it for his private practice. Clinics were held at regular intervals. His rounds in the obstetric wards of the main hospital were notoriously lengthy and prone to anecdote. This was to allow demonstration of his knowledge. In so doing, he implied the lack of it in the junior doctors and students that accompanied him. He would coldly berate the ignorance of the unfortunate junior who was unable to answer his question. They would have no option but to accept this since references from Thresher would often dictate their future career. He sometimes returned to his habit of quoting Latin to the luckless, knowing well that they would not be able to understand. His trademark pauses would have full effect as they waited for his translation. A pathology test had not arrived from the laboratory. Thresher admonished the younger doctors with a tirade that advised them that they were unlikely to become anything of significance with such blinding inattention to detail. He concluded with one of his favourite phrases:

‘Perfer et obdura, dolor hic tibi prodent olim.’ He hoped they were paying more attention now than they did when they were obtaining clinically vital information for their superiors. He continued. ‘It means – and it is to be hoped you understand – it means “remember this pain, one day it will be useful to you…” though personally, I rather doubt it.’ Thresher was not a popular figure. His duties grew less onerous as the years passed. He devoted most of his time to private practice and retained Rowan House as his kingdom with the tolerant approval of the hospital board. More often now, there were lights at the windows, sparks that moved at random patterns. Within the closed theatres, there was a whispering, faintly audible, and points of light hovered and moved. They swirled in patterns and lingered by the windows. There was unmeasured sadness there. As dawn broke the lights faded, but they did not leave, and they grew slowly in number. Many dawns followed, and Thresher grew older. His role now was largely administrative, though he took care to ensure he was retained to advise on clinical matters as and when his expertise would be of some value. In recognition of his long service, his photograph had been framed and added to the row of portraits of his predecessors. The photograph was black and white. Thresher stared outward, his expression familiar to many humiliated subordinates. On an engraved plate below that bore his name, he had requested a Latin quotation be inscribed.

Finis coronat opus

An English translation was added:

The end crowns the work

There was no inscription to note the dates of his tenure. That would soon follow. Blustery wind had battered the windows of Rowan House. Thresher was at his desk. It was lunchtime, and the other staff had gone over to the main hospital. He still conducted the occasional clinic, but no longer performed any surgeries. No anxious young women sought him out, desperate for help and willing to pay for his vaunted skill and speed. The years had seen his decline from clinical eminence and he did not like it. He rose from his desk and walked down the corridor to the lifts. Thresher wanted to look at the operating theatre again. The equipment and fittings were to be moved to the main hospital. He saw this as a subtle erosion of his standing. The lift, now rarely used, creaked and wheezed upward. He picked his way through the ward area. Once, it had been an island of order and precision. Now in decline, it was a clutter of dust, damaged hospital beds and old filing cabinets. He pushed open the doors to the theatre. The anaesthetic smell still lingered. He fancied himself an old unappreciated warrior, returning to a neglected battlefield where weeds grew and achievements were forgotten. He looked around the operating theatre. There was a film of dust on the overhead lamps. The suction machine, long unused, had been pushed into a corner of the room. The CLINICAL WASTE container was empty. His footsteps seemed to echo as he paced the room, and he looked up at the windows. There were glimpses of the grey sky. Thresher was aware of a faint dizziness and a slight blurring of his vision. Some months ago he had been examined by a medical colleague, a physician, who had prescribed medication for Thresher’s blood pressure. The latter had been – to quote the physician – ‘moderately elevated.’ Thresher had been reluctant to comply, believing in his own immortality. For the most part he felt well, an occasional headache, a little dizziness on standing. Today, however, in this theatre, far more threatened. He could not ignore it. Outside, the wind seemed to rise and fall. the room began to swirl around Thresher. He reached for a trolley to steady himself. It tipped and crashed to the floor. Thresher slumped against the wall, a numbness in his limbs. One lens of his spectacles cracked. He could see lights. There seemed to a pattern to their movement, and they grew closer. Thresher tried to call out. The words would not come, and there was no-one to hear them. There would be no more words, though understanding was to linger. Blurred, the dancing lights grew closer. There were colours now, a shifting blend of crimson and purple. Thresher tried to stand but could not, his limbs no longer his own. He turned his head. the lights were becoming shapes. Dominic Thresher, Consultant in Obstetrics, was able to recognize those shapes. There were eyes, though they did not open. The skulls were smooth, and colours whirled and blended behind them. Thresher had rarely known fear. He now felt a sense of dread that seemed to crawl and settle like a blanket. It was beyond his comprehension. It could not be. The shapes seemed to pirouette, behind them a shimmering. They moved more quickly now, movements no longer random but patterned, a darkened and nameless choreography. Their dance became circular, and they moved nearer to Thresher. He could not move. He became aware of another sound. It was so familiar he did not recognize it. In the far corner of the theatre, the suction machine had turned on. The overhead lamp, so often used for his work, flickered on and off. There was another sound now, growing in intensity and above the sound of the suction. It was joined by another, and a third, and many others forming a chorus that battered at the edges of his fading consciousness. It was a choral shriek of pain that had been echoing down the years. It had resounded around Rowan House, and none had heard it. Thresher did so now, and it brought with it a terrible sense of bewilderment, a deranged familiarity bordered with fear. He tried to raise his hands to cover his ears but could not. He would live, after a fashion. Sometimes the sound faded, but it would never leave. He had been found by one of the administration staff from the main hospital. Sent over to list the equipment to be transferred, he had found Thresher semi-conscious on the floor. An ambulance had been called. As he was carried down the corridor, he could see the photographs on the wall. As the ambulance crew paused to wait for the groaning lift, Thresher saw his own face staring out from his portrait. His spectacles were cracked, but he could read the engraving.

Finis coronat opus

The end justifies the work

*

Thresher did not return, though his name was to endure. In view of his eminence and service, and perhaps in sympathy with the devastating stroke he had suffered, Rowan House was to be renamed Thresher House. However, it was no longer to be used for any clinical purposes. It became an outpost of administration, of which there seemed to be no end as the hospital grew. The theatres were emptied, and the ward area reduced to cold radiators and old wastepaper baskets. A new block was constructed at St Nicholas, specifically to house the battalions of maintenance and administrative staff. Thresher House was no longer required, and two large skips were placed outside. The theatre and ward areas were to be sealed off and the lift disabled. There was little that could be utilized by the other areas of the growing hospital, and so the skips were gradually filled. The furniture from Reception was thrown away, along with the telephones and the framed picture. It was the same one, a beach swept by storm, that many apprehensive women had seen while waiting to be shown into Thresher’s presence. Thresher’s vast desk was heaved into the skip. The weight splintered some of the wooden chairs that had stood in reception. Before the theatre area was closed off, a workman walked down the corridor, lifting the framed photographs from the wall, which was flaked and bubbled with damp. Nobody needed them, and he had merely been instructed to remove them. Another workman held a large brass padlock. The first workman went outside, the frames held awkwardly.

‘No one needs this lot,’ he said, and threw them into the skip. Some of the glass shattered. When the other man emerged, he took out another padlock and pulled the door closed. The power had already been disconnected, as had the plumbing. It was late afternoon on a bleak autumn day, and the weeds were left to grow. Thresher House, neglected, had become an unkempt shell. A few years later, its namesake died. Thresher passed on to claim his own small share of a darkened eternity. Shapes remained behind the locked doors of the rotting building. They moved at the windows. Sometimes there was a pattern, and sometimes they became reflections. They looked out at the brightness and singing of the kindergarten opposite. If it were possible, their sadness deepened further, though they could not know why. Through closed eyes, they could sense the children at play. In the kindergarten, a child would look up, and perhaps see some fading lights in the dusty windows opposite. There are those that are lost and have never been loved. Their loneliness brings a sadness beyond imagining, deep and unending. The sound of little children singing, it is to be hoped, brings a brief dawn into the dereliction that lingers on, in dust and shadow, that forever shapes their days. The lights still glimmer in Thresher House. Perhaps they may fade, but they will never leave. Nobody now can hear their screams, and there is no peace in their silence.