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They wheel him into the operating room at a quarter past one. He is pushing fifty - grey streaks in his hair turn white every day.

"Relax", he hears her say, as if from a great distance. "This is a routine procedure."

Her voice is clinical - bored and apathetic. He wonders if she cares whether he lives or dies.

He wants very badly for someone to care, as she steps towards him, needle in hand. He would give them everything he has.

But all he has is a broken pacemaker, and his toolbox is all the way at home.

"Myocardial infarction set in quickly thereafter. There was nothing we could do."

She has to fight from breaking into tears as she delivers the message, the same message she is delivering every other week now. The bereaved only look on, wide-eyed and disbelieving - it hurts worst when she feels their numbness serrate her, like a knife with so many edges cutting deep.

She tries so hard to walk away unaffected every time. She tells herself to grow detached, to not ask questions, to dissuade any affection towards her patients - to be gruff and aloof, a pillar of the community doing a needful and important task, nothing more. And no two ways about it, her father used to say.

But the two-year-old whose heart was weak and ill-suited to pumping still haunts her in that second of darkness when she blinks. She has not slept in three days.

The other doctors tell her she'll be fine, she'll get used to it, that this is the price of doing the occasional good. But, in her heart of hearts, she has long since shut them out.

The patient was male, in his fifties, in with a pacemaker that had been misbehaving. It had not been a routine operation.

In a small corner of his chart, she jots down - impersonally, formally - time of death ten fifty one pm, and goes home to throw up.

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