‘Thank you,’ the mother said.

  I high-fived Zac one more time.

  ‘You’ve made a new friend,’ his mother added, turning to me.

  I waved at the boy as they left Doctor Pender’s consulting room.

  ‘So, what do you think, Doctor Pound?’ Doctor Pender asked, once Zac and his mother had left.

  I blew out my cheeks and bit on my bottom lip. ‘Cerebral palsy?’ I offered. ‘Spastic diplegia, at a guess. To judge by the contractures of ankles and feet, scissoring, late motor milestones – his mum said he only started to walk a few months ago.’

  Doctor Pender nodded in agreement. ‘Sadly, I think you’re right. Be careful not to overdo the high fives – you’re their doctor, not their daddy.’

  I turned away to the window, looked out across Truro’s rooftops. I did try to shut myself away in my old attic bedroom in Newlyn to read my medical textbooks and lecture notes, but it only lasted a day. It’s been unbearable to see Mum so sad at my being at home with her when I should be up at Cambridge. So yesterday evening I decided to phone Doctor Pender at the Treliske Hospital in Truro. I didn’t go into details, just said I was down in Newlyn for a few days and could do with coming in for a chat. He’s been something of a mentor to me ever since I first contacted him about gaining medical work experience at the Treliske. A first-gen medic like me, he was also state educated and is now a consultant paediatrician. His brusque manner belies a huge heart and he’s one of the main reasons I want to specialise in paediatrics, proof that men can make good paediatricians too. He’s always prepared to go the extra mile, to wage war on NHS bureaucracy on behalf of his patients.

  ‘So, how’s it going?’ he asked as he typed up his notes on Zac. ‘I don’t remember having the time to come home for a few days during my first year at medical school, let alone hang around our local hospital.’

  I told him what I told Mum, that I’d been present at a party where a student had died. I was the last person to see him alive and had tried to save him, but there was now an ongoing police investigation and my college had sent me home to sit it out until the media storm settled.

  This time it was his turn to blow out his cheeks.

  ‘You really don’t want to screw this up, you know,’ he said, sitting back, arms behind his head as he swivelled in his chair.

  ‘I’m trying not to.’

  ‘Good. You’ve got a great career ahead of you if you want it. Paediatrics, whatever. Personally, I think you’re trying to specialise way too early. But do you really want it? That’s what you’ve got to ask yourself. Do you really want to be a doctor? Is this the life for you?’ He swivelled back and forth in his chair, gesturing at his office. ‘Because if it isn’t, I’d suggest you don’t go back to Cambridge. Don’t piss away taxpayers’ time and money. It costs a lot to train a doctor.’

  ‘It is what I want to do,’ I said, looking him in the eye.

  Doctor Pender’s in his forties, happily married with a young family. Lives on the north coast at St Agnes, cycles to work, saves lives, surfs at weekends. What’s not to like? His is a life worth living. And I want to be sitting where he is one day.

  ‘Then why the fuck are you going to parties where people are jumping out of windows and killing themselves?’ he said, standing up. ‘Did no one tell you about fitness to practise? The need for medical students to be whiter than white, cleaner than clean? We partied in my day, of course we bloody did, harder than other students – we were medics, that’s what you did – but no one touched drugs, and no one ever died. Not as far as I remember.’

  I was warned about all that. We all were. Professor Beale couldn’t have been clearer about the need to behave, but did any of us actually read the GMC’s fitness-to-practise guidelines for students that he handed out in freshers’ week?

  ‘Patients trust us with their lives,’ Doctor Pender continued. ‘We have to justify their confidence in us – in everything that we do.’

  ‘I get it,’ I said. ‘I was just in the wrong place at the wrong time. If things had worked out differently, I could have been the hero, saved a man’s life, but he was dead by the time I reached him.’

  ‘So what do you want from me?’ he asked, sitting back down again. He’d said his piece. It was strange hearing him speak like that. The voice of authority, the establishment. I’d always had him down as a bit of a rebel. A street-fighter.

  ‘To be here for a while,’ I said. ‘Do whatever needs doing. Volunteer my services again, for what they’re worth. Prove to my director of studies, to myself, to you, to my mum and late dad, that I’m serious about wanting to become a doctor.’

  ‘Fair enough,’ he said, turning to the notes on his desk. He had other patients to see. ‘A & E can always do with some help. They’re understaffed right now – who isn’t? I’ll talk to them, liaise with the work-experience coordinator. Come back tonight – say 8 p.m.? Nights are currently pretty lively.’

  51

  ‘Red rooms are pretty much the darkest places on the internet,’ Ji says, without any emotion, ‘where viewers pay big money to watch live streams of people being tortured and killed. Viewers can also interact, determine the victim’s fate, by bidding with bitcoins or other crypto-currencies.’

  ‘On the dark web?’ Adam asks, glancing around Ji’s minimal, pared-down office. Adam’s got too much clutter in his life.

  ‘The dark web,’ Ji repeats. ‘Successor to sites like rotten.com.’ He pours two glasses of Talisker malt whisky into expensive, heavy-bottomed glasses and passes one to Adam. Even by Ji’s standards, it’s early for a drink, which worries Adam. ‘Some say they owe their name to the eighties horror movie Videodrome, which featured a red torture room,’ Ji continues. ‘Others believe it’s a variation of “red rum” – “murder” backwards.’

  ‘Sounds like an urban myth to me.’

  Adam has heard a bit about the dark web, that it’s not all bad: the unsearchable underbelly of the internet, a place for whistleblowers as well as paedophiles, drug dealers and gun runners. But he’s never subscribed to the more outlandish conspiracy theories.

  ‘That is the general view,’ Ji says. ‘And so far there’s no actual proof that red rooms exist. Every day, rumours pop up on 4chan and Reddit forums. But they’re just elaborate hoaxes. “Seven captured Islamic State fighters to be tortured and executed live on air – you decide how they die.” That one rears its ugly head every few months. It’s like the stories of living dolls, gladiator fights to the death, hitmen for hire. People believe that the deeper you dig on the dark web, the more depraved things get. And right at the bottom are the red rooms.’

  ‘But it’s not like that?’ Adam asks.

  ‘If you’d asked me a month ago, I would have said no, it’s not like that. These things don’t actually exist – there’s no demand for them, no public appetite.’

  ‘But now?’ Adam takes a nervous sip of his whisky.

  ‘But now… now there’s some evidence that red rooms might actually be a reality.’

  ‘What sort of evidence?’

  Ji sits back, sips on his own whisky. ‘The problem with the dark web, from a purely technical rather than moral point of view, is that Tor, the browser that most people use to access it, runs too slowly to live-stream anything. It’s the same with other dark-web browsers – they all run their traffic through multiple servers to avoid detection and conceal their IP addresses. Typically, to resolve a request of one megabyte takes between eight and ten seconds, meaning live-streaming is out of the question. Impossible. You couldn’t even watch snails having sex.’ Ji smiles at his own analogy. ‘But now there’s a new browser on the block, which can live-stream at commercially acceptable speeds.’

  ‘How do you know this?’ Adam asks, fearful of where this might be heading.

  ‘I keep my ear to the ground.’

  ‘For business or pleasure?’ Adam remembers his friend’s fondness for rotten.com, which has long since closed.

  ‘Purely professional these days.’ Ji grins. ‘While we have no formal presence on the dark web, we need to keep in touch with what’s happening, follow the latest trends. My team has been revisiting how to combine reality-TV shows with gaming elements. Exploring ways to encourage greater user engagement.’

  ‘Not really my bag,’ Adam says. He can’t think of anything worse. He dislikes reality-TV shows even more than videogames.

  ‘But it is a lot of people’s “bag” – and potentially very lucrative,’ Ji says. ‘We noticed viewers were paying serious money to influence contestants’ choices on screen. That’s when we came across a particular site on the dark web.’

  ‘What site was it?’ Adam asks, dreading the answer.

  Ji stands up and looks out of his window, across Green Park, swilling the whisky around his glass.

  ‘I don’t want to worry you, Adam. I might be wrong about this, and it might have nothing to do with what may be happening to you.’

  Adam swallows. ‘You’re worrying me more by not telling me.’

  ‘We only had access for a few minutes until we were thrown off the site. It was a red room of sorts, I suppose. Call it a “red life”. From what we could tell, someone’s everyday existence was being covertly filmed. An office worker in Warsaw. Married with one child. Warsaw has a lot of CCTV cameras – more than almost every other city in Europe. The game had been running for a while, we thought. Maybe several weeks.’

  ‘A game?’ It doesn’t sound much fun.

  ‘People were bidding in real time to make certain things happen in this man’s life.’

  ‘What sort of things?’

  ‘We weren’t on the site long enough, but top of the list was a car crash with life-changing injuries.’ He pauses. ‘No one had bid for that yet. Too expensive. Further down, things were more tame: a prostitute honeytrap; kidnapping his child; emptying his bank account; an arson attack on his home.’

  In which warped world are any of these events tame?

  Ji turns away from the window to face Adam. ‘But there was one thing that makes me worry for you,’ he says.

  Adam holds Ji’s gaze, searching his friend’s eyes for reassurance. ‘And what’s that?’ The whole damn thing is making Adam worried.

  ‘The prize at the end.’ Ji takes a breath. ‘Have you heard of NFTs? Non-fungible tokens?’

  ‘Sort of – I don’t really understand them.’ But they’ve piqued Adam’s interest, one of those Generation Z trends that he feels he should know about, that keeps popping up in the news. And in his spam folder. ‘I heard about the artist who sold an NFT for $70 million.’

  ‘An NFT is a digital certificate of ownership that’s recorded on a shared ledger, a blockchain like Ethereum,’ Ji says. ‘And you’re right, they’re currently big in the art world, as a way for collectors to own original digital images. They’re big in my world too – play-to-earn blockchain games are all the rage right now. NFTs can be used to represent in-game assets – swag, weaponry – and give them real-world value.’

  ‘How does this relate to me?’ Adam asks, struggling to follow his friend. Always a challenge when Ji’s talking about gaming and swag and guns, however much he tries to keep things simple.

  It’s a while before Ji answers. ‘Because the ultimate prize for this particular red room game we came across was the man’s life. Whoever bid the most for him to die won an NFT for the man’s soul.’

  ‘His soul?’ Adam sits up.

  ‘In many ways, it’s the perfect fit – every human soul is unique,’ Ji says. ‘And an NFT offers proof of that uniqueness.’

  Adam closes his eyes, panic rising. It sounds like just the sort of twisted thing Louis would be into. His first instinct is to ring Tania, check that she and Freddie and Tilly are OK.

  ‘Do you really think that’s what might be happening to me?’ he asks.

  ‘I don’t know, Adam. As I say, I could be completely wrong. But if I’m right, there’s only one way to make the game stop.’ Ji looks at his friend. ‘The victim has to stop performing for the audience. He must leave the stage, disappear. Go dark.’

  52

  May 1998

  I watched in awe as the junior doctor in A & E listened calmly to the patient’s description of what had happened to her.

  ‘She took a bite out of my back, a bloody great chunk,’ the woman said. ‘Maybe she was hungry, I dunno. We’d just had a Maccy D, so I can’t see why she was. Thing is, you don’t just bite your best mate, however hungry you are. Ex best mate. Bitch. Wanna see?’

  The woman was drunk – the smell of alcohol was overpowering – and already pulling up her blood-soaked top to show us her bite wound. The teeth marks were impressive, but her attacker had decided to abandon rather than close the deal, as it were. There was no actual chunk of flesh missing.

  ‘We’ll get this cleaned up by the nurse, give you some co-amoxiclav to stop any infection, and have you on your way,’ the doctor said. ‘Take her over, will you Adam?’

  ‘Sure,’ I said, excited to be doing something. Up until now, I had just been an observer.

  ‘That it?’ the woman said. ‘Aren’t you going to take some skin off my fat arse and fill the hole in my back?’

  ‘That won’t be necessary,’ the doctor said. I could see she was stifling a smile. ‘Your back – and your arse – seem fine to me.’

  Last night was my fourth night of work experience in Minors in the Emergency Department. Doctor Pender did put in a word for me, as promised, and I’ve been loving every second. The trauma of Cambridge – Lecter’s death, Louis’ blackmail – seems a world away, but I also know that I’ll have to return there sooner rather than later if I’m ever to be in this environment as a doctor rather than as a volunteer. After each shift I’ve been getting home at dawn, sleeping for a few hours and then turning to my medical books. Doctor Beale is doing what he can to supplement the lectures and classes I’ve been missing. Yesterday he also said that he might have some good news for me soon.

  So far it had been relatively quiet in Minors, unlike Majors and Resus, which had both been frantic. In addition to bitten backs, we’d had a patient presenting with paper cuts, two unconscious drunks – ‘frequent flyers’, according to the ambulance paramedic, who dropped them off every night – and a sweet-smelling toddler who’d swigged from a bottle of perfume. I was tasked with keeping him entertained while he waited to be seen by a doctor, but he did all the entertaining. Ethanol, the same alcohol used for distilled spirits, can make up as much as 90 per cent of a scent. Fortunately, he’d only consumed a small amount, but enough for him to stumble and slur his words while beaming cutely at everyone, which had the whole department in inappropriate giggles.

  I was about to escort the woman with the bite wound over to a nurse when the on-duty registrar, an Australian, popped her head into our curtained-off cubicle. ‘We’re down to three hours fifty,’ she said. ‘Do I hear cheering? Deafening applause? This time last week, we were five hours forty.’

  ‘Want me to change it on the board?’ I asked. This was my other big responsibility of the evening: updating the waiting time for patients to be seen.

  ‘Would you?’ the registrar said. She’s a good friend of Doctor Pender’s – they go surfing together – and knew that he’d arranged for me to volunteer in A&E.

  ‘No worries,’ I replied.

  If she’d asked me to clean the floor with my tongue, I would have obliged. I’m always just so happy to be there, in amongst those people. When I was asked in my Cambridge interview why I wanted to become a doctor, I tried to avoid the clichéd answer, that I wanted to help others, and opted instead to talk about Dad and his death, and Mum and her ongoing problems. But the truth is that nothing tops watching people get patched up and sent on their way again. That and the sense of responsibility, the fact that people trust doctors with their lives. A sixth-year medic who came to talk to us at Cambridge said that doctors are the maintenance people, the caretakers of humanity, and that, better still, no one remembers their names. Which is just as it should be. Doctors don’t do it for the glory; they do it for the species.

  The mood in the Emergency Department changed when the call came through that the air ambulance was about to land. It had taken off from the helipad at the front of the hospital 45 minutes earlier and was now returning with its human cargo: a man in his mid-twenties who had fallen – possibly jumped – from the cliffs at Porthcurno, below the Minack Theatre.

  ‘Adam, mate,’ the registrar said, calling across the room, ‘get yourself over to Resus.’

  I checked with my junior doctor, who watched enviously as I followed the registrar into the Resuscitation Unit. I shouldn’t have been allowed in there, for legal as well as practical reasons.

  ‘This one could get interesting,’ the registrar continued. ‘Paramedics found him on the rocks, no pulse. An angler pulled him out of the sea unconscious. Not so easy round there – do you know it?’

  I knew it well, had passed that stretch of coastline many times when I was on the gill-netter. I went to the window and watched as the helicopter blades spun down in the floodlights. And then I was standing in the corner of Resus, listening to the senior doctor brief his team. He’d already done a pre-brief, but the patient’s condition had deteriorated on board the helicopter. I tried to make myself as inconspicuous as possible, standing in a corner. No one asked me to leave.

  ‘This patient’s intubated and hypotensive. Possible anaphylaxis,’ the senior doctor said. ‘There’s swelling around the lips and face. Pulse is erratic, and he’s hypothermic. OK, let’s get him hooked up,’ he added with more urgency as the patient was wheeled in.

  I watched as his vital signs were checked: systolic blood pressure, body temperature, respiration rate, oxygen saturation.

  ‘This patient’s way too cold,’ the senior doctor said, looking up at the screen.

  ‘Core body temperature twenty-six,’ a team member confirmed.

  ‘Twenty-six?’ The senior doctor looked up to double-check.