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at the base of each finger - the tips of which are flat and broad, like the suckers on a salamander. There's an immodest length to the thumbs which curve back, banana-style, and even at rest have a double-jointed look, more suited to the circus ring, among the clowns and trapezists. And the hands, like much of the rest of Perowne, are gaily freckled in a motley
    19 Ian McEwan
    of orange and brown melanin extending right up to his highest knuckles. To a certain kind of patient this looks alien, even unwholesome: you might not want such hands, even gloved, tinkering with your brain.
    They are the hands of a tall, sinewy man on whom recent years have added a little weight and poise. In his twenties, his tweed jacket hung on him as though on narrow poles. When he exerts himself to straighten his back, he stands at six feet two. His slight stoop gives him an apologetic look which many patients take as part of his charm. They're also put at their ease by the unassertive manner and the mild green eyes with deep smile-wrinkles at their corners. Until his early forties, the boyish freckles on his face and forehead had the same unintimidating effect, but recently they've begun to fade, as though a senior position has at last obliged him to abandon a frivolous display. Patients would be less happy to know that he's not always listening to them. He's a dreamer sometimes. Like a car-radio traffic alert, a shadowy mental narrative can break in, urgent and unbidden, even during a consultation. He's adept at covering his tracks, continuing to nod or frown or firmly close his mouth around a half-smile. When he comes to, seconds later, he never seems to have missed much.
    To a degree, the stoop is deceptive. Perowne has always had physical ambitions and he's reluctant to let them go. On his rounds he hits the corridors with an impatient stride his retinue struggles to match. He's healthy, more or less. If he takes time after a shower to scrutinise himself in the full length bathroom mirror, he notes around his waist a first thickening, an almost sensual swelling below the ribs. It vanishes when he holds himself erect or raises his arms. Otherwise, the muscles - the pecs, the abs - though modest, keep a reasonable definition, especially when the overhead lamp is off and light falls from the side. He is not done yet. His head hair, though thinning, is still reddish brown. Only on his pubes are the first scattered coils of silver.
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    Most weeks he still runs in Regent's Park, through William Nesfield's restored gardens, past the Lion Tazza to Primrose Hill and back. And he still beats some of the younger medics at squash, centring his long reach on the The' at the centre of the court, from where he flaunts the lob shots which are his special pride. Almost half the time he beats the consultant anaesthetist in their Saturday games. But if an opponent is good enough to know how to shift him from the centre of the court and make him run, then Henry is done for in twenty minutes. Leaning against the back wall, he might unobtrusively check his own pulse and ask himself whether his 48 year-old frame can really sustain a rate of one hundred and ninety? On a rare day off he was two games up against Jay Strauss when they were called - it was the Paddington rail crash, everyone was called - and they worked twelve hours at a stretch in their trainers and shorts under their greens. Perowne runs a half-marathon for charity every year, and it's said, wrongly, that all those under him wanting advancement must run it too. His time last year - one hour forty-one was eleven minutes slower than his best.
    The unassertiveness is misleading, more style than character - it's not possible to be an unassertive brain surgeon. Naturally, students and junior staff see less of his charm than the patients. The student who, referring to a CT scan in Perowne's presence, used the wTords 'low down on the left side', provoked a moment's rage and was banished in shame to