She stared at him for a long, long minute. And then she lifted the cup from her nephew’s hands and set it on the desk.

‘Cady, look. There’s blocks in the corner,’ she told him, motioning to where Nate kept a basket of toys to amuse small children. ‘Can you build me a house?’

Cady considered and then nodded, with all the gravity of a carpenter agreeing to sign a contract for house construction.

‘Sure.’ He knelt on the floor and started to build. One block after another. The sight was somehow comforting compared to the unbelievable conversation that was taking place over the desk.

But then the doctor in him focused. The child seemed to be building more by feel than sight. He was lifting the coloured blocks and feeling their edges, fitting them together with a satisfactory click.

Was he blind? Maybe he normally wore glasses…

It wasn’t his business. Cady wasn’t his patient. Somehow this crazy conversation had to resume.

‘Right,’ Nate said. He took a deep breath and braced. ‘Tell me.’

‘My sister was… I think you could almost call her manic.’

‘Now, that’s what I don’t understand.’ Nate thought back to the last time he’d seen Fiona. Manic? For some reason the description suddenly seemed apt. He hadn’t known why then. He didn’t know why now.

‘In what sense was she manic?’

‘I told you she had diabetes.’

He thought that through and couldn’t make sense of it. ‘Diabetes is not usually a life sentence and it has nothing to do with a person’s mental state.’

‘It does if you’re as perfect as Fiona.’ Gemma shrugged. ‘You need to understand. Fiona…well, she was two years younger than me and from the time she was born she was perfect. My mother certainly thought so. My mother was a beauty queen in her own right. My father left us before I can remember, and all my mother’s pent-up ambitions centred on Fiona. Perfect Fiona.’ She took a deep breath, fighting back bitterness that had been instilled in her almost since birth.