Time flew when you were in the field, Isobel thought to herself as she realized, between patients, that she had already been in Chad five days.

“Breathe in.” She spoke in French to her patient, a four-year-old boy with feverishly bright eyes and a high temperature. Medpax’s pediatric hospital was in the middle of nowhere. Their patients mostly came from the villages dotted around it. Sometimes they had patients from any of the nomadic groups that lived in the desert. Families often walked for days to get there, and the children who came with them were almost always in a bad way. One of the biggest concerns was that people waited too long and arrived at the hospital too late. In the worst cases, the children died immediately upon arrival. When that happened, sometimes the doctors were blamed. The attitude toward medicine was almost medieval from a Western point of view, with all the superstition that accompanied it. Much of Medpax’s long-term work was going to the villages and talking about the benefits of taking children to the doctor instead of using the shamans and their downright dangerous methods. I hope I made a difference, she thought, because the children who died here were mourned just as deeply as they would be back home. It was just that Chadian parents had to have strategies for outliving one or more of their children, because it happened so often. But a Chadian parent’s grief was just as deep and painful as any Westerner’s. “Très bien,” she said, and then moved on. She examined a six-month-old baby with breathing difficulties. Undernourished and with a lung infection. That was the most common diagnosis here.

“Did he have diarrhea?” she asked in French.

The mother, a girl who didn’t look much older than sixteen, nodded.

“We’ll give him a drip,” Isobel said to the nurse, then gave the mother a reassuring smile. “You can sit with him. And you will get something to eat.”

“Merci, Docteur,” the mother whispered.

Isobel moved on again. She had at least twenty more patients to see. She had met some of them the past fall, and their joy at seeing her again was mutual. A broken arm that had healed as it should, an undernourished child who had grown bigger and could now smile at her. But some of those she had met and treated last time were dead now. Car crashes, famine, and infections killed many in this country, one of the hardest places to live on earth. But the majority of today’s patients were new, part of a never-ending stream. She wiped the sweat from her brow. There was no thermometer, but she would have been surprised if the temperature was much lower than 115.

After she dealt with the morning’s new patients, malaria, lung inflammations, and wounds that wouldn’t heal in the constant heat and humidity, she went by the doctors’ office. It consisted of a table and a generator-powered refrigerator behind a curtain. She opened the refrigerator. Like everything else, PET bottles were in short supply, but she had bought some juice at the airport, kept the bottle, and now refilled it with filtered water regularly. She drank it in slow gulps.

The curtain flapped and Idris joined her.

“How’s it going?” he asked.

“I saw to that painful abdomen. Put in a drip. How was the C-section?”

Strictly speaking, it was a pediatric hospital, but the woman had urgently needed the operation and there hadn’t been time to send her to the bigger hospital in N’Djamena. The journey took three hours by car, but their patients didn’t have cars. Or phones. Or radio equipment. Most of them had nothing.

“It went well.” Idris checked the time. “But it’s almost six. You have to get back.”

That was the frustrating thing. Needing to leave the patients, not knowing how many would make it through the night. But breaking the curfew was madness, and not something she wanted to do without good reason. A dead doctor did no one any good.

“Are you working tonight?” she asked.

“Yes.”

Idris worked harder than anyone Isobel had ever met. He was at the hospital every day and every other night. Month after month. The hospital also had some local staff members, and their level of knowledge was much higher than many people back in Sweden realized. Once, when Isobel asked Idris what his specialty was, he laconically replied, “Everything.” Doctors in Chad needed to know basic medicine, be able to perform a C-section, operate on an appendix, and deal with tricky breech births immediately after they finished their education. The country had fewer doctors per inhabitant than any Western country; the doctors were responsible for far more patients. All of this created hugely knowledgeable doctors. But it also led to one of the most serious problems of developing countries: a terrible brain drain as trained doctors fled to nations with better working conditions.

“We’re completely full. Let’s hope nothing happens.”

And by “nothing,” he meant anything from a serious traffic accident to a conflict, to an outbreak of cholera. Or worse.

That was often too much to hope for.

“Inshallah,” said Isobel.

Idris, who was about as much of a Christian as she was, nodded in agreement.

Her driver, Hugo, who helped out with everything from driving to cleaning in the hospital, gave her a ride back to Massakory, the village where she was staying. People at home always asked how far apart things were in Chad. How far is it to the capital? How close is the village to the hospital? But those weren’t relevant questions down here. What looked like a ten-minute drive on the map could easily end up being a bumpy, shaky, eternal-feeling journey that took an hour. Maybe the road had washed away. Or a tree might’ve fallen, or a new roadblock had appeared. You never knew. But today, the trip took less than fifteen minutes, and it passed without incident.

“I’ll pick you up in the morning,” Hugo said, and he disappeared off into the Chadian evening to the sound of a muezzin. Isobel greeted the guard—everyone who could afford one had a guard in Chad—and went into the building. She was covered in sand. It came on the wind from the Sahara and mixed with sweat to produce a coating on the skin. She washed herself as thoroughly as possible, changed to a clean T-shirt, and went to the kitchen. She was given a bowl of food by the cook, a woman who looked around forty, but who Isobel knew was younger than she was, and supported her six children by cleaning and cooking for the few Westerners who came to Massakory.

“Merci,” said Isobel. It was the same meal as ever: bean stew with onion and something that looked like tomatoes. People often thought that food in African countries automatically meant fresh mangoes and luxurious fruits, but here in Chad, there was practically nothing to eat.

After she ate, she took out her computer and headed for the corner of the house where, if she was lucky, she could connect to the Wi-Fi. The Skype icon told her she had an incoming message. She clicked on it and opened the window. Assumed it was Leila. She read the message.

Alex Grip would like to add you as a contact.

Accept. Decline.

She blinked. Hesitated. Was it really Alexander? What could he want?

She accepted with a click. Waited, her hands clasped over the keyboard.

When the call came in with the usual bubbling sound, it was a video call. She clicked the green icon and waited.

Alexander had been waiting for the Skype call for two hours. Chad was in the same time zone as Sweden, which meant that Isobel was six hours ahead of him. According to Leila, the curfew came into force at six her time, and so he had sat there, staring at the screen, since twelve New York time. He had briefly gotten up to make some coffee, and when he came back, she had accepted.

The screen flickered, and then she was there. It felt like he could breathe normally for the first time in hours. He hadn’t been entirely sure she would want to talk to him, but now she filled the screen in front of him.

“Hi, Alexander.”

She had on a white T-shirt and her hair was in a ponytail. Somewhere behind her, the sun shone, and he could see plain concrete walls and faded posters bearing the UNICEF logo. She didn’t smile, just gave him a cautious look.

“Hi there. How are you?” he asked.

“I’ve had a few long days,” she replied lightheartedly, taking a sip from a bottle of beer. It suited her, drinking beer. “And you?”

“I’m well.” It was true. Now that he had her in front of him, he felt better than he had in a long while. “What are you doing?”

“Not a lot. There’s a curfew in the evenings, and at night it’s too dangerous to go outside. Between sunset and sunrise, I have to be here on the base, so I drink beer and try to relax. Gather my thoughts.”

“Is it safe?”

She raised an eyebrow. “Thanks for asking. It’s fine right now. There was some fighting in a neighboring village, but nothing here.”

“Where are you staying?”

“Medpax has a house at a compound here. I’m staying here alone, but there are some Red Cross people next door. We play cards sometimes.”

“How are things with the kids?”

“Today was a good day. No one died.”

“I’m really sorry about the last time we met. Do you have time to talk for a minute?”

“Wait, let me put my earbuds in.”

He watched her plug the simple white earbuds in, first into the computer and then her ears. It felt strangely intimate. The knowledge that his voice was now going straight into her ears, wouldn’t be heard by anyone but her. She nodded when she was ready. He moved closer to the screen.

“I know what you think, but I didn’t sleep with that girl.”

“Okay,” she said, but he saw the doubt on her face. He wished there was some way he could show her he was telling the truth. Two seconds after he and Qornelia left the restaurant, he had put her in a taxi and sent her away. Had known the whole time that she wasn’t the one he wanted.

“I just wanted you to know that. And I’m sorry I … I don’t know. That I acted like an ass.”

That I feel something I’ve never felt before, and it’s scaring the shit out of me.

She smiled slightly. “Thanks for letting me know. I’m glad you got in touch.”

The picture started to jump.

“Alexander?”

“Hello?”

“The Internet is overloaded here, so it’s going to go off. Do you hear me?”

The picture froze and jumped again. “You’re disappearing. Take care, Isobel. I’ll call back tomorrow, okay?”

He heard her reply: “Yes.”

The call ended.

He closed the laptop. Stood up. Looked down at New York, sprawled out beneath him. He would go out for a run. And give Romeo a call. It was time to pull himself together.