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      ‘I need it,’ she said as I pulled her away to the waiting room. She spoke with desperation, her tone salvaging something in my mind that I had stored away without fully considering. Lenke was wrong when she said that Phoebe ate things that weren’t food; she hadn’t eaten anything inedible since she came to me. She had only drank, I realised, with a rush of blood to my ears. My mind stuttered as I tried to follow what the pitching sensation in my stomach was prompting. Phoebe had ingested soap, shampoo, shower gel and now liquid alcohol gel.

      I’d been so busy thinking about the signs and symptoms of autism that perhaps I’d missed what was staring me in the face. Did she feel dirty? I wondered, watching as she sank heavily into one of the hard-backed chairs and pulled her legs up towards her stomach. Could it be that the poor child was trying to cleanse herself from the inside out?

      Any further revelations were forestalled by the appearance of her name on a flashing screen above our heads.

      Doctor Kenwick was old school and thorough, hence his surgery always ran at least an hour behind his other, younger colleagues’, so I was grateful that the receptionist had decided to allow us to jump the queue. ‘What can I do for you today, young lady?’ the doctor asked, peering over the top of his spectacles. He was so overweight that his stomach protruded over his belt and the buttons of his shirt appeared dangerously close to popping open, but the cheeriness of his expression more than made up for it, his deep jowls moving independently of each other as he smiled at his new patient.

      ‘What can I do for you today, young lady?’ Phoebe repeated, causing his smile to rapidly vanish.

      ‘I’m sorry, doctor,’ I said, marvelling that in spite of her delicate condition, she was still capable of mimicking strangers. ‘Phoebe drank some shampoo during the night and now she has a bad tummy ache,’ I said, producing the bottle from my bag. ‘She’s been sick several times this morning. We’re not sure what time you drank it, are we?’ I looked at her but she was in that other world of hers, flapping and rolling her eyes. ‘Autism,’ I said under my breath, raising my eyebrows and inclining my head towards her. I couldn’t help but register the look of disgust Phoebe gave me when I said it.