THE UNEASE WAS not confined to the hospital. It seemed to rise with the turbulent brown river swollen by the April rains, and in the evenings lay across the blacked-out city like a mental dusk which the whole country could sense, a quiet and malign thickening, inseparable from the cool late spring, well concealed within its spreading beneficence. Something was coming to an end. The senior staff, conferring in self-important groups at the corridor intersections, were nursing a secret. Younger doctors were a little taller, their stride more aggressive, and the consultant was distracted on his round, and on one particular morning crossed to the window to gaze out across the river for minutes on end, while behind him the nurses stood to attention by the beds and waited. The elderly porters seemed depressed as they pushed the patients to and from the wards, and seemed to have forgotten their chirpy catchphrases from the wireless comedy shows, and it might even have consoled Briony to hear again that line of theirs she so despised—Cheer up love, it might never happen.

But it was about to. The hospital had been emptying slowly, invisibly, for many days. It seemed purely chance at first, an epidemic of good health that the less intelligent of the trainees were tempted to put down to their own improving techniques. Only slowly did one detect a design. Empty beds spread across the ward, and through other wards, like deaths in the night. Briony imagined that retreating footsteps in the wide polished corridors had a muffled, apologetic sound, where once they had been bright and efficient. The workmen who came to install new drums of fire hose on the landings outside the lifts, and set out new buckets of fire-fighting sand, labored all day, without a break, and spoke to no one before they left, not even the porters. In the ward, only eight beds out of twenty were occupied, and though the work was even harder than before, a certain disquiet, an almost superstitious dread, prevented the student nurses from complaining when they were alone together at tea. They were all generally calmer, more accepting. They no longer spread their hands to compare chilblains.

In addition, there was the constant and pervasive anxiety the trainees shared about making mistakes. They all lived in fear of Sister Marjorie Drummond, of the menacing meager smile and softening of manner that preceded her fury. Briony knew she had recently accumulated a string of errors. Four days ago, despite careful instruction, a patient in her care had quaffed her carbolic gargle—according to the porter who saw it, down in one like a pint of Guinness—and was violently sick across her blankets. Briony was also aware that she had been observed by Sister Drummond carrying only three bedpans at a time, when by now they were expected to go the length of the ward reliably with a pile of six, like a busy waiter in La Coupole. There may have been other errors too, which she would have forgotten in her weariness, or never even known about. She was prone to errors of deportment—in moments of abstraction she tended to shift her weight onto one foot in a way that particularly enraged her superior. Lapses and failures could carelessly accrue over several days: a broom improperly stowed, a blanket folded with its label facing up, a starched collar in infinitesimal disarray, the bed castors not lined up and pointing inward, walking back down the ward empty-handed—all silently noted, until capacity was reached and then, if you had not read the signs, the wrath would come down as a shock. And just when you thought you were doing well.

But lately, the sister was not casting her mirthless smile in the direction of the probationers, nor speaking to them in the subdued voice that gave them such terrors. She hardly bothered with her charges at all. She was preoccupied, and often stood in the quadrangle by men’s surgical, in long conferences with her counterpart, or she disappeared for two days at a time.

In another context, a different profession, she would have seemed motherly in her plumpness, or even sensual, for her unpainted lips were rich in natural color and sweetly bowed, and her face with its rounded cheeks and doll’s patches of healthy pink suggested a kindly nature. This impression was dispelled early on when a probationer in Briony’s year, a large, kindly, slow-moving girl with a cow’s harmless gaze, met the lacerating force of the ward sister’s fury. Nurse Langland had been seconded to the men’s surgical ward, and was asked to help prepare a young soldier for an appendectomy. Left alone with him for a minute or two, she chatted and made reassuring remarks about his operation. He must have asked the obvious question, and that was when she broke the hallowed rule. It was set out clearly in the handbook, though no one had guessed how important it was considered to be. Hours later, the soldier came round from his anesthetic and muttered the student nurse’s name while the surgical ward sister was standing close by. Nurse Langland was sent back to her own ward in disgrace. The others were made to gather round and take careful note. If poor Susan Langland had carelessly or cruelly killed two dozen patients, it could not have been worse for her. By the time Sister Drummond finished telling her that she was an abomination to the traditions of Nightingale nursing to which she aspired, and should consider herself lucky to be spending the next month sorting soiled linen, not only Langland but half the girls present were weeping. Briony was not among them, but that night in bed, still a little shivery, she went through the handbook again, to see if there were other points of etiquette she might have missed. She reread and committed to memory the commandment: in no circumstances should a nurse communicate to a patient her Christian name.

The wards emptied, but the work intensified. Every morning the beds were pushed into the center so that the probationers could polish the floor with a heavy bumper that a girl on her own could barely swing from side to side. The floors were to be swept three times a day. Vacated lockers were scrubbed, mattresses fumigated, brass coat hooks, doorknobs and keyholes were buffed. The woodwork—doors as well as skirting—was washed down with carbolic solution, and so were the beds themselves, the iron frames as well as springs. The students scoured, wiped and dried bedpans and bottles till they shone like dinner plates. Army three-ton lorries drew up at the loading bays, bringing yet more beds, filthy old ones that needed to be scrubbed down many times before they were carried into the ward and squeezed into the lines, and then carbolized. Between tasks, perhaps a dozen times a day, the students scrubbed their cracked and bleeding chilblained hands under freezing water. The war against germs never ceased. The probationers were initiated into the cult of hygiene. They learned that there was nothing so loathsome as a wisp of blanket fluff hiding under a bed, concealing within its form a battalion, a whole division, of bacteria. The everyday practice of boiling, scrubbing, buffing and wiping became the badge of the students’ professional pride, to which all personal comfort must be sacrificed.

The porters brought up from the loading bays a great quantity of new supplies which had to be unpacked, inventoried and stowed—dressings, kidney bowls, hypodermics, three new autoclaves and many packages marked “Bunyan Bags” whose use had not yet been explained. An extra medicine cupboard was installed and filled, once it had been scrubbed three times over. It was locked, and the key remained with Sister Drummond, but one morning Briony saw inside rows of bottles labeled morphine. When she was sent on errands, she saw other wards in similar states of preparation. One was already completely empty of patients, and gleamed in spacious silence, waiting. But it was not done to ask questions. The year before, just after war was declared, the wards on the top floor had been closed down completely as a protection against bombing. The operating theaters were now in the basement. The ground-floor windows had been sandbagged, and every skylight cemented over.

An army general made a tour of the hospital with half a dozen consultants at his side. There was no ceremony, or even silence when they came. Usually on such important visits, so it was said, the nose of every patien............