It was the sound of hammering that woke him, pounding a steady rhythm of metallic chinks. He felt terrible. Perhaps it was the flu.

    The hammering stopped at the sound of his groan.

    Warren’s eyes were cemented with grit. He decided he must have been lying awkwardly through the night; he felt numb. Yet, it wasn’t just a leg or an arm that was still asleep; he couldn’t feel anything from the neck down. Then Warren realised he had absolutely no recollection of retiring to bed the night before.

    He strained his eyes open.

    He was definitely not lying in his bedroom.

    He stared up at a ceiling comprised of a latticework of support beams - untreated two-by-fours, flecked with red paint and dusty cobwebs. A single, un-shaded light bulb hung from a length of white flex, and a pull cord dangled beside it. There was a cool dampness to the room, and the vague smell of chemicals.

    Thoughts foggy, Warren tried to sit up, but his body was a dead, unresponsive weight. He turned his head and saw his right arm, splayed out straight from the shoulder. His hand was palm up, the fingers curled like a dead spider. He tried to move it with no success.

    He looked to the other side, and blinked slowly as he tried to rationalise the sight. Just like his right arm, the left was outstretched . . . but a nail had been driven through his upturned palm and into the table beneath, creating a pool of blood.

    Warren began choking on words.

    At that moment a hand reached over from the head of the table, and placed a damp, foul smelling cloth over Warren’s mouth.

    The room spun and darkened.

“Wake up, doctor.”

    Warren was on the yacht he had hired last year in the Seychelles. The sun was bright, the sky clear. Gulls shrieked distantly and the gentle sound of water lapped against the hull. Sandy was on deck, tanned and sleek in her bikini. She lay on a wooden recliner, reading a book, lost to the story.

    “Wake up, doctor.”

    Warren fixed fresh martinis for them both in the galley. He carried the drinks up on deck, and paused to admire his wife’s form.

    They were in the middle of nowhere, he realised lustily.

    “This martini will cost you one item of clothing,” Warren called, and grinned mischievously. He then frowned. Sandy’s stomach had suddenly become distended.

    She looked up from her book with a charming smile. “Wake up, doctor,” she said.

    Warren’s wife, the yacht, the Seychelles, and all its serenity, then faded to blackness.

    Sandy?

    Had he thought that or spoken aloud?

    A journal appeared in the darkness, the pages open and filled with words written in blood. The letters began to run, saturating the paper before Warren could read them. He tried to flip the page, but it came away in his hand like wet tissue. More blood flowed from the words beneath.

    “I said wake up!”

    A cold shock splashed over Warren’s face, and he snapped into consciousness. Freezing water blinded his vision, and flooded down his nostrils and throat. He choked and spluttered.

    “I-I can’t feel my body,” he spat, desperately. “What’s going on?”

    “I’ve anaesthetised you,” replied a man’s voice, coolly.

    It came from behind, at the head of the table. Warren struggled to see the face, but couldn’t twist his head to the proper angle. But he did notice his left hand had also been nailed to the table now, and tears came to his eyes. The wound looked crude, bloody and painful, but totally unfelt.

    “Where am I?” Warren begged.

    “You are in my home.” Again the voice was calm, stoic, carrying more than a hint of an accent. French? Swiss? “Actually, it’s more accurate to say you are beneath my home, but I’m splitting hairs with you.”

    “I know your voice,” Warren whispered, his words distant. “I know you.”

    “And to further my reputation as pedant,” continued the man, “You are lying on a rather charming butchers block that I recently acquired.”

    For the first time, the owner of the disembodied voice moved into Warren’s view. With his back to his captive, he walked the length of the table, drying his hands on a small towel.

    “I found it in a quaint nostalgia shop along the Old Kent Road,” he said, quietly. “It’s Victorian, or so I’m told. In its time, it would’ve been used for jointing larger cattle. Given its age, it was surprisingly cheap.”

    He threw the towel to one side, and turned at the foot of the block to face Warren.

    “You!” Warren accused.

    “Surprised?”

    “Melville-”

    “Doctor Melville,” the man corrected. “Let’s keep this professional.”

    From the angle he lay at, Warren could only see Melville from the midriff up. His olive-skinned face and black, straggly hair were sweat-streaked. Damp patches spread out from the armpits of his white shirt, the sleeves rolled to the elbows. A leather apron hung from his neck, coated with dark blotches.

    “What are you doing?” Warren demanded.

    Melville pushed back his hair and wiped his brow. “Isn’t that obvious?”

    Warren swallowed. The beginnings of a memory flickered in his head. “You . . . You attacked me!”

    “I had no choice,” Melville replied. “I will not allow my privacy to be invaded, or my hard-earned life ruined by the likes of you!”

    Warren’s eyelids felt heavy and fluttered as he struggled to keep them open.

    Melville sighed and shook his head. “I had hoped you would be a little more coherent by now, but I can see I was too hasty. I’ll give you another couple of hours, doctor; time enough for your head to clear. Then, we will talk, yes?”

    Warren wondered if he managed to reply, but fell unconscious before he decided on an answer.

Warren sat at a desk, reading from a journal under lamplight. A shocked expression decorated his face. Melville stood in the doorway watching Warren, a dark smile stretching his lips. Warren noticed Melville and jumped to his feet. A moment passed and neither man did more than stare into the other’s eyes. Then Warren shouted and lunged at Melville, but Melville was bigger and stronger and easily pushed Warren away, and sent him crashing into a filing cabinet. Warren fell, but rose quickly. As he did, Melville grabbed the telephone from the desk and smashed it into Warren’s face – once, twice, three times – and Warren was down, unconscious. Slightly out of breath, Melville steadied himself, and placed his makeshift weapon back onto the desk. He flipped open an address book, and searched through it until he found the name Derning, Albert Shaw. He traced a finger along to the contact number on the right then lifted the phone receiver and dialled out.

It was a burning smell that woke him this time, the stench of searing, thick and hot. Warren groaned. A strong hand lifted his head from the block and placed a glass of cool water to his lips. Warren drank greedily, soothing his parched throat.

    His body remained unfeeling, and his head ached dully. But his mind was cleared of fog, and he remembered everything. Squinting his eyes open, Warren’s gaze was met by Melville looming over him with a half-emptied glass in his hand.

    “Just listen to me,” Warren said, trying hard to sound reasonable. “Don’t make this worse for yourself. We can work something out; send you to med school . . . anything!”

    “And why would I want that?” Melville said, amiably. “Experience counts for much more than book-browsing in this profession.” He turned and placed the glass on a side bench, then made his way to the foot of the block.

    “But your license isn’t legal,” Warren said.

    “Just paperwork,” Melville sighed. “Tell me, during my service at your hospital how many misdiagnoses have I made, hmm? How many patients have I lost in surgery?” Melville leant forward, resting his hands on the edge of the block. “Exactly none,” he continued. “I think I’ve proved myself enough.”

    Warren saw his hands were still impaled with nails, and felt the first sparks of anger flare inside him. “What about France?” he said.

    Melville’s face became hard. “It was comments like that, which landed you in this position, doctor.” He cocked his head to one side. “You should have respected the privacy of my journal. My past was not for your eyes.”

    “I didn’t go looking for it,” Warren shouted. “You left it open on your desk!”

    “I know, but my carelessness did not give the right to read it.” Melville turned his back on Warren, and gazed about the cellar. “A journal is a curious thing. Once begun, it becomes addictive, almost like a friend you cannot deny. It helps me to understand the world, to know myself better.”

    “To know yourself?” Warren whispered. “How? The man you say you are is dead!”

    Melville turned back to face Warren, and conceded the point. “Technically, yes, but I have lived so long as the real Dr. Melville, I hardly remember my former identity at all.”

    “You murdered him!”

    There was a quick, charged silence.

    “Understand something,” Melville whispered. “In France I was a poor man. I simply didn’t have the money to fund myself through medical school. It took me a long time to find someone like Melville. But the search was worthwhile. Stealing his doctor’s license was considerably less expensive than school fees.”

    “What about his family?” Warren said. “Did you ever think of them?”

    Melville chuckled. “He had no family; that’s what made him the perfect candidate. We were alike in so many ways: our age was the same, our appearances were similar, and we had no living relatives. I followed his progress for five years, you know, always waiting, always patient. I knew his favourite foods, where he liked to drink. I learned his habits; the films he watched; the books he read; the company he kept . . .”

    “You murdered him,” Warren stressed.

    “Yes I did!” Melville’s voice was cold. “On the very day he passed from medical school with all the qualifications I needed.” His eyes became distant. “Switching identities was easy. Killing him was the hard part. It felt like murdering a friend.”

    “And the twenty before him?” Warren asked through gritted teeth. “How hard were they?”

    “Junkies, whores, and the homeless!” Melville snapped, showing real emotion for the first time. “They were as good as dead already.” He calmed his tone and shrugged. “I had to learn anatomy somehow, and they made perfect cadavers. Their sacrifices gave me the experience I was too poor to afford. I taught myself surgical procedure, doctor. I think that is to be admired.”

    Warren’s head thudded back against the block. The muscles and tendons in his neck burned and ached. The numbness in the rest of his body gave a curious warmth, and his headache was nauseating. He started to sob.

    “Tears of fear or guilt?” Melville said.

    “You don’t have to do this,” Warren pleaded, struggling to see his captor’s face. “You could disappear. Once the authorities know I’m missing, it won’t take long before the police are knocking at your door.”

    Melville clucked his tongue. “What kind of a bargaining chip is that? The authorities have absolutely no reason to suspect me. You know, I was as concerned as the rest of the staff when you didn’t show for work this morning.”

    “Oh God,” Warren moaned. “What are you going to do with them?”

    Melville’s expression was one of disappointment. “Please, doctor, I would neither threaten or harm any member of your staff. There’s no point. This is between you and I.”

    Warren thrashed his head from side to side, praying for his body to feel something. “I never meant to read your journal,” he cried. “You left it on your desk . . . everyone had gone home . . .” He gave up struggling. “I didn’t think it would matter!”

    “Well it did. I can only be thankful I caught you in time. You should have taken my journal to the police the instant you realised my deceit.” He sighed. “But, I suppose curiosity, blessedly, does strange things to us all, and you simply couldn’t stop reading. Pity for you you’re not stronger. You might have beaten me in our little scuffle last night.”

    “Please,” Warren sobbed. “My wife . . . she’s-”

    “Pregnant?” Melville finished. “I know. She told me.”

    All expression dropped from Warren’s face.

    “I went to see her,” Melville explained. “To enquire after you. She’s terribly worried; you’re normally such a logical man. It wasn’t like you at all when you didn’t go home last night. She’s convinced the pregnancy has triggered a mid-life crisis.” Melville gave a sympathetic smile. “I know my meeting with her seems a little callous, but I had to maintain my ignorance. And it was good for her to have someone to talk to, I think.”

    “You bastard!” Warren spat.

    “Bastard?” Melville said, and raised an eyebrow. “Last night you called me a butcher.”

    “Leave my wife alone. I’m warning you!”

    Melville snorted. “I have no further interest in Sandy or your unborn child. They can hardly be blamed for your behaviour. Though I did advise her to call the police. You had been acting so strange at work recently, it seemed the wisest thing to say. Of course, I’m always there as a friendly ear should she need one.”

    “Let me go!” Warren shouted. He looked despairingly at the nails in his hands. If only he could feel enough to move, he could rip them free and . . . and . . . “You fucking animal!” he roared.

    Melville seemed a little embarrassed by the insult. “Yes, I must apologise for your crude restraints. I simply didn’t have time to fit proper shackles. Think of them as an improvisation.” He snorted a quick laugh. “And, as you’ve recently read, I’m very good at improvising – always have been. So too am I ever the opportunist, doctor. Take Mr Derning for instance.”

    Warren’s teeth were gritted. “W-What?”

    “You remember Mr Derning, surely? You referred him to me?”

    “What’s he got to do with this?” Warren hissed.

    “Well, you were right to send him my way. You see, the arteries in his left leg might as well be filled with cement.” Melville shrugged. “Oh, he could follow our advice and stop smoking and cut down on fatty foods, but it makes no difference now. Mr Derning is going to lose that leg no matter what he does.”

    “What are you talking about, Melville?”

    “Opportunism,’ Melville said, and grinned. “The techniques for amputations have changed and evolved over the years, but for me it remains an operation that truly transforms a surgeon into an artist. There’s genuine craft involved, skill and pride. But, I am embarrassed to admit, amputation remains a procedure I have yet to properly perform.”

    Warren shook his head, dislodging tears. “Please,” he said. “What are you doing?”

    “If Mr Derning’s leg is to be removed, then it has to be done in one chop, so to speak, from mid-way down his thigh. On a cadaver, however, one can take the time to practise on both limbs. You start with the foot, just above the ankle; then the calf, just below the knee; and lastly the thigh. This allows for optimum practise of sawing techniques - after all, it wouldn’t do at all to splinter pieces of bone into the wound.”

    “Melville-”

    “Oh, I know what you’re thinking: at this stage of my career, ordering a cadaver to practise on would do little to enhance my reputation, and you are right. In fact, my lack of surgical experience in this area almost forced me to refer Mr Derning to yet another surgeon. However, if my experiences in France taught me anything . . .” Melville dipped out of view and picked something up, “ . . . it was never let the opportunity to learn something new pass you by.”

    He placed on Warren’s chest a foot, amputated just above the ankle. The stump glistened wetly, and a horrified cry rose in Warren’s throat.

    “It’s a clean amputation,” Melville boasted, above his victim’s cries. He lifted a second foot, just as neatly shorn, and placed it next to the other. “A matching pair,” he joked. “Oh . . . they’re yours, in case you were wondering.”

    “Jesus,” Warren whimpered. He struggled to see down the length of his body, and caught a fleeting image of his legs devoid of feet, before his head thumped back against the block. “Jesus fucking Christ . . . What have you done . . . you . . . you . . .”

    “Butcher?” Melville suggested. He pursed his lips and looked at the stumps of Warren’s legs. “Even though there’s little tearing of flesh, and the cauterisation is holding, my sawing technique is leaving much to be desired. I’ve splintered the shinbone on your left leg. The right side is better, but not by much.” He picked up a surgical hacksaw from a side bench. He gripped it tightly and began to saw the air, studying his movements. “I think the angle of my push is fine, it must be something to do with my drag back. What do you think, doctor?”

    “Get me to a hospital!” Warren’s teeth were chattering with shock, and he started making small hiccupping sounds.

    “Why? You’re already in good company.” Melville bounced the saw on his shoulder. The stainless steel glinted under the single light bulb; the blade was lined with dried blood. “Mr Derning will benefit from your sacrifice, doctor, just as I have.”

    “Don’t.” Warren’s voice sounded weak, little more than a whisper. “I trusted you. We were friends.”

    Melville smiled. “Yes . . . and now I have a big decision ahead of me: do I stay at your quaint little hospital, maybe even take over the running myself? Or do I move on and find a new life somewhere else?” He shrugged and turned his attention to Warren’s legs. “Decisions, decisions, eh?” The saw blade glinted as he placed it into position. “Now, be sure to tell me if this becomes too uncomfortable, doctor.”