Here at the Royal London Journal of Medicine, we have a highly trained team of medical and healthcare professionals from all walks of life. Get to know Ibrahim al-Rayess, MD, MB Bchir, on a professional and clinical level.


doctor photo jpg TK


Public health, trauma surgery and fine English tailoring are Ibrahim’s passions. He is a medical doctor and trauma surgeon with graduate degrees in public health and surgical medical science. Dr al-Rayess was born in Damascus, Syria, where he practiced medicine at Al Mouwasat and Damascus General Hospitals, having taken his MB BChir from Cambridge followed by postgraduate study in public health and surgery at London’s University College Hospital in the UK. He returned to London last year to take on the role of visiting editor at the Royal London’s Bloomsbury offices. Dr al-Rayess’s most recently edited paper is an analysis of the development of the public healthcare system in Turkey – in the context of that country’s bid for EU membership and of the Syrian conflict. Dr al-Rayess is currently working on a piece on ethical guidelines in medical publishing in an eastern context, is second editor on a clinical review of cellulitis, and primary editor on an analysis of the rise of opportunistic Leishmaniasis in refugee camps in south Sudan – in the latter case he draws on his extensive experience working in Syrian refugee camps in southern Turkey. Dr al-Rayess is very tall, very thin and is the father of two daughters, age six and eleven, neither of whom he has seen in two years. One of his current projects has been to find them on YouTube. He is paid very well at the Royal London, and he has an apartment – with barely a kitchen to speak of – in the iconic Isokon Lawn Road Flats in London’s Belsize Park; the same building where another refugee from a different kind of fascism, Walter Gropius, once lived and worked.

Dr al-Rayess – Ibrahim, as he likes to be known – is taking the afternoon off. He heads to Jermyn Street to buy some shirts, and possibly a pair of shoes, and later in the evening he plans to watch a horror movie – another of his passions. Tonight’s film is to be an old favourite (if that is the right word for the dull click of satisfaction, the sense of cruising hostility, blankness, that watching horror provides him), The Cabin in the Woods. He is also preparing to drink, as he watches, as a bad Sunni Muslim, his first alcohol ever: an entire bottle of vodka, if possible, made by a popular manufacturer recommended to him today by a young woman in the Bloomsbury Oddbins, 42° Below. For today, this morning, not long after an abandoned meeting for the Royal London’s ongoing process review, he had found on YouTube the first video featuring his daughters, as well as his sister-in-law and her cousin, filmed at their country house in al-Tal outside Damascus. This video was two years old.

Ibrahim is fifty-three years old and has seen a few things in his professional career. He has a rather hooked and sideways-tending nose with a notably twisted septum; a clearly Arab complexion of deep patinaed chestnut; heavy eyebrows; a deeply wrinkled brow; yet the palest blue eyes in that shade the English like to call gray. Those eyes got him in trouble a few times in the last months in Syria.

Now, Ibrahim was on the Piccadilly line to Piccadilly station, heading toward the twin Meccas of English tailoring excellence, Savile Row and Jermyn Street. The cliché was not inaccurate given the extent that both holy destinations were encircled and shamed by venality and the tawdry market: bogus Zamzam; Abercrombie and Fitch. He was sitting still. Across the modestly crowded tube carriage was a middle-aged Sikh, a lawyer or banker, standing by the doors, and Ibrahim was making a very close yet subtle, unobtrusive study of the man’s wardrobe. This was not one of those Frenchmen modelling the garish and clichéd le look Anglaise with its virulent corduroys, clashing cashmeres and loud tweeds stiff and still unbroken-in. The professional Indian, Ibrahim had come to understand, appreciate and closely watch, were most often the best-dressed men in London.

He was a man of fifty, a professional, a doctor, lawyer, banker. He wore the turban and kara bracelet of a Sikh. He had a ferocious beard. And such a suit. Clearly Huntsman, single buttoned, single breasted. A lay person would never notice it. This is its beauty. Ibrahim had one himself. One of the great pleasures, that: to stand in basted cloth on those Huntsman floorboards emperors and presidents and princes have trod, and have the head tailor emerge from the workshop, stand behind one in the mahogany mirror in a daze abstracted, his head bent just so, like a surgeon contemplating knife to skin, then reach with one hand around hips childbearing or skinny and jutting, like his – as in theatre, it did not matter here – to gently place his forefinger upon the precisely personal spot whereupon an assistant tailor quickly pins a single paper button, thence to return to the workshop with neither greeting nor civility of any kind.

Huntsman: the acknowledged world authority in the perfectly balanced single buttoned coat (please don’t call it a jacket). Ibrahim automatically appraised, in a disassociation one might hesitate to call enjoyment, the deep Yorkshire cloth, 12oz or slightly heavier, the drape and fall, the wet of the weave, the horn buttons, the handsewn buttonhole at a sober angle by a sober 90° notched lapel of canvassed, horsehair-lined­ – and sober – width.

Those investment bankers and hedge fund managers who request the buttonholes of their loud lapels sewn at jaunty angles, even vertical – Ibrahim looks away.

This was a form of pleasure. The contemplation of the perfection of a craft, worn by a man who knew its worth, and his own. That at least was the illusion, the surface, some consolation. Please: no cuffs on the trouser.

A very restrained chalkstripe on a dark charcoal, simple, single-breasted suit made by Huntsman. A go-to suit for any occasion, anywhere in the world. Such was the tailoring that in it one could comfortably pole-vault. Kicking off at about £5,000, depending on the cloth you chose. Certain types liked to have gold woven in, or to take a suit in cashmere, or Vicuña. A beautiful suit but a fabric so fine your £10,000, your £20,000, would last just a single glorious season. The shirt beneath was anonymous enough to be high bespoke, either one of the Savile Row tailors or a shirt specialist like Emma Willis or Budd. Definitely not the proportions of a Turnbull & Asser or Harvie & Hudson. Dr al-Rayess could recognise Hilditch & Key stitching and collar rake from this distance, but with a closed jacket it would be a challenge for anyone. The tie looked like Drake’s by its restraint – the Sikh had it in a slightly lighter burgundy Jacquard silk that did not lack for the dramatic with his dark skin. A pocket square puffed not folded in fine paisley golds and cobalt blues. The shoes were clearly a pair of Edward Greens, second only to Lobb, shoemakers to the future King, not impossibly bespoke, around £800 off the shelf for that pair of simple black Oxfords with light broguing to the toecap. The man was clearly on his way to or from a business meeting or a lunch at which he was a recognised power and had no need to dominate. His hand hung from the Tube handle, shirtcuff extending – even with his arm thus raised and extended – precisely half an inch from suitcuff to the base of his thumb. A Patek Phillipe glinting goldly there.

Ibrahim made the inventory, and several more details beside, in a series of seconds in which his mind rather resembled his expression – calm, affectless, autopiloted, nearly peaceful. Empty, someone assisting might say. The same expression he would wear when catheterizing a superior vena cava, splitting a rib cage, picking the angle of IV attack for a patient with rolling or reticent veins. We never blame the patient for a blown vein, and we release the tourniquet at once to lessen bruising – they’ll thank us for it later if not right away.

There were things to look at: observe their behavior: you are not really there with them.




Ibrahim emerged from Piccadilly station, exit Regent street south, Piccadilly west side. A pleasant buzz on the street, a readily negotiable swarm of Spaniards like lazy flies. The circus’ pedestrian traffic was self-regulating now since they took the traffic barriers down – fear of death kept people still. He headed south through sky-staring tourists, then west at the Tesco to Jermyn Street.

It was one of London’s smaller tragedies, perhaps, that Bates’ Hatters’ shop at 21A had closed. There was no frame to present the picture of the tweed cap, the felted bowler, the pristine panama, quite like the mahogany and dusty carpet of that little hole in the wall. The stud inside had been twenty feet high at least and rising either side of the narrow little shop mahogany shelving built into the walls held flatcaps in all the tweeds piled like pancakes. The shop was unenterably old and English when Ibrahim first visited the street as a young student. When he returned a year ago as a surgeon, sterilized father and man of exploded parts, it was gone.

Squeezed out by the rents, the brutal rates. The developers’ developments. The whole east end of Piccadilly was going that way – hotels. Next door was multinational Hawes & Curtis, who lend the borrowed shine of Jermyn Street and its history of rolled umbrellas, rentboys, royalty and the highest of shirtmaking artistry on to their made-in-China cotton shirts; silky on the shelves and unwearable cardboard two launderings later. Jones, and Emmet. Tesco. Balamaes Street, a dead end with Church’s shoes on the corner – an English classic eschewed since Prada bought them up – marked the pale beyond which, east, it was hopeless to find anything made in England. The next block west held some doubtful compromises: TM Lewin, Charles Tyrwhitt, another Hawes & Curtis, landbanking their business into prosperity. But then, at number 97, the real business began: shirts by Harvie & Hudson. Opposite by the Princes Arcade: shirts by Hilditch & Key, shirtmakers since 1899.

Ibrahim’s steps slowed by Victorian facades, glossy black wrought iron, tile, and the window displays: Sea Island cotton shirts in butcher’s stripes, suspenders in navy barathea with polished brass clasps and kid leather fasteners, socks in silk by Pantherella, crimson silk knots for cufflinks, classic navy blazers with great brass buttons – fully canvassed though none of it bespoke, of course. But Ibrahim’s steps slowed. He absorbed the looks that the gentlemen of Harvie & Hudson, of Hilditch & Key, Turnbull & Asser, have assembled for his pleasure and inspiration. A spring; something seriously innocent; a game a man can play. Opposite was the church hall of St. James’s – in which they had installed a Caffè Nero: cappuccino, panini, pasta. A peace was here, opposed to that. In the assemblage of elements, their very range and number, the depth of accrued taste: Ibrahim dipped his fingers in the English aesthetic and savoured it. He saw and recognised the hand of Richard Harvie in the particular combination of contrast collar and paisley tie. The large pattern and the small. He saw Alan from Hilditch & Key – an altogether different proposition to H&H, to the trained eye – saw Alan’s hand in the stack of folded H&K shirts grading by colour from a loud pink pinstripe at the bottom through the rainbow, crowned by a plain poplin, button-cuffed classic collar in utterly simple, perfect white Egyptian cotton. Ibrahim knows the feel of that cotton, and that, like the 12oz wool of worsted cloths by Holland & Sherry – it is both balm and armour.

Ibrahim’s steps slowed, as he passed these storefronts. And the bottle of vodka sloshed softly in his trenchcoat’s poacher’s pocket. His wallet – Swaine Adeney Brigg, pigskin and bridle – was in the other pocket but he’d forgotten his briefcase, left it under his desk when he’d risen and walked out of the gently buzzing, late morning, post-aborted-meeting offices of the Royal London. He’d closed his browser window and simply left the office. Walked out. The YouTube video he’d watched had been uploaded, with maybe thirty other videos seemingly completely unrelated other than by the Syrian civil war, none later than a year ago, by a SyrianSmurf19. When, presumably, SyrianSmurf19 was killed. WARNING: GRAPHIC. There were forty seconds of Assad soldiers dancing to a flute in a barracks somewhere. There was mobile phone footage of a blurred shape moving against a piece of concrete in the middle of a street that the caption revealed was: ‘#Damascus #Syria l Woman Thrown in the St After #Assad Shabeeha Rape Her, and Then Snipers & Tanks Take Shots’. Another: ‘#Damascus #Syria #Assad Shabiha Round Up Males for Torture, Execution & Make Man Eat His Hair’. Uncaptioned, four men with guns turn another four men without guns into floppy meat and drop them into an oubliette in the middle of a dusty void. A bloody roomful of naked bound men are pointlessly kicked in the smalls of their backs, by the bruising already rendered camouflage, by the same dancing soldiers. A dusty severed foot posed in rubble. And then two-thirds down there was a thumbnail of the familiar view from his sister-in-law’s first-floor bedroom balcony over the couple of dozen feet of tended garden, forget-me-nots and green beans, to the eight-foot security wall.

It was her cousin’s country house in al-Tal where he’d hidden them. The upload date was two years ago. He could see his youngest daughter’s topknotted ponytail at the bottom of the frame. He’d put on his headphones. The Royal London office murmured about him. He could hear his sister-in-law holding the camera saying oh, no, no, please don’t let them. He could hear his elder daughter crying in confusion. No no no no no. He could see the video had been lifted from the camera Sahlah had been given for Christmas and had been cut by someone to show only this: the truck pulls up full of soldiers and plain clothes shabiha (he’d translated that as ‘apparitions’ in one of his early guest editorial blogs) in the alley beyond the security wall and the lead shabiha jumps down from the tray and quickly shins up the wall, not even looking up to the women and the girls in the window filming him, as if he knows exactly what and who is up there where the linen curtain in shot billows out and in, a bright blue sky beyond. The shabiha drops down into the garden and unlocks the big wooden door to the street and in the squad of soldiers comes, into the garden, to the house. The video shakes and shivers. The caption is not to be remembered.

Ibrahim caught his own reflection in the window to Hilditch & Key. Their navy blue; the font sublime. The finest shirtmakers in the world. Beyond him the 1 p.m. sun shone for an effervescent instant goldly down Jermyn Street on its afternoon decline, having barely, it seemed, breathed the day. He could see his dark outline in the sober navy Burberry trench. The rest of him was filled with bright yellow ties, formal wingtip shirts, cotton pyjamas too.




The homeless like Jermyn Street and its wealthy street traffic, and they don’t seem to get moved along. Many years ago Lady Diana used to visit Turnbull and Asser, and the staff would close the doors for her to shop. Dodi Fayed was a director of the company, and she first met him there when buying pyjamas for her young boys. Ibrahim had once asked Brian, the old branch manager, about the princess – Brian was just an assistant, a young man of twenty, lurking in the background then. ‘Oh, we did look forward to it,’ he said. ‘A Diana day was a good day.’ Ibrahim cannot quite help himself, usually – he prefers to deal with the English help when he shops. Too many stores were hiring presentable but semiliterate immigrants who didn’t – couldn’t – know the product; what it meant. Often knew far less than the doctor himself.

About the Oxfords in the crosshatched Russian reindeer leather at New & Lingwood, for example – how in 1974 bundles of the leather hides were found intact and perfectly preserved in the mud and ribs of the Danish two-master Catharina von Flensburg, sunk in Plymouth Sound in 1786. And subsequently sold off in tiny batches to London’s best shoemakers and leather workers. ‘The Russia reindeer.’ Marvellously supple and idiosyncratic and overwhelmingly expensive. Why Cordings covert coats were never on sale. (Whyever? They sell no matter what the price.) The limited shirtings and sizings in the slimfit Hilditch and why they had no gussets. Or who were flippant, rude, their English offensive to the ear. Or prematurely blank, brutalised by the money, the bastards they served, and the complexities of the class system of which they’d been incongruously placed at the bleeding edge with nothing to protect them but a pretty face.

There’d been a post-Christmas sale at Crockett & Jones and Ibrahim had dropped in to look over the racks of exquisite English shoes. The small shop was uncomfortably packed, as was per usual in the holiday sales. One of the staff was an Iranian named Henry, frazzled and on some contact high after too many hours of too many customers from too many places, too many voices, too many spiels. He was pitching the shoes to a keffiyehed Saudi, who wasn’t quite following Henry’s received pronunciation but nodding blankly as if traumatised: ‘The Hand Grade range are our finest range of shoes, sir,’ Henry said, ‘and utilize the finest calf leather with channelled, oak-bark tanned soles. The shoes are Goodyear welted in calf leather sourced from Italian cows who speak five languages hand-made in our Northampton factory, the ancestral home of fine English shoemaking,’ and Ibrahim looked up slowly at that and caught Henry’s eye and the handsome young Iranian saw him and winked. Ibrahim nodded back – they all knew him there – but never again darkened their door when Henry was visible in the soft, expensive light within. At Tricker’s the staff were all working-class men with East Midlands accents and frank, direct manners; they seemed to have come straight from the factory and that was all right. Steer clear of the smart-arse South African at Cordings, the Chinese girl at Emma Willis. Emiko Matsuda at Foster & Son was a different proposition as she was in bespoke and had the troubled eyes and underslept abstraction of a real apprentice – he recognised the look of the foundation year one doctor in her. But Ibrahim liked to be served by an Englishman. He liked a bit of English irony, English fancy, the English fantasy. And here he was, after all, was he not? In England.

Past the homeless man squatting at the end of Princes Arcade he could see inside the smaller Hilditch & Key. The Spanish girl wasn’t working in the shop today. There was no one immediately visible, and he climbed the old limestone steps and opened the shop door to its gentle tinkle of tingling bells.

‘Speah some chain, sir,’ the homeless man hissed, from his blanket. ‘Ahm ahngry. Nahfink teat.’

There had once been a great and sudden calm as one wandered in through the carousels of Pantherella and the hanging handslipped Hilditch ties, coloured seasonally to the shirting. A great calm in that wooden cave. In the very artisanal, near-rusticity they managed to bring to even the plain plastic packaging of the new season’s ready-to-wear shirts, stacked collar-to-tail in their mahogany cubbyholes. The shelving was made bespoke – for there was a sliding board that emerged at waist height for contending shirts to be laid out for the customer’s attention. Glass-fronted wooden cabinets of Hilditch handkerchiefs, scarves, boxer shorts, pocket squares.

There was Alan at the counter – not the anxious Alex Wong. Alan Thomas. His roundness, his rotundness elevated to a virtue by a double-cuffed Hilditch shirt in bold blue Bengal stripes and a solid pink silk tie, with a pair of Albert Thurston suspenders in Brigade of Guards wine-stripe boxcloth holding up a pair of plain gray flannels. A pale, giggly sort of man with a bobbing head, anxious to please; thusly dressed he might have been an older banker or eccentric backbencher. He was in fact incredibly solicitous, and incredibly efficient and surprisingly witty, and Ibrahim was usually pleased to see him.

‘Good afternoon, sir,’ Alan said, and he nodded wobblingly. He seemed to both reach out to the customer and to simultaneously recoil in self-reflexive horror at having had to do so, and the possibility of intrusion or offence.

‘Good afternoon, Alan,’ Ibrahim said.

The anonymity, the English game, always forever shattered in that accent.

He went to the shelves of slimfits in his collar size.

Alan wobbled behind the counter slightly, consulting an invoice. Leaving wide the opening for Ibrahim to indicate his needs. Ibrahim stood in front of the cubbyholes of new season’s shirtings, barely looking. He raised his chin and Alan, thus signalled, came silently from behind the gigantic ancient Victorian cash register made of piebald brass and wood gone honey with age. Would he remember Ibrahim’s name from the made-to-measure ledger? This had been an important thing to him, years and lives ago.

‘Something for work, or something for the weekend, sir?’ Alan said, and Ibrahim turned – Alan smiled at his little cliché and seemed so vulnerable Ibrahim mechanically smiled back.

‘Some shirts please, Alan,’ Ibrahim said as he might have normally when they might both have enjoyed the small moment.

‘Certainly, sir. If you’ll just allow me to check your measurements again – ‘ That careful again: even if he’d forgotten him from his last bespoke order he’d slipped away from the potential offense.

‘Of course,’ Ibrahim said, a touch too roughly.

Alan took his measurements in seconds: collar size, chest size, waist, and nape of the neck to base of the thumb down the arm bent at the elbow. ‘Sir’s lost weight,’ he said with a faint, gently deniable edge of approval.

It was once a marvellous game, and a pleasure to be a player. Taste like asphalt, ass, felt in his mouth.

‘Give me,’ Ibrahim suddenly said, almost croaking, ‘one each of the new fabrics in my size. I don’t need them … adjusted. Socks, a selection of the Pantherellas, in 9. That tie –’ he pointed – ‘five plain white pocket squares in the handrolled silk, a pair of – a pair of the navy gingham pyjamas in medium, and a gown in royal blue in medium, and that – that –’ he looked ‘– scarf too.’

‘Yes, sir,’ Alan said immediately and unhesitatingly, ‘if you’ll just bear with me a moment –’

‘How long will it take?’ Ibrahim said, and he was sweating.

‘Not too long at all, sir. If sir would like to take a seat –’

Alan, desperately trying to understand what was going on, indicating the ancient wooden occasional chair by the narrow stairs up to the workshop, trying very hard not to compound the inexplicable offense, when he said seat spat a fat bubble of spittle from his lip.

A cell of sputum, it lofted from him, large enough to heft a cargo of the shirt salesman’s spit but also to fly forth, describing a long, lazy, flat parabola, floating almost, in some uncanny and exquisite balance of glistening saliva and captured breath within rendering its flight in near slow motion between them. Floating, flying slowly, languidly, to land and expire in spit and tiny spatter on the blue gabardine of the trenchcoat at Ibrahim’s chest.

Both men looked at each other for a very long moment. Alan’s trembling smile had gone. His hand was still extended, indicating the chair.

The doorbell tinkled. A young woman entered. She looked down at the carousel of socks. Then up at the frozen pair of well-dressed men by the shelves of shirts.

Ibrahim turned his face away. ‘Will come back,’ he croaked thickly. He cleared his throat. ‘I will come back.’

‘Of course, sir,’ said Alan. ‘Of course, sir.’

It being far better not to acknowledge the thing had happened at all, of course.




He took the Northern Line from Leicester Square around half-past three in the afternoon with a pair of Edward Green oxfords in oxblood cordovan packaged in individual shoe bags, then wrapped in tissue, in a shoebox, in a carry bag, plus four New & Lingwood shirts, also in a carrybag and wrapped in tissue, and a pair of Turnbull & Asser pyjamas made in England using Italian cloth woven from Egyptian cotton, in an embroidered cotton bag in yet another carry bag, and a thousand-pound Cordings mackintosh. In a carry bag.

Around Mornington Crescent he rose to stand by the Tube doors, leaving the New & Lingwood bag on the seat. An obese and unshaven young white man in a pilled and stained gray marl Adidas tracksuit across the aisle eyed the tall Syrian doctor in the dark coat. His lightless gray eyes; the other bags of shopping hanging from his hand. Camden Town. At Belsize Park the train deep underground. The train slowed, came to a halt. The doors opened. Ibrahim stepped off and the obese man, with an otherwise complete lack of movement, tensed his jowls and shouted, violently, ‘Oi.’

Several passengers visibly flinched. Ibrahim, on the platform, turned around.

Shopping, mate,’ the man said. He leaned – only his head – to indicate the bag left behind. Ibrahim just looked at him, his face empty.

‘Your shopping, mate,’ the man shouted, as if for the benefit of speakers of a second language. The train departure warning sounded. Ibrahim didn’t move. The obese man leapt up, uncannily fast, snatched the bag handles, and with a wide swing of his arm threw the bag viciously fast out through the doors of the train. The bag slapped out on the platform and hissed across the tile in a flat spin. The doors closed.

‘Wa-hey,’ said a young man waiting for the next train.

The bag lay there. Ibrahim just turned away, toward the elevators, and the carriage’s and platform’s collected grins, of those who saw him go, turned to headshakes and laughter, as the train pulled away.

What a loony, they seemed to say.




Into premature darkness down past the high brick Georgians of Downside Crescent, in a light rain falling. Points of brake lights bleeding lines of rippling red down the road at him, roving over his face. Home. At the Isokon Dr al-Rayess laid the bags out on his neatly made bed. He lifted the bottle of vodka from his coat pocket and set it out on the coffee table in front of his TV. He took a glass from his emaciated kitchen, shed his coat, loosened his tie. He cued up The Cabin in the Woods and set it playing, sat down on the sofa. Out through the curtained windows the streetlamp played through the dissembling leaves of the Isokon’s streetside maple in the first breezes of the storm. He opened the bottle, poured a generous measure of the vodka neat, and left it on the table. He looked at the screen and there was the American star of The West Wing TV series Bradley Whitford talking to another older bureacrat about Whitford’s wife – she had childproofed their home before they’d even managed to get pregnant. They are the artificers, the technicians, the arrangers of a narrative that plays out in the film’s second strand: the slow torture and sacrifice of a clique of American teens in genre cliché, in order, the film asserts, to propitiate some bloodhungry gods of violence. The nuancing of the stereotypes of the American children being the refinement of the film as a genre piece that is then undone.

Slam, a very loud musical sting, a smash cut and the title card:The Cabin in the Woods. Ibrahim held up the glass of his very first vodka. Turning it slightly. Held it to the light. The curve of the meniscus. The slow roll. He sniffed it. He drank down half. He did not react. Looking at the television. The introductory scenes of the five young Americans who were to die. He held his breath a while, then exhaled. The light of the streetlamp a pale camouflage rippling on his bare walls. He drank down the rest of the glass and poured another.

He opened his laptop. Killed Chrome. Opened Firefox. As the artificers’ plans and role in the teenagers’ demise were steadily made more and more apparent, the young Americans drove out to the cabin in the woods. He opened up Quadrivium, and opened up a new Royal London visiting editor blog. Each editor has one, a semi-official blog, dedicated to the obiter dicta (Latin: ‘said in passing’; pleasingly pronounced: oh, bitter) of their primary work in editorial. The offcuts of opinion and experience in the field, and their own business, largely – and published online in the RLJM directly via Quadrivium, and on trust. He drank another full glass, gasping slightly at the end of this one. On screen – the harbinger. The one who warns, to no avail, the doomed children, was being made fun of by the artificers, who had him on speakerphone. Ibrahim in the cold light of the TV and the streetlamp, his face a turning – the smudging and the dragging down one side of – is it pain? Or the taste of vodka, his first. Gray light on his gray eyes. He typed. Time passed. A zombie sawed the head off a young girl.




An hour later, the guest editor blog on the conflicts of interest of the authors of the paper on Turkish healthcare written and irrevocably and irretrievably posted live to the Royal London site, Ibrahim had drunk five glasses of the good vodka. Dressed in his English clothes. The Royal London: impact factor: intimidating. 150,000 unique visitors monthly, from Mumbai to Whitehall. He was watching the last remaining American boy and girl descend by elevator into the fundament of the story, a labyrinth of monsters’ cells where they wait beneath the world to be released. All those helpless to do the damage they do. The spider. The hellraiser. The ghost. The valkyrie. The young ballerina with a face made of teeth. He’d first seen this film in London six months out of Turkey, where he’d worked at the refugee camp just across the border, treating the freshly wounded as they arrived from Syrian territory – as well as dealing with the refugee camp’s signature Leishmaniasis, exposure, basic trauma, malnourishment, and STIs from the rapes that were happening seemingly without cease. After he’d fled Damascus. Where he remembered the secretary of his department at Al Mouwasat hospital coming to his office – crying – to tell him there were ‘government officers’ here for him. Telling her it was fine, soothing her, a gentle squeeze of her shoulder, hey it’s all right, and managing to maintain some dignity and not make any futile protests or falters as he allowed himself to be taken by taxi to the Air Force Intelligence building where they had his wife in the cells and he was first beaten severely then forced to watch what they did to her. Knowing the girls were away and safe. The way Ibrahim al-Rayess had taken the punches, had cried, had told them to leave her, had told them that she was his crown, had not prevented anything that subsequently happened to her, but to gut him and make him guilty and to film him all the while was enough to convince them he was innocent. And when he was released he went from there faithfully back to the hospital to treat those more needful than he until such a time as they were no longer watching him as closely as before and he could flee Damascus for al-Tal to see Sahlah and Maliha for the last time. Where he said goodbye and held them and told them – told them – they were safest here with his sister-in-law at her cousin’s house and not to leave, and he travelled incognito north, heading for the border. Was dragooned into a roaming mixed brigade of Libyans and Iraqis and kept there operating for a week on casualties out of the storm in Idlib, and stayed on another month till the retreat, when they all left, north. Crossed the border into Turkey on a wet November afternoon to offer his help in the refugee camp of flooded UN tents. Writing emails in the evenings to the UK and US universities, hospitals and Royal Colleges. Informed by the Syrian Observatory for Human Rights that his daughters had been abducted and killed the previous September, that his life was in imminent danger. Took the offered short-term post at the Royal London Journal of Medicine a week later. Where each day in the mauve carpeted offices of editorial he looked for his children on YouTube.

Monsters burst forth from the building’s elevators, helpless to do anything but maim and kill in their particular and idiosyncratic ways anyone they could touch in a near autistic abandon. The first time he saw the scene and the last time ever – not saw the scene; was simply present – he’d cried, on this couch. Scratching at his cheeks and eyes.

Ibrahim al-Rayess in his Huntsman suit and oxblood Edward Greens stood in the flickerlit room drinking his sixth glass of vodka, visibly swaying. He’d posted a blog asserting the authors of the Turkish piece just published – among whom were high-level individuals at the WHO and IMF and the International Society for Infectious Diseases – were stone cold liars elbow deep in the pockets of their government and of several named large corporations, and had misled him, the journal, his tech editor and the peer reviewers with crippled data and selective citations and outright lies about the ongoing privatisation of Turkish healthcare to further the country’s EU bid, still hung up on immigration, infrastructure and basic human rights, and line those corporate pockets now and for decades into the future. The blog was live. It was not retrievable, as per Royal London policy. We do not correct our texts once they are online. 42° Below. He waved the glass round gently, swinging the last inch of vodka in the foot of the glass. Watching the viscosity. The rise and hang. Needle, line, IV bag and a thousand-milligram bottle of anaesthesia-grade propofol laid out neatly upon the coffee table. ‘Milk of amnesia,’ the anaesthetists call it. Royal London policy is to post errata. We do not delete. Anything published under our banner is there forever.


Excepted from a new novel entitled The Royal Free

Crossing Borders