There was an announcement: Lettuce angel men. We aren’t countering some tab bulence. Please retahn to yah seat at thees time and fasten yah seat belt. Satsuki had been letting her mind wander, and so it took her a while to decipher the Thai steward’s shaky Japanese.

She was hot and sweating. It was like a steam bath, her whole body aflame, her nylons and bra so uncomfortable she wanted to fling everything off and set herself free. She craned her neck to see the other business class passengers. No, she was obviously the only one suffering from the heat. They were all curled up, asleep, blankets around their shoulders to counter the air conditioning. It must be another hot flush. Satsuki bit her lip and decided to concentrate on something else to forget about the heat. She opened her book and tried to read from where she had left off, but forgetting was out of the question. This was no ordinary heat. And they wouldn’t be touching down in Bangkok for hours yet. She asked a passing stewardess for some water and, finding the pill case in her pocketbook, she washed down a dose of the hormones she had forgotten to take.

Menopause: it had to be the gods’ ironic warning to (or just plain nasty trick on) humanity for having artificially extended the lifespan, she told herself for the nth time. A mere hundred years ago, the average life span was less than fifty, and any woman who went on living twenty or thirty years past the end of her periods was an oddity. The difficulty of continuing to live with tissues for which the ovaries or the thyroid had ceased to secrete the normal supply of hormones; the possible relationship between the post-menopausal decrease in oestrogen levels and the incidence of Alzheimer’s disease: these were not questions worth troubling one’s mind over. Of far more relevance to the largest part of humanity was the challenge of simply obtaining enough food to eat each day. Had the advancement of medicine, then, done nothing more than to expose, subdivide, and further complicate the problems faced by the human species?

Soon another announcement came over the PR system. In English this time. If there is a doctor on board, please identify yourself to one of the cabin attendants.

A passenger must have been taken sick. Satsuki thought for a moment of stepping forward, but quickly changed her mind. On the two other occasions when she had done such a thing, she had merely had run-ins with practising physicians who happened to be on the plane. Each of those men had seemed to possess both the poise of a seasoned general commanding troops on the front line and the vision to recognize at a glance that Satsuki was a professional pathologist without combat experience. ‘That’s all right, Doctor,’ she had been told with a cool smile, ‘I can handle this by myself. You just take it easy.’ She had mumbled a stupid excuse and gone back to her seat to watch the rest of some ridiculous movie.

Still, she thought, I might just be the only doctor on this plane. And it might even be the case that the patient is someone with a major problem involving the thyroidal immune system. If that is the case — and the likelihood of such a situation did not seem high — then even I might be of some use. She took a breath and pressed the button for a cabin attendant.

The World Thyroid Conference was a four-day event at the Bangkok Marriott. Actually, it was more like a worldwide family reunion than a conference. All the participants were thyroid specialists, and they all knew each other or were quickly introduced. It was a small world. There would be talks and panel discussions during the day and private parties at night. Friends would get together to renew old ties, drink Australian wine, share thyroid stories, whisper gossip, exchange the latest news on their professional positions, tell dirty doctor jokes, and sing ‘Surfer Girl’ at karaoke bars.

In Bangkok, Satsuki stayed mainly with her Detroit friends. Those were the ones she felt most comfortable with. She had worked at the University Hospital in Detroit for close to ten years, doing research on the immune function of the thyroid gland. Eventually she had had a falling out with her securities analyst husband, whose dependency on alcohol had grown worse year by year, in addition to which he had become involved with another woman — someone Satsuki knew well. They separated, and a bitter struggle involving lawyers had gone on for a full year. ‘The thing that finally did it for me,’ her husband claimed, ‘was that you didn’t want to have children.’

They had finally concluded their divorce settlement three years ago. A few months later, someone smashed the headlights of her Honda Accord in the hospital parking lot and wrote JAP CAR on the hood in white letters. She called the police. The big, black policeman filled out the damage report and then said to her, ‘Lady, this is Detroit. Next time buy a Ford Taurus.’

What with one thing and another, Satsuki became fed up with living in America and decided to go back to Japan. She found a position at a university hospital in Tokyo. ‘You can’t do that,’ said a member of her research team from India. ‘All our years of research are just about to bear fruit. We could be nominated for a Nobel Prize — it’s not impossible.’ He pleaded with her to stay, but Satsuki’s mind was made up. Something inside her had snapped.

She stayed on alone at the hotel in Bangkok after the conference ended. ‘I worked out a vacation for myself after this,’ she told her friends. ‘I’m going to a resort near here for a complete rest — a whole week of nothing but reading, swimming and drinking nice, cold cocktails by the pool.’

‘That’s great,’ they said. ‘Everybody needs a breather once in a while. It’s good for your thyroid, too!’ With handshakes and hugs and promises to get together again, Satsuki said goodbye to all her friends.

Early next morning, the limousine pulled up to the hotel entrance for her as planned. It was an old navy-blue Mercedes as perfect and polished as a jewel and far more beautiful than a new car. It looked like an object that had slipped whole from someone’s other-worldly fantasy. A sparely built Thai man probably in his early sixties was to be her driver and guide. He wore a heavily starched white short-sleeved shirt, a black silk necktie and dark sunglasses. His face was tanned, his neck long and slender. Presenting himself to Satsuki, he did not shake her hand but, instead, brought his own hands together and gave a slight, rather Japanese, bow.

‘Please call me Nimit. I will have the honour to be your companion for the coming week.’

It was not clear whether ‘Nimit’ was the man’s first name or last. He was, in any case, ‘Nimit’, and he told her this in courteous, easy-to-understand English devoid of either American casualness or British affectation. It had, in fact, no perceptible accent. Satsuki had heard English spoken this way before someplace, but she couldn’t remember where.

‘The honour is mine,’ said Satsuki.

Together, Satsuki and Nimit passed through Bangkok’s vulgar, noisy, pollution-ridden streets. The traffic barely moved, people cursed each other, and the sound of car horns tore through the atmosphere like an air raid signal. In addition to which, there were elephants walking down the street — and not just one or two of them. What were elephants doing in a city like this? she asked Nimit.

‘Their owners bring them from the country,’ he explained. ‘They used to use them in logging operations, but there was not enough work for them to survive that way. They brought their animals to the city to make money doing tricks for foreign tourists. Now there are far too many elephants here, and that makes things very difficult for the city people. Sometimes an elephant will panic and run amok. Just the other day, a great many automobiles were damaged that way. The police try to put a stop to it, of course, but they cannot confiscate the elephants from their keepers. There would be no place to put them if they did, and the cost of feeding them would be enormous. All they can do is leave them alone.’

The car eventually emerged from the city, entered an expressway, and headed straight north. Nimit took a cassette from the glove compartment and slipped it into the stereo, setting the volume low. It was jazz — a tune that Satsuki recognized with some feeling.

‘Do you mind turning the volume up?’ she asked.

‘Yes, Doctor, of course,’ said Nimit, making it louder. The tune was ‘I Can’t Get Started’, in exactly the same performance she had often heard in the old days.

‘Howard McGhee on trumpet, Lester Young on tenor,’ she murmured, as if to herself. ‘JATP.’

Nimit looked at her in the rear-view mirror. ‘Very impressive, Doctor,’ he said. ‘Do you like jazz?’

‘My father was crazy about it,’ she said. ‘He played records for me when I was a little girl, the same ones over and over, and he would have me memorize the performers. If I got them right, he’d give me candy. I still remember most of them. But just the old stuff. I don’t know anything about the newer jazz musicians. Lionel Hampton, Bud Powell, Earl Hines, Harry Edison, Buck Clayton . . . ‘

‘The old jazz is all I ever listen to as well,’ said Nimit. ‘What was your father’s profession?’

‘He was a doctor, too,’ she said. ‘A paediatrician. He died just after I entered high school.’

‘I am sorry to hear that,’ said Nimit. ‘Do you still listen to jazz?’

Satsuki shook her head. ‘Not really. Not for years. My husband hated jazz. All he liked was opera. We had a great stereo in the house, but he’d give me a sour look if I ever tried putting on anything besides opera. Opera lovers may be the narrowest people in the world. I left my husband, though. I don’t think I’d mind if I never heard another opera again for as long as I live.’

Nimit gave her a little nod but said nothing. Hands on the Mercedes steering wheel, he stared silently at the road ahead. His technique with the steering wheel was almost beautiful, the way he would move his hands to exactly the same points on the wheel at exactly the same angle. Now Errol Garner was playing ‘I’ll Remember April’, which itself brought back memories for Satsuki. Garner’s Concert by the Sea had been one of her father’s favourite discs. She closed her eyes and let herself sink into old memories. Everything had gone well for her until her father died of cancer. Everything — without exception. But then the stage turned suddenly dark, and by the time she noticed that her father had vanished forever from her life, everything was headed in the wrong direction. It was as if a whole new story had started with a whole new plot. Not a month had passed after her father’s death when her mother sold the big stereo along with her father’s jazz collection.

‘Where are you from in Japan, Doctor, if you don’t mind my asking?’

‘I’m from Kyoto,’ answered Satsuki. ‘I only lived there until I was eighteen, though, and I’ve hardly ever been back.’

‘Isn’t Kyoto right next to Kobe?’

‘It’s not far, but it’s not “right next to” Kobe. At least the earthquake seems not to have caused too much damage there.’

Nimit switched to the overtaking lane, slipping past a number of trucks loaded with livestock, then eased back into the cruising lane.

‘I’m glad to hear it,’ said Nimit. ‘A lot of people died in the earthquake last month. I saw it on the news. It was very sad. Tell me, Doctor, did you know anyone living in Kobe?’

‘No, no one. I don’t think anyone I know lives in Kobe,’ she said. But this was not the truth. He lived in Kobe.

Nimit stayed silent for a while. Then, bending his neck slightly in her direction, he said to Satsuki, ‘Strange and mysterious things, though, aren’t they — earthquakes? We take it for granted that the earth beneath our feet is hard and immobile. We even talk about people being “down to earth” or having their feet firmly planted on the ground. But suddenly one day we see that it isn’t true. The earth, the boulders, that are supposed to be so solid, all of a sudden turn as mushy as liquid. I heard it on the TV news: “liquefication”, they called it, I think. Fortunately we hardly ever have major earthquakes here in Thailand.’

Cradled in the rear seat, Satsuki closed her eyes and concentrated on Errol Garner’s playing. Yes, she thought, he lived in Kobe. I hope he was crushed to death by something big and heavy. Or swallowed up by the liquefied earth. It’s everything I’ve wanted for him all these years.