Excerpt from The Betrayal by Helen Dunmore, plus links to reviews, author biography & more

How the man is abasing himself. He will hate Andrei for it afterwards, once all this is over. No one makes a better enemy than a man who has had to beg for your help.

But perhaps Russov really has missed something. He's thorough, but he goes by the book. It's also just conceivable that he's aware of this - that he's not as self-satisfied as he always seems... In which case he might be doing exactly what ought to be done in such a case: seeking a second opinion.

'You still haven't told me anything about this child,' says Andrei. Another throat-clearing. Russov's hand strays to his jacket pocket, where he keeps his cigarettes, and then falls to his side. His eyes stare into Andrei's, but remain opaque.

'My thinking was that it would be best for you to come to the case quite fresh.'

A rising breeze makes the lime trees shiver all over. Hold back, thinks Andrei. Don't commit yourself. Not instantly, like this. He recognizes it already as one of those moments that has the power to change everything. Perhaps he won't be able to avoid it. If you put everything else aside, there's still a sick child here, and he needs the best possible treatment.

What if Russov gets it wrong again?

But Andrei has Anna to think of, and Kolya.

Their faces rise up in his mind, oblivious. There's a knot of tiny lines on Anna's forehead, but when she looks up and sees him that knot will clear. And there is Kolya, tall and thin, narrow-shouldered because he hasn't grown into his height yet. Kolya frowning at his homework, then suddenly jumping up and crashing across the living room because he's spotted a mouse under the table. Or claims he's spotted one - Kolya wants a cat, and Anna isn't keen.

Kolya, lunging between child and man, and out of step with both. Andrei's heart beats hard. Whatever happens, these two mustn't be touched.

But Russov didn't want any of this, either. He's just a trapped, ordinary man. Reasonably competent, reasonably conscientious. And now quite reasonably afraid.

'So, you'll see the boy?' asks Russov.

'Have you got the case notes with you?'

His colleague hesitates.

'It was just a preliminary examination, you understand. I've done no tests. There's been no possibility of making any sort of diagnosis. The boy was brought in last night with certain symptoms, that's all. By private ambulance,' he adds, as if this hopelessly irrelevant detail will make up for all the blanks.

In a flash, Andrei does understand. The bare minimum has been put into writing.

'But you must have ordered tests. You must have thought about what would be needed.'

'I don't want to prejudice your own examination.'

Andrei feels himself recoil. Even here, out in the courtyard where surely nobody can be listening, his so-called colleague won't talk. He's studied hard all right, in the unwritten subject that runs through every other course of study. Keep your tongue and your hands still, unless you are absolutely sure that it's safe to move them. Don't take risks. Don't stand out. Be anonymous and average; keep in step.

'It was Doctor B. I. Russov, of course, who made the initial examination and first suggested the diagnosis that was later confirmed...' He'll do anything to avoid that. Much better for Russov to be able to say: 'I asked a colleague - a first-rate general paediatric physician and one of our finest diagnosticians - if he would examine the patient. Dr Alekseyev has a particular interest in juvenile arthritic disease, and given that my own caseload does not permit me to take the special interest in this case which it requires, it seemed the best course of action to hand over the case as soon as possible. Consistency of care, you understand, is of the utmost importance.'

The Betrayal © 2010 by Helen Dunmore; reprinted with the permission of the publisher, Grove/Atlantic, Inc.