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One night – a strategic night – Rick was kissing his way from my shoulder down my arm when he paused. I could feel his lips hovering above the crease in my arm. I waited but he didn't continue. ‘Um, Ella,’ he said at last. I opened my eyes. He was staring at the crease; as my eyes followed his gaze my arm jerked away from him.

‘Oh,’ I said simply. I studied the circle of red, scaly skin.

‘What is it?’

‘Psoriasis. I had it once, when I was thirteen. When Mom and Dad divorced.’

Rick looked at it, then leaned over and kissed my eyelids shut.

When I opened my eyes again I just caught a flicker of distaste cross his face before he controlled himself and smiled at me.

Over the next week I watched helplessly as the original patch widened, then jumped to my other arm and both elbows. It would reach my ankles and calves soon.

At Rick's insistence I went to see a doctor. He was young and brusque, lacking the patter American doctors use to soften up their patients. I had to concentrate hard on his rapid French.

‘You have had this before?’ he asked as he studied my arms.

‘Yes, when I was young.’

‘But not since?’

‘No.’

‘How long have you been in France?’

‘Six weeks.’

‘And you will stay?’

‘Yes, for a few years. My husband has a job with an architectural firm in Toulouse.’

‘You have children?’

‘No. Not yet.’ I turned red. Pull yourself together, Ella, I thought. You're twenty-eight years old, you don't have to be embarrassed about sex anymore.

‘And you work now?’

‘No. That is, I did, in the United States. I was a midwife.’

He raised his eyebrows. ‘Une sage-femme? Do you want to practise in France?’

‘I would like to work but I haven't been able to get a work permit yet. Also the medical system is different here, so I have to pass an exam before I can practise. So now I study French and this autumn I begin a course for midwives in Toulouse to study for the exam.’

‘You look tired.’ He changed the subject abruptly, as if to suggest I was wasting his time by talking about my career.

‘I've been having nightmares, but -’ I stopped. I didn't want to get into this with him.

‘You are unhappy, Madame Turner?’ he asked more gently.

‘No, no, not unhappy,’ I replied uncertainly. Sometimes it's hard to tell when I'm so tired, I added to myself.

‘You know psoriasis appears sometimes when you do not get enough sleep.’

I nodded. So much for psychological analysis.

The doctor prescribed cortisone cream, suppositories to bring down the swelling and sleeping pills in case the itching kept me awake, then told me to come back in a month. As I was leaving he added, ‘And come to see me when you are pregnant. I am also an obstétricien.’

I blushed again.

My infatuation with Lisle-sur-Tarn ended not long after I stopped sleeping.

It was a beautiful, peaceful town, moving at a pace I knew was healthier than what I'd been used to in the States, and the quality of life was undeniably better. The produce at the Saturday market in the square, the meat at the boucherie, the bread at the boulangerie – all tasted wonderful to someone brought up on bland supermarket products. In Lisle lunch was still the biggest meal of the day, children ran freely with no fear of strangers or cars, and there was time for small talk. People were never in too much of a hurry to stop and chat with everyone.

With everyone but me, that is. As far as I knew, Rick and I were the only foreigners in town. We were treated that way. Conversations stopped when I entered stores, and when resumed I was sure the subject had been changed to something innocuous. People were polite to me, but after several weeks I still felt I hadn't had a real conversation with anyone. I made a point of saying hello to people I recognized, and they said hello back, but no one said hello to me first or stopped to talk to me. I tried to follow Madame Sentier's advice about talking as much as I could, but I was given so little encouragement that my thoughts dried up. Only when a transaction took place, when I was buying things or asking where something was, did the townspeople spare a few words for me.

One morning I was sitting in a café on the square, drinking coffee and reading the paper. Several other people were scattered among the tables. The proprietor passed among us, chatting and joking, handing out candy to the children. I had been there a few times; he and I were on nodding terms now but had not progressed to conversation. Give that about ten years, I thought sourly.

A few tables away, a woman younger than me sat with a five-month-old baby who was strapped into a car seat set on a chair, shaking a rattle. The woman wore tight jeans and had an irritating laugh. She soon got up and went inside. The baby didn't seem to notice she'd gone.

I concentrated on Le Monde. I was forcing myself to read the entire front page before I was allowed to touch the International Herald Tribune. It was like wading through mud: not just because of the language, but also all the names I didn't recognize, the political situations I knew nothing about. Even when I understood a story I wasn't necessarily interested in it.

I was ploughing through a piece about an imminent postal strike – a phenomenon I wasn't accustomed to in the States – when I heard a strange noise, or rather, silence. I looked up. The baby had stopped shaking the rattle and let it drop into his lap. His face began to crumple like a napkin being scrunched after a meal. Right, here comes the crying, I thought. I glanced into the café: his mother was leaning against the bar, talking on the phone and playing idly with a coaster.

The baby didn't cry: his face grew redder and redder, as if he were trying to but couldn't. Then he turned purple and blue in quick succession.

I jumped up, my chair falling backwards with a bang. ‘He's choking!’ I shouted.

I was only ten feet away but by the time I reached him a ring of customers had formed around him. A man was crouched in front of the baby, patting his blue cheeks. I tried to squeeze through but the proprietor, his back to me, kept stepping in front of me.

‘Hang on, he's choking!’ I cried. I was facing a wall of shoulders. I ran to the other side of the circle. ‘I can help him!’

The people I was pushing between looked at me, their faces hard and cold.

‘You have to pound him on the back, he's not getting any air.’

I stopped. I had been speaking in English.

The mother appeared, melting through the barricade of people. She began frantically hitting the baby's back, too hard, I thought. Everyone stood watching her in an eerie silence. I was wondering how to say ‘Heimlich manoeuvre’ in French when the baby suddenly coughed and a red candy lozenge shot out of his mouth. He gasped for air, then began to cry, his face going bright red again.

There was a collective sigh and the ring of people broke up. I caught the proprietor's eye; he looked at me coolly. I opened my mouth to say something, but he turned away, picked up his tray and went inside. I gathered up my newspapers and left without paying.

After that I felt uncomfortable in town. I avoided the café and the woman with her baby. I found it hard to look people in the eye. My French became less confident and my accent deteriorated.

Madame Sentier noticed immediately. ‘But what has happened?’ she asked. ‘You were progressing so well!’

An image of a ring of shoulders came to mind. I said nothing.

One day at the boulangerie I heard the woman ahead of me say she was on her way to ‘la bibliothèque ’, gesturing as if it were just around the corner. Madame handed her a plastic-covered book; it was a cheap romance. I bought my baguettes and quiches in a rush, cutting short my awkward ritual conversation with Madame. I ducked out and trailed the other woman as she made her daily purchases around the square. She stopped to say hello to several people and argued with all the storekeepers while I sat on a bench in the square and kept an eye on her over my newspaper. She made stops on three sides of the square before abruptly entering the town hall on the last side. I folded my paper and raced after her, then found myself having to hover in the lobby examining wedding banns and planning permission notices while she laboured up a long flight of stairs. I took the stairs two at a time and slipped through the door after her. Shutting it behind me, I turned to face the first place in town that felt familiar.