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The document discusses the book 'Computerized Systems for Diagnosis and Treatment of COVID-19' edited by Joao Alexandre Lobo Marques and Simon James Fong, which covers advancements, challenges, and trends in technology related to COVID-19. It highlights the development of new medical technologies, the challenges faced in implementing computerized diagnostic systems, and the need for ongoing research in the context of the pandemic. The book aims to provide insights into the impact of COVID-19 on healthcare technology and the importance of computerized systems in managing the disease.

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Complete Download Computerized Systems For Diagnosis and Treatment of Covid 19 1st Edition Joao Alexandre Lobo Marques PDF All Chapters

The document discusses the book 'Computerized Systems for Diagnosis and Treatment of COVID-19' edited by Joao Alexandre Lobo Marques and Simon James Fong, which covers advancements, challenges, and trends in technology related to COVID-19. It highlights the development of new medical technologies, the challenges faced in implementing computerized diagnostic systems, and the need for ongoing research in the context of the pandemic. The book aims to provide insights into the impact of COVID-19 on healthcare technology and the importance of computerized systems in managing the disease.

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Joao Alexandre Lobo Marques
Simon James Fong Editors

Computerized
Systems
for Diagnosis
and Treatment
of COVID-19
Computerized Systems for Diagnosis
and Treatment of COVID-19
Joao Alexandre Lobo Marques · Simon James Fong
Editors

Computerized Systems
for Diagnosis and Treatment
of COVID-19
Editors
Joao Alexandre Lobo Marques Simon James Fong
Laboratory of Applied Neurosciences Faculty of Science and Technology
University of Saint Joseph University of Macau
Macao, Macao Macao, Macao

ISBN 978-3-031-30787-4 ISBN 978-3-031-30788-1 (eBook)


https://doi.org/10.1007/978-3-031-30788-1

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse
of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or
the editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Contents

Technology Developments to Face the COVID-19 Pandemic:


Advances, Challenges, and Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Joao Alexandre Lobo Marques and Simon James Fong
Lung Segmentation of Chest X-Rays Using Unet Convolutional
Networks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Bruno Riccelli dos Santos Silva, Paulo Cesar Cortez,
Rafael Gomes Aguiar, Tulio Rodrigues Ribeiro,
Alexandre Pereira Teixeira, Francisco Nauber Bernardo Gois,
and Joao Alexandre Lobo Marques
Segmentation of CT-Scan Images Using UNet Network for Patients
Diagnosed with COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Francisco Nauber Bernardo Gois and Joao Alexandre Lobo Marques
Covid-19 Detection Based on Chest X-Ray Images Using Multiple
Transfer Learning CNN Models . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Bruno Riccelli dos Santos Silva, Paulo Cesar Cortez,
Pedro Crosara Motta, and Joao Alexandre Lobo Marques
X-Ray Machine Learning Classification with VGG-16 for Feature
Extraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Bruno Riccelli dos Santos Silva, Paulo Cesar Cortez,
Manuel Gonçalves da Silva Neto, and Joao Alexandre Lobo Marques
Classification of COVID-19 CT Scans Using Convolutional Neural
Networks and Transformers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Francisco Nauber Bernardo Gois, Joao Alexandre Lobo Marques,
and Simon James Fong
COVID-19 Classification Using CT Scans with Convolutional
Neural Networks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Pedro Crosara Motta, Paulo Cesar Cortez,
and Jao Alexandre Lobo Marques

v
vi Contents

TPOT Automated Machine Learning Approach for Multiple


Diagnostic Classification of Lung Radiography and Feature
Extraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Francisco Nauber Bernardo Gois, Joao Alexandre Lobo Marques,
and Simon James Fong
Evaluation of ECG Non-linear Features in Time-Frequency
Domain for the Discrimination of COVID-19 Severity Stages . . . . . . . . . . 137
Pedro Ribeiro, Daniel Pordeus, Laíla Zacarias, Camila Leite,
Manoel Alves Neto, Arnaldo Aires Peixoto Jr, Adriel de Oliveira,
João Paulo Madeiro, Joao Alexandre Lobo Marques,
and Pedro Miguel Rodrigues
Classification of Severity of COVID-19 Patients Based on the Heart
Rate Variability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Daniel Pordeus, Pedro Ribeiro, Laíla Zacarias, João Paulo Madeiro,
Joao Alexandre Lobo Marques, Pedro Miguel Rodrigues,
Camila Leite, Manoel Alves Neto, Arnaldo Aires Peixoto Jr,
and Adriel de Oliveira
Exploratory Data Analysis on Clinical and Emotional Parameters
of Pregnant Women with COVID-19 Symptoms . . . . . . . . . . . . . . . . . . . . . . 179
Joao Alexandre Lobo Marques, Danielle S. Macedo, Pedro Motta,
Bruno Riccelli dos Santos Silva, Francisco Herlanio Costa Carvalho,
Renata Castro Kehdi, Letícia Régia Lima Cavalcante,
Marylane da Silva Viana, Deniele Lós, and Natália Gindri Fiorenza
Technology Developments to Face
the COVID-19 Pandemic: Advances,
Challenges, and Trends

Joao Alexandre Lobo Marques and Simon James Fong

Abstract The global pandemic triggered by the Corona Virus Disease firstly
detected in 2019 (COVID-19), entered the fourth year with many unknown aspects
that need to be continuously studied by the medical and academic communities.
According to the World Health Organization (WHO), until January 2023, more than
650 million cases were officially accounted (with probably much more non tested
cases) with 6,656,601 deaths officially linked to the COVID-19 as plausible root
cause. In this Chapter, an overview of some relevant technical aspects related to
the COVID-19 pandemic is presented, divided in three parts. First, the advances
are highlighted, including the development of new technologies in different areas
such as medical devices, vaccines, and computerized system for medical support.
Second, the focus is on relevant challenges, including the discussion on how com-
puterized diagnostic supporting systems based on Artificial Intelligence are in fact
ready to effectively help on clinical processes, from the perspective of the model pro-
posed by NASA, Technology Readiness Levels (TRL). Finally, two trends are pre-
sented with increased necessity of computerized systems to deal with the Long Covid
and the interest on Precision Medicine digital tools. Analyzing these three aspects
(advances, challenges, and trends) may provide a broader understanding of the impact
of the COVID-19 pandemic on the development of Computerized Diagnostic Support
Systems.

J. A. Lobo Marques (B)


Laboratory of Applied Neurosciences, University of Saint Joseph,
Estrada Marginal da Ilha Verde, 14-17, Macao SAR, China
e-mail: [email protected]
S. J. Fong
Faculty of Science and Technology, University of Macau, Macau SAR, China
e-mail: [email protected]

© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 1


J. A. Lobo Marques and S. J. Fong (eds.), Computerized Systems for Diagnosis
and Treatment of COVID-19, https://doi.org/10.1007/978-3-031-30788-1_1
2 J. A. Lobo Marques and S. J. Fong

1 Introduction

During the last years, the global COVID-19 pandemic triggered by the Corona Virus
Disease, firstly detected in 2019, has created strong and significant impacts on man-
agement practices for public health systems, definition of health indicators, and the
development of new technologies. With an unprecedented speed in human history,
while the most devastating disease since the global alliance after the second World
War created the World Health Organization (WHO) was exponentially spreading, sci-
entific achievements and technology advances were obtained worldwide in crucial
areas to fight the pandemic, such as new vaccine development processes, low-cost
medical devices (from centrifuges to mechanical ventilators), computerized diag-
nostic systems using data from clinical laboratory analysis, medical imaging and
biosignals analysis systems.
The COVID-19 Pandemic entered through many different short-term cycles of
infections, and consequently number of deaths, in just a few years in different parts of
the world, which usually happened according to the restrictive public health measures
and the surges of new variants of the virus in different countries. Despite the better
understanding of the disease, it still presents many challenges and several unknown
aspects that need to be continuously studied by the medical/health and academic
communities. According to the World Health Organization (WHO), until January
2023, more than 650 million cases were officially accounted (with probably similar
number of even more non confirmed cases) with 6,656,601 deaths, with a current
average of 10,000 deaths per week officially linked to the COVID-19 as the most
plausible root cause.
In addition to the direct and obvious consequences to the patients’ health condi-
tions, the COVID-19 created a significant burden to the public health system in every
location, from developing countries to the most economically developed societies.
The number of necessary resources to support the exponential demand represented
a quite challenging condition, creating issues in several dimensions, such as hospital
beds, intensive care units devices, mechanical ventilators, antibiotics, or even gloves,
among many others. From the human side, the impact on the multidisciplinary staff
working on clinical premises was enormous. The professionals were under a dual
stress condition: first, the patients under extreme severe conditions and increasing
number of deaths from a disease with no treatment in many cases; and, second, the
personal risk of getting infected.
The harmful consequences of the COVID-19 in the whole world, created a global
effort to develop efficient processes and systems to cope with the new challenges
not only in the recurrent peaks, but also in a permanent way, since the disease is
recurrent and a large number of patients keep different symptoms and issues for a
long period of time, what is classified as Long COVID. It is important to notice that
during the first twelve to eighteen months, one of the main focus was to use different
computerized solutions based on epidemiological models. Since the beginning of
the pandemic, even With preliminary data, classic approaches, such as the SIR/SEIR
numerical models, were widely used [1]. With the pandemic global spread and more
Technology Developments to Face the COVID-19 Pandemic … 3

accurate data collected, including different variants of the virus, new approaches
were able to be tested [2], including nonlinear models [3] and probabilistic models
based on Monte Carlo simulation [4].
Today, despite all the efforts to automatize the diagnostic through computerized
systems, there is still a lack of practical applications working on clinical premises
and effectively improving physicians interpretation or providing diagnostic support.
The cause relies on many different aspects, such as poor integration between sci-
entific developments and industry, access to most recent technologies from many
different hospitals (especially the ones with lack of resources) and barrier to the
introduction of innovative processes, creating real constraints to the adoption of new
technologies. With that in mind, it becomes extremely necessary to comprehend the
positive impacts for the area of healthcare of adopting computerized systems for the
diagnostic and management of patients with COVID-19.
In this Chapter, a critical overview of some relevant technical aspects resulting
from the COVID-19 pandemic is presented, divided in three parts. First, the advances
are highlighted, including the development of new technologies in different areas
such as medical devices, vaccines, and computerized system for medical support.
Second, the focus is on relevant challenges, including the discussion on how com-
puterized diagnostic supporting systems based on Artificial Intelligence are in fact
ready to effectively help on clinical processes, from the perspective of the model
proposed by NASA, Technology Readiness Levels (TRL). Finally, two trends are
presented with increased necessity of computerized systems to deal with the Long
Covid and the interest on Precision Medicine digital tools.

2 Technology and Scientific Advances

As previously mentioned, the global effort created within technical and the academic
communities boosted new technology developments and scientific publications. In
this section, three areas are highlighted for discussion, as presented in Fig. 1.

2.1 Development of New Vaccines

One of the major technical advances during the COVID-19 pandemic was the fast
development of new technologies and the process acceleration for obtaining viable
types of vaccines against the SARS-Cov-2 virus and its variants. Regulatory agencies
such as the Food and Drug Administration (FDA) from the United States of America,
establish new processes to speed up the approvals with the maximum possible rigor
and evaluations of the clinical trials.
Many concerns were raised from different groups of health professionals and
members of organized societies, in order to make it possible to verify the credibility
and feasibility of the developed products. On this matter, it is important to highlight
4 J. A. Lobo Marques and S. J. Fong

Advances during the


Covid-19

Computerized
Development of New
System for Diagnosis
Vaccines Medical and Treatment
Devices

Fig. 1 Three areas of significant scientific and technological advances triggered during the COVID-
19 pandemic

that only vaccines developed by important and high level companies or joint institu-
tions were approved and released on the market, such as Pfizer, Johnson & Johnson,
among a few others were considered, given the significant technical challenge.
The Mayo Clinic provides a timeline updated with simplified and non technical
description, following the FDA approvals [5]. Firstly, in 2020, the FDA gave emer-
gency approval for use to two mRNA COVID-19 vaccines, the Pfizer-BioNTech and
the Moderna COVID-19 vaccines less trials, testing and retesting than is normally
required, but still proving that the products are safe for human use and effective
against the virus. Following, in 2021 emergency use authorization is provided to
the Janssen/Johnson & Johnson vaccine. In addition, the Pfizer-BioNTech vaccine is
approved for children aged between 5 to 15. More recently, in 2022, the Moderna vac-
cine, now called Spikevax, is authorized and the FDA authorizes the Pfizer-BioNTech
for children aged between 6 months to 11 years old. Finally, the Novavax vaccine
was approved for people aged more than 12 years old.
The scenario of technological development is completed with different vaccines
developed in China and India, and several plants in different countries. For exam-
ple, in India, currently with approximately 67% of the population fully vaccinated
with at least two doses, a local production of the formula developed by Oxford and
AstraZeneca is named Covishield. As another example, in Brazil, statistics indicate
that 81% of the population received at least two doses of any type of vaccine, the
local production of the brand Coronavac follows actually the formula of the giant
Chinese pharmaceutical company called Sinovac.
Another challenge is the high number of reinfections, which occurs when after
a first infection with the SARS-CoV-2 virus, the person recovers and later becomes
infected again. When someone is infected for the first time, some immune protection
against the virus, however, the reinfection is very common and the reasons are under
study. There are ongoing studies to better understand issues related to COVID-19
reinfection, for example, how often can it occur, who is at greater risk of reinfection,
Technology Developments to Face the COVID-19 Pandemic … 5

how long after the previous infection can a new infection occur, how severe/severity
and the risk of transmission to third parties after re-infection. Some reasons can
be stated, especially when associated, may be the cause of reinfection, such as the
long duration of the pandemic, since people change the capacity of response of
their immunity, making them again more vulnerable to reinfection. In addition, the
vaccine immune protection provided may lose effectiveness with time, creating the
challenge for public health systems to create permanent programs for administering
booster dose. From the epidemiology management perspective, after stressful periods
of lockdown, elevated number of deaths and economic constraints, there is a natu-
ral relaxation in some prevention measures, including protection and surveillance,
creating also weak processes for data collection and decreasing the data reliability.
Finally, the emergence of new variants of COVID-19, which can be more contagious,
even if not as deadly as before for vaccinated individuals. For example, the omicron
variant is twice as contagious as the previous ones, including delta. This variant is
associated with a greater likelihood of reinfection, however, although several new
variants of COVID-19 are discovered with some regularity, apparently this virus does
not mutate as much as the flu virus.

2.2 New Medical Devices

The area of medical devices is vast and this Section is to discuss some relevant tech-
nology advances as a result of the exponential spread of the COVID-19 worldwide,
creating significant constraints for public health systems. A key area is related to res-
piratory support technologies, since the use of Mechanical Ventilators with invasive
ventilation has been commonly adopted for severe cases of the disease when patients
are suffering from acute respiratory insufficiency (ARI). A position paper about the
topic is presented in [6].
A new technology development in the area is called “ELMO” and it is a helmet
for respiratory support designed and manufactured as a response to the COVID-19
pandemic. It is a non-invasive and safer respirator helmet for healthcare professionals
and patients created in April 2020 by a task force involving a public-private partner-
ship. The innovative equipment emerged as a new step for the treatment of patients
with hypoxemic acute respiratory failure by Covid-19 [7, 8]. The clinical trials related
to the new device are registered at the Clinical Trials portal [9]. According to the
ELMO Registry survey, a research developed by the Health Research Management
of the School of Public Health of Ceará (ESP/CE), an agency linked to the Health
Secretariat of the State of Ceará (Sesa), 66% of the patients who used the device did
not need to move to mechanical ventilator. So far, the study has evaluated about 1570
medical records of people who were hospitalized in the city of Fortaleza. Statistics
indicate the rates of the need of mechanical ventilators reach 60% of the total number
of patients in Intensive Care Units as a consequence of the COVID-19. With the new
developed technology, this number was reduced to 34%.
6 J. A. Lobo Marques and S. J. Fong

2.3 Computerized Systems

The adoption of digital technologies as a result of the COVID-19 pandemic increased


exponentially and the impact on clinical processes and practices was significant. This
topic is the major area of the book, so an overview of how Patient’s electronic data is
managed, including the new pervasive use of patient’s digital data, is presented. The
necessity of collecting reliable data to be shared created the need of not only secure
and reliable communications infrastructure but also the design and implementation
of new processes.
As a major example, during the pandemic, Telehealth and Telemedicine systems
were widely used as temporary solution to support patients and also to address
the lack of specialists or operational staff. For example, considering Radiology, the
integration of existing PACS (Picture Archiving and Communication Systems) to
telecommunication systems to allow remote reporting or second opinion was already
a common practice for two main reasons. One is technical. To transmit a huge number
of digital images per patient to a server, generated by imaging devices such as CT-
Scans, MRI’s, X-Ray, Ultrasound, and to share among different medical specialists,
a consolidated digital infrastructure is required. The second reason is related to
resources. Radiology specialist are not easy to find and they are expensive. The
possibility of setting up centralized image centers and allowing one specialist to
provide support to several different institutions, even in remote locations, was a
win-win situation.
With the constraints created by the COVID-19, other specializations also
demanded to have support of online digital tools to have consultations, follow ups
and second opinions as well. Obviously, ethical aspects were a major concern from
medical associations and social institutions, to protect the patients from fraud, data
leakage, or lack of privacy and confidentiality in a sensitive medical analysis. Special
and temporary authorizations were granted during the period of extreme crisis and
many issues related to credibility and data security were at least partially assured and
the popularity significantly increased.
In Brazil, for example, as a direct consequence of the pandemic, the Federal
Council of Medicine (Conselho Federal de Medicina - CFM) formally authorized
and regulated the adoption of Teleconsultations [10]. Actually, the Resolution No.
2,314/2022 is broad and defines and regulates Telemedicine in the country, as a
form of medical services mediated by technology and communication. The legal
framework is based on strict ethical, technical and legal parameters, can potentially
benefit millions of patients from the public health system and state the guidelines for
security, privacy, confidentiality and integrity of patient data. The registered medi-
cal professional has the autonomy to decide whether to use or refuse telemedicine,
indicating face-to-face care if considered necessary. The face-to-face medical con-
sultation remains the gold standard and the autonomy is limited to the principles
of beneficence and non-maleficence of the patient and in line with ethical and legal
precepts. In addition, formal acceptance must be provided from the patient side.
Technology Developments to Face the COVID-19 Pandemic … 7

The data management becomes a critical aspect of this. Several aspects such as
data custody, handling, integrity, veracity, confidentiality, privacy, irrefutability and
guarantee of professional secrecy of information are necessary to be address. In
addition, the physician identity must be verified with digital signature, issued by
internationally accredited institutions and the data protection must be in compliance
with the requirements from the data protection law. This brings additional critical
responsibility for the Electronic Health Record Systems (EHRS) to keep reliable
and records with the proper security level to meet the standards of representation,
terminology and interoperability.

3 Challenges for Technology Adoption and Maturity

The high inter-patient variability of symptoms and severity of the Coronavirus dis-
ease influences multiple aspects, such as resources allocation, patient selection for
clinical trials, and individualized strategies for treatment, including vaccination. Vari-
ability aspects include a variety of demographics and clinical variables, including
geographic and social/economic characterization, biological aspects (age, sex, race),
previous diagnostic of comorbidities, and several studies are also identifying genetic
aspects, and immune system status and capacity to respond to the disease [?].
This scenario creates significant impact not only on the design and application
of clinical protocols and processes, but also on the development of computerized
systems for diagnostic support and treatment, which should obtain satisfactory and
acceptable performance during the modeling and testing phases, but mainly needs
to be validated and obtain the necessary maturity for effective implementation on
clinical premises for supporting the decision making process related to the patients.
There is a significant gap between academia and market. The results obtained
in the academic environment and published in scientific conferences and journals
sometimes are lost on the way to be launched as products in the market, with proper
testing, maturity, and problem-solving modeling. This gap should not be considered
as a negative aspect, in general. It is, actually, part or the process. The development
of specialized clinical support applications are a result of many technical advances
which first versions were published as academic works, until moving to the maturity
level to become a product.
Nevertheless, during the COVID-19 pandemic, the focus of helping the patients
in minimizing their risks or saving their lives, created the necessity to integrate with
the clinical practices to support medical decision solutions still in preliminary stages,
most of the times based on Artificial Intelligence (AI) and Machine Learning (ML)
advanced models and techniques. Some of them could perform a satisfactory role, but
on the other hand a significant number could not. One interesting path to provide a
classification of these systems could be adopting the classification scale Technology
Readiness Levels (TRL’s) to these systems, following specific strategies for efficient
definitions, given the specificity of this technical area [11]. An introduction with
comments regarding common challenges are presented in the following subsection.
8 J. A. Lobo Marques and S. J. Fong

3.1 AI Systems and Technology Readiness Challenges

The development of computerized diagnostic support systems based on artificial


intelligence techniques is significantly increasing, from classification systems based
on neural networks [12] to more advanced and complex models based on Deep
Learning [13] networks. According to the most recent developments on the software
industry, the Joint Research Center (JRC) of the European Commission published a
comprehensive report proposing a methodology to categorize and assess several AI
research and development technologies, by mapping them onto Technology Readi-
ness Levels (TRL) (representing their maturity and availability) [14].
Besides the readiness level, the aspect of Generality is a key element to be rec-
ognized when considering the analysis of AI systems, since generality is a measure
of capacity or performance evaluation of these models. So the level assignment will
be directly related to the level of specialization of a proposed solution. For example,
the TRL for an AI tool proposed for the analysis of medical images should be clearly
identified not only according to which kind of image (which sometimes will differ
according to the type of equipment, supplier and even hardware version), but also
which specific disease classification or application it is designed to address. If the AI
system is a detector, it will detect anomalies in the collected image or set of images,
such as a tumor. If the proposed intelligent solution is an advanced classifier, it may
have different levels of readiness for a segmentation task, which will allow allow
classification of virtually an infinite number of subgroups.
The list of nine TR Levels, with a proper definition originally proposed by National
Aeronautics and Space Administration of the United States of America (NASA)
[15] and a contextualized application in Machine Learning systems and eventual
challenges that the system may face is presented in Table 1.
The next step for AI systems is to align expectations with their end users, the
medical and clinical staff, to prove its point and become a necessary tool, with a
clear definition of not acting as a substitute of professional specialists, but as an
advanced tool to support these specialists to provide better decisions and improve
the patients diagnosis or outcome.

4 Current Trends

As a relevant trend, the integration of two areas was selected to represent the contin-
uous impacts of the long term results of the pandemic: the challenge of a significant
number of patients living with persistent symptoms as a consequence of the disease,
which is classified as Long COVID; and the definition of personalized approaches
and multiple biometric data together with the use of Computerized Systems based
n Artificial Intelligence to establish a growing area of Precision Medicine, with a
focus on COVID-19 and Long Covid patients.
Technology Developments to Face the COVID-19 Pandemic … 9

Table 1 xxxx
Level Definition Contextualization in ML
TRL1 Basic principles Scientific publications and studies of a machine
observed learning technique and its applications. Not
considered a solution for real-life scenarios
TRL2 Technology concept Implementation of preliminary data analytic
formulated approaches. This is also a preliminary phase with no
possibility of clinical applications
TRL3 Experimental proof AI Components, such as different classifiers,
of concept implemented but not integrated as a system. Prior to
testing in lab environment. Limited solution for
practical application
TRL4 Technology Solution with AI algorithms validated in a laboratory
validated in the lab limited environment, normally using previously
available data. Still not possible to use in a real-life
environment and most of the times already demands a
significant amount of resources to create the testing
environment
TRL5 Technology Validation of the AI system in an environment closer
validated in a to the real application and integration of different
relevant environment modules. This is probably the most common phase of
AI systems with the intention to become a commercial
application
TRL6 Technology The AI solution is implemented in a simulated
demonstrated in a environment or advanced lab. The path between
relevant environment validation (TRL5) and demonstration is sometimes
interrupted with the lack of possible external
application of the system for demonstration
TRL7 System prototype The intelligent system is implemented as a prototype
demonstration in in one operational environment, such as a clinic or
operational hospital. Moving from relevant (TRL5 and TRL6) to
environment operational environment (TRL7) is a very difficult
step because of multiple requirements such as legal
aspects, regulatory frameworks and the significant
necessary investment
TRL8 System complete The AI system performance is tested and formally
and qualified approved in real life environment. In this level there is
still a long way to achieve a smooth user adoption of
the AI system in the operational environment
TRL9 Actual system System fully adopted and and AI support for decision
proven in operational making becomes part of the clinical processes and
environment protocols. The practical use of the system will
determine if it becomes a useful tool or just one
additional functionality not used in a daily basis
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isn’t she? Isn’t she? Oh, I’m so happy you’re here—do let’s all three
be pals—I hate everyone else in this beastly place ... little funny,
sorrowful, creamy kid, I like you—I like you——”
And all the while her eyes were on the soldier. And all this
boundless slippery exuberance was for the soldier—at the soldier—it
did not matter upon what pretext it vented itself. Warmth and
excitement to spare for Deb too ... Deb felt this, or she would have
torn herself away from the embrace ... but Jenny was wholly
unconscious that she was making love to a man with a girl as the
intermediary; she was no self-analyst. But the soldier and Deb, in
one look exchanged, established that mental kinship which exists
between those who see things alike introspectively and from the
outside view; with meaning duplicated and tripled; made grotesque
by circumstance or contrast; backwards from the future, and twisted
this way and that by imps of irony; kinship of those who can see
with the chill impersonality of gods on Olympus, and also with
pointed application to their own tiny scheme of things; restless
subtle kinship of those who dream and those who question.
And even as they silently hailed each other, he smiling a little
under his fair drawn eyebrows, and she very serious; hailed each
other through the froth and tumble of Jenny’s excited talk, the white
light which rayed the ceilings and walls of the room, was sucked into
soft inky chokiness....
“Little beast has gone out,” commented the soldier, in disrespectful
reference to Cora. “Light her again, and let’s sit round and be
comfortable.”

II

Of course Deb did not sell Cora.


Round Cora they hacked a sort of intimate privacy, with privileges
for their trio alone. Cora was their excuse, the ostentatious cause of
their withdrawal from the rest of the boarding-house: they were
going to smoke a cigarette with Cora; they were going to fry
potatoes on Cora; Cora was depressed, and needed the instalment
of a fresh wick. Perhaps they rather overdid Cora; but the intangible
need binding them together needed to solve itself into tangible
expression. Cora, whether as an exaggerated joke or a
temperamental goddess, was ... convenient. “Are you coming home
to Cora to-night?” or “I saw Cora was lit, so I walked in!” Deb was
High Priestess of the Oil-can; Jenny, principal engineer and
mechanic; and the soldier serenely enjoyed results, as was typical of
him.
And then Stella Marcus crystallized their dependence on the Cora
legend into a pun. They took up the nickname—“The Chorus meets
to-night!”—schoolgirlish methods of allusion ... but Jenny and the
soldier had been battered by realities, and welcomed the silliness of
their present relapse. And Deb, her soul a responsive barometer,
sank alternately to the soldier’s semi-humorous apathy of nothing-
worth-while, and leapt again to Jenny’s soaring irresponsibility.
The soldier had been thus labelled by Deb in the spirit of irony,
when he told her that he had been twenty-three years in the army,
and was not, as she had at first imagined, one of that gallant
mushroom crop raised by the call of war. He had been in India and
South Africa, Aden, Singapore, Malta and Gibraltar. It was difficult to
conceive of anyone less of the accepted military type: an
individualist of the let-me-alone order; an atheist; a keen but
destructive logician; a hopelessly romantic pessimist; he could not
understand ready-made standards of conduct, of honour, of
conviviality; would not conform to the prevalent disposition to flock
together, pray together, stand or fall together. A soldier, even a good
soldier, without esprit de corps, was a deplorable spectacle; hardly
likely to prove an acquisition to the mess. His fellow-officers, after a
perplexed interval of acquaintance, were wont to pronounce him a
rum beast. To which, very occasionally, was made the resentful
addition: “Tries to be funny”—when Burton Ames unleashed his
weary but mordant form of humour. He was more popular with his
men, who appreciated the eccentric interest he was prone to waste
on them singly and as persons, however much he depreciated them
collectively.
Fitly, he should have been apprenticed to some trade or profession
which combined the essentials of a sailor, an explorer, a landed
proprietor, a hermit and a carpenter. The career of Robinson Crusoe
answered all requisites to perfection....
Out of Deb’s little crowded room, made vivid by her own books
and pictures, he created for himself a sort of amateur desert island,
away from the gregarious herd in the smoking-room and lounge and
drawing-room downstairs. His own room was bare and
uncomfortable, as only a soldier’s can be who has many times
shifted camp, and without a woman to look after him. And Jenny’s
larger room was liable to intrusions from Dolph and Bobby. But in
Deb’s room he hung curtains, and fiddled with Cora, and altered
furniture, and smoked his pipe, and examined books, and listened to
Deb’s wicked imitations of their fellow-boarders, and cooked
potatoes by his own home-made method of so many heart-beats to
the moment and so many moments to the boil, and confided in Deb
and Jenny his love of complete solitude, with ever-deepening
tranquillity of mood. Sometimes they all went out together on some
impromptu ramble leading to Hampstead Heath or a cinema or a
coffee-stall. But usually they were to be found in a careless group
round Cora; Burton Ames lumbering in the only armchair; one figure
a-sprawl on the bed; the other flopped on the floor; accommodation
of the soldier’s huge inert limbs reducing to nil the already limited
space. A clammy February and bleak March urged a desire to
huddle, morally and actually. It was scarcely possible for one of them
to make a movement without brushing against one of the others....
Sometimes Dolph would meander into the room in funereal quest of
his wife; and sometimes Aunt Stella left her rubber of bridge to
exchange a few jokes with Major Ames. But for the most part they
were tacitly left alone, or unjustly alluded to as a “noisy gang” by Mr
Gryce, whose room was below theirs.
Ferdie Marcus was far too glad that Deb was occupied and
amused to question the propriety of this bedroom intimacy. If all had
gone well, if there had been no war, the poor child would have
continued in possession of her own sitting-room in “Daisybanks,”
where she had formerly received her friends—“ragged” with her
friends was the mysterious term applied—Ferdie had, of course,
appropriated it to his own use: “Na, my darling, did you have a good
rag this evening?”... He gathered she was having a “rag” now; it was
natural to her age; but everything that Deb did, he whittled to fit
this assumption of nature—only natural that the child should want to
be out—only natural that the child should want to be at home
—“Leave them alone, Stella; Jenny Carew is always present; it is
only natural that Deb likes the company of young folk. Forty-six, is
he? All the better, then; a harmless fogey, almost as old as I am; it
livens him up to be with Deb and the pretty little Carew—tells them
tales of war ... ho! ho! the new Othello. Only, Stella ... Papa need
not know what is going on—wass? He would not understand.”

Harmless? Certainly Burton Ames intended to be harmless. He did


not believe himself in love with either Deb or Jenny. He valued them
for their companionship, for their interest in himself, for their distinct
and unique personalities. They were a stimulating find among the
heterogeneous nomads of boarding-houses. He thought he liked
them as two charming boys. With his scorn for platitudes and for
platitudinous happenings, he underrated the dangers of propinquity.
If one were careful ... his careful attitude was his undoing; it goaded
Jenny and Deb out of shelter. They knew well enough that from their
reliance on—well, on Cora, was sure to arise this equation of danger;
they courted it, hunted it, even. Ames was such an insistently
masculine factor in that room; a girl’s room. The very rough feel of
his sleeve—Jenny knew ... every time she moved.... And she was a
restless creature, forever thrilling her wings.
Jenny was just an atom of life-force, twinkling wildly, all the time,
in every direction; jostling to be noticed, petted, admired; a gyrating
dizzy mote in the sunslant; a savage little brown bundle of sexual
impulses. That was primarily Jenny. Funnily opposed to this, some of
her instincts and education and ways of speech were those of the
typical suburban sparrow: she was suspicious of people who could
correctly pronounce foreign languages; scoffed at what she called
“highbrow stuff.” What else was Jenny than this? Most of all,
perhaps, an insatiable mother; wearing herself out in service to
anyone sick or bothered; proud of these calls on her reputation for
quick practical efficiency. Cooking, bandaging, scrubbing—she had
five brains on each hand. Her notion of spoiling a beloved person
was by virtue of touch ... a smother of kisses ... chair and cushions
and fire ... healing contact of warm flesh upon flesh ... cosseting
ways that were all the realities she knew or cared about. “That sort
of rubbish never did anyone a bit of good!” she would interrupt with
almost shrewish impatience, when Deb and the soldier were astray
in realms ethical or fantastic. Life was four walls and a roof—babies
within, and the smell of dinner, and sacrifice, and somebody crying,
and body’s pain.... A little fun to be squeezed in at the cracks; fun
that was substantial, and never ethereal; fun that was crowds and a
pretty dress, a waltz, chocolates, a bottle of wine, a ride in a motor-
car....
And love was just touch again—for Jenny.
Jenny had no reserves and no discrimination; she could hastily
damn a stranger to perdition without any attempt at sane reasoning
—and a week later one would find her impenitently ensconced at the
other extreme of judgment. She was not actually beautiful: a small,
round head, and a small round chin; brown sloe eyes tilted at the
outer comers; round the eyes and mouth a crinkling resemblance,
mirthful, mournful, to a baby monkey; Bobby, her young son, had
inherited this. But her eyebrows were delicate umber sickles on the
low white forehead. And she could look all things in a second’s space
of time....
Jenny had been given sordid tragedy for her lot on earth: poverty
of the shoddiest kind; illness that had brought her three times
gaspingly close to death. And she had come out well in the test ...
better, perhaps, than a schooled philosopher. Loyal to Dolph,
competent in the bread-struggle, plucky in the very extremities of
pain. To Deb and the soldier she was a sort of Complete Home on
tour. He, especially, seemed to rely on her for the daily wants of an
ordinary man adrift and ill. For he was already a victim of the war;
shell-shock and neurasthenia had left him incompetent for any more
strenuous job than his present light ordnance duties. Jenny rejoiced
in the very egoism which brought him to her at all times with some
slow ponderous helplessness to confide: “Look here—what am I to
do?”—She gave prodigally, without thought of barter. And as
between her husband and Ames existed that casual masculine
friendship which blooms mainly on the borrowing and lending of
matches, she was able, under cover of this, to cosset him to her
heart’s content; run into his room with soup and custards when he
was laid up, ask for his clothes to patch and darn—all the little real
things ... advantages of a married woman again.... Deb fretted
against her own disabilities. It seemed that Jenny, without
cheapening herself in the soldier’s esteem, could softly trail her
fingers across his furrowed brows ... murmur: “Darling, how hot
your head is!” ... Deb’s modesty bled in scarlet on her cheeks and
neck. Jenny, how can you? how can you? ... and oh, if I could only
do the same! But she was still dream-crusted with the convention
that a man shall avow, and a girl deny or concede; could not force
herself to reverse the process, even though Jenny scored—scored all
the time.... The soldier’s head lay for an instant drawn back against
Jenny’s shoulder. Jenny, magically stilled by the contact, was
crooning a song that the sea might have composed to the beloved
vessel at last in harbour. Deb, wistful of the other’s frank facility in
wooing, redly ashamed lest the soldier should despise it, hating
Jenny for giving him cause to despise it, mutinous at her own
instinctive adherence to girlhood’s creed, Deb whispered to herself in
promise for this empty moment: “When I am married....”
III

“When I am married”—and marriage is found with love as surely


as the picture-coupon in the opened packet of cigarettes, inessential
but inevitable. Yet here she had fallen in love where no ultimate
together-being was possible; even no passionate response
forthcoming. Then was this love at all?—hitherto accepted as a
divided flame burning to some splendid fulfilment....
Deb knelt in front of Cora, perplexed, musing; a vestal before the
altar. What if she had envisioned the altar of romance as a
mountain-peak in the sunset? Here it was a mat before an oil-stove.
An altar, nevertheless, where she made painful sacrifice of illusion.
For love was complete in itself, without past or future. She might not
put eager question, before admitting love: is he young? is he free?
does he care? does it hold chance of the final happiness? But she
must accept it, barren and bitter and an unshared burden, a journey
without ultimate lure of rest. Love was the big thing—the conviction
remained. Only she had thought it conditional. And it was absolute.
... Slowly she lit a match, and applied it to the wick. From the
mirrors and walls of the many-cornered room, a dozen Debs
rendered variation of her dense black hair, her thick storm-grey eyes,
and lustreless ivory skin. For Deb’s looks were of that mutable type
which inspired every fourth-rate art faddist to paint her Holding a
Melon; or in a Blue Jacket; or with head flung back against their
favourite bit of Chinese drapery; or absorbed in the contents of a
dust-bin (symbolic realism); or as a figure on an Egyptian frieze; or
as Mary Magdalene; or as a Wood-nymph pursued by Silenus; or as
a coster girl dancing to a barrel organ by naphtha-lights; or merely
as “Deborah, an Impression”—till the sight of Deb herself was a
repose from these fantastic and distorted relics of pre-war art-
phases.
Deb as Reverie of a Girl, was so absorbed that she let the match
burn down to her fingers before she was recalled to actualities.
Quickly she let it drop; and at the same moment Jenny rushed in:
“The Chorus is off for to-night, Deb; isn’t it a shame? Mad’m
llorraine is giving a squawking party in her room, and you and I have
been specially invited.”
This was catastrophe.
“Oh Jenny—must we? Hasn’t she invited the soldier?”
“Out of compliment to us two, yes. But she can’t stick him, really,
because he doesn’t jump about opening doors like a foreign
monkey-on-a-stick.”
“I wish he would open some doors—to-night. I know exactly what
will happen, Jenny: La llorraine will say: ‘Come, now we will be truly
cosy!’—and immediately block all forms of ventilation. And then she’ll
sing as if she were let loose again in the Paris opera-house, and I
shan’t know if it’s my head bursting, or the walls and ceiling, or her
voice. Old Gryce will object, and so will grandpapa, but they won’t
take any steps, because each one will be afraid of putting a stop to
something that is annoying the other more than himself——”
“Darling idiot, why did you ever say you wished you could hear
her sing?”
Deb wailed: “I didn’t know that it meant a prima-donna’s powerful
mezzo-soprano in a bed-sittingroom already containing two suites of
Louis Quinze furniture, and forty-two cases of fur cloaks, and a
permanent dog with permanent asthma, and an anthracite stove
fire, and a grand piano, and complicated domestic arrangements for
producing food at a moment’s notice, and a clothes-line, and litter
from their last year’s variety entertainment, and My Child My Solace
complete with curls——”
Jenny stopped laughing as the last item was catalogued. “Dolph’s
potty about her....”
“About Manon....” Deb nodded gravely. She and everybody else
had noticed what was so blatantly happening. She cuddled on the
floor beside Jenny’s knees, and leant her cheek against the other’s
dangling hand; then she slid her lips along the smooth warm arm
the whole way up to the elbow.... One comforted Jenny by Jenny’s
own methods.
For the coming of La llorraine and her daughter to the second
floor of Montagu Hall Hotel had made a difference to the Chorus. It
was not so tight-fitting. A rival cluster of intimacy had been
established by the newcomers, Stella Marcus, and Dolph Carew; and
Jenny was perforce drawn into it from time to time ... Dolph was
insistent that she should be kind to Manon, aged sixteen. And La
llorraine, with her overpowering conviviality, had sought to make an
undivided bohemian settlement out of the bedroom inhabitants of
the second floor; all doors open at all times, and a general pooling
of minor difficulties.... “Now Stella, my dee-urr, will you be kind and
count me that washing while Manon play with Bobby Carew and I
buy a von-derful cream cheese for the Countess who dejeuners with
me in my room to-day. Then need I say, my dee-urr, that I expect
you to com’ in and share.” And Stella, who took delight in La
llorraine, replied: “Chère Madame, you are as generous with your
Countess as with your cheese.”
La llorraine stood for the Continent, as the Continent ached in the
memory of those who had loved it before 1914. Not for any one
country or another, but for all the gay cities: Paris, Vienna, Berlin,
Rome, St Petersburg ... irrespective of the distinctions of war.
Actually, she was born in some small town on the divisions of Russia
and Poland. Her present appellation, which covered stage and
private use, could, in its initial eccentricity only be explained by the
admiration awakened in her on first encounter with ffoulkes, ffolliott,
and ffrench.... “My dee-urr, but what an advertisement! Bah—I know
how to catch that public by the ear. They are swine, I tell you ... but
this will br-r-ring them in millions. You will see!” So she became La
llorraine. And as La llorraine, she stood for every aspect of
continental life; garret, and hotel and court; grande dame, and then
third-rate mummer; the popular artiste, or the good thrifty woman
who can cook succulent dishes for her household. Physically, she
was built on a magnificent scale, and always wore plain and
expensive black—save for breakfast, when she horrified the
boarding-house by appearing in a soiled dressing-gown, red-and-
gold Turkish slippers, and a knitted blue woollen shawl over the
short dyed yellow hair which formed such a crazy mop to her clear-
cut aristocratic face, long and pale, with kind eyes and delicate,
sneering mouth. There was no adventure of the demi-monde too
lurid for imagination to cast her as heroine; and against that she
could whisper mysterious tales of court intrigue, and call Grand-
Dukes by their pet names, with an air that betrayed her a careless
participant of their intimate revels.
Fiercely she adored Manon, whose hair hung in streaked yellow
curls over her shoulders, and from whose red, greedy little wolf’s
mouth one could envisage the dart of a red pointed little tongue.
Manon fulfilled all expectations as the foreign ingénue: soft, lisping
voice, demure eyelids. In a frequent spasm of recollection, La
llorraine would dismiss her from the room when the conversation
was too adult for due preservation of a maiden’s bloom; but on
those occasions that her mother forgot to dismiss her, no doubt
Manon picked up much valuable information.... Certainly, whether
from innocence or art, she managed Dolph Carew exquisitely, never
seeming aware of an infatuation so blatant that it shrieked itself
aloud at every moment; yielding not a dewdrop of her freshness to
his importunity; and at the same time contriving to keep him
attached and useful. “My dee-urr,” La llorraine declaimed to Stella
Marcus, “such a clown for my Manon?—not for anything in that
world. I have ... plans for her!” ... a queer impression stealing on the
heels of her remark, that Manon was designed to be mistress of a
third-rate illegitimate royalty of a fourth-rate kingdom.... A faded
Louis drawing-room in vieux-rose—an old roué bowing his entrance
... waxed moustache and imperial ... careful buttonhole.... “I have
sent for my little daughter!” regally from La llorraine.

Grumbling prophecies were afloat in Montagu Hall, that some


catastrophe was bound soon to happen among that second-floor
crowd—the Carews, the Marcuses, Burton Ames, and—with
vindictive inflexion—those disreputable mummers! It was really
getting insupportable; and fancy Mrs Carew taking no steps about
her husband’s ridiculous behaviour with that nasty little thing in
ringlets, but to be instead forever running after Major Ames, who
isn’t my idea of an officer—not at all well-set-up—and the noise—
and in and out of the bedrooms—how Mr Marcus can allow his
daughter ... but it isn’t as if they were English, no, nor Dutch either,
although they never said they were. Did you know that they dressed
up on Christmas Eve, all the lot of them, and had a procession up
and down the stairs, and the—girl—wore—tights?——
Thus Deb mimicked with diabolical accuracy, the existing Drawing-
room Opinion.
“And very attractive you looked in ’em, darling!”
“Jenny, I believe when our gang was singled out for influenza last
month, they looked on it as an awful visitation of justice; a sort of
plague of Egypt.”
“Perhaps it was. Everyone in the house escaped it except our
landing. Do you remember the day I had bolted five aspirin, and the
soldier sauntered in, and looked at me, and thought I was dying,
and gasped out: ‘Oh, I w-won’t detain you.’ Ass!—but I think it saved
my life, I laughed so. And the night I was so awfully bad that Dolph
specially got up out of bed to make a cup of Bovril for Manong?”
“Don’t, Jenny! I ... I hated him, that time.”
“Ah, well, I’ve had some jolly enough razzles with old Dolph; he
can’t help it when he gets taken this way.” Into Jenny’s tones had
crept that note of possessive defence that one hears from the
woman in the police-court, shrewishly denying the black eye given
her by her “man.” “Poor old boy! he’s gloomier than ever; but then I
married him because he reminded me so of Martin Harvey. Dolph
says that Manong makes him feel pure again, which is out of my line
as I forfeited my purity in his sight by having married him. It sounds
a bit mixed up, and I don’t quite see where I come in—with the
washing on Saturday morning, I s’pose. Only I’m hanged if I don’t
have my little fling too.”
“Does Dolph mind the soldier?”
“Lately he does; haven’t you noticed? yellow with jealousy; tries to
keep both eyes on his wife, and not lift them off Manong; wants to
confide his woes in me, and take the high moral stride as well. Can’t
be done, my lad! But it was quite a rag during the ’flue, Deb; we
were all able to take patterns of each other’s dressing-gowns,
weren’t we? La llorraine in ermine and her head tied up in a duster
was a treat. She and your aunt can tell some smoke-room stories
when they get started—my word! Dolph was shocked—afraid
Manong would hear.”
“The soldier was bad that one week.”
“Wasn’t he? And wouldn’t let me do much for him either, worse
luck. I almost wondered if I should have wired for his wife, off my
own bat. But he’d have been so furious.”
“Why? doesn’t he like her?”
“Child—don’t you know? he’s crazy about her....”
“Oh....”
“Didn’t you know? Why else do you suppose he’s so precious
backward with us? Hang it, Deb, we’re not exactly unattractive. The
chances he’s had.... Another man would have worn my throat away
with his lips at it, before now!” Jenny clenched her hands
passionately. “Deb, haven’t you noticed that he’s never kissed either
of us?”
“Yes. I had noticed.”
“He told me the whole story, mooching about the streets in a fog
one night. He had fooled about with some chit, not caring for her a
tuppenny curse—as he might have fooled with us. Someone told his
wife; and she just gave him notice to quit—‘I’ll send for you when I
can bear the sight of you again!’ ... that was four years ago. God!
she must be made of ice. With a war on, too. Can’t she guess that
the man wants looking after; and that if her fingers don’t sew his
buttons on, someone else will volunteer for the job. Not that I’ve
had much from him, except thanks, for trying to buck him up and
brush him up ... a more dejected-looking object I’ve never seen than
when he first slouched in here. Thanks? oh yes, he thanked me
then, in the fog, for having listened to his drivellings; as if I could
have helped myself, with his hand grabbing my elbow; I was bored
stiff. That was before you came in with us, kid.”
“I’ll drop out again.... You’re married, Jenny, and so is he, and you
can fit each other with what’s left over. But I want something whole
——”
“Yes; you’ve got everything to give. But you and I might just as
well go on being pals, darling,—he doesn’t care a rap for either of
us. And he’d be terrified of me without you, Deb; or of you without
me. I’ve never struck such a Cautious Willy. When he’s left alone
with one of us he goes to fetch his pipe—till the other comes back. I
tell you, it works up all the devil in me....”
“And in me....”
“Deb, he’s a real man, or I shouldn’t care like this. He’s been
perfectly sweet to me once or twice. Perfectly ... dear. He can be,
when he likes. Have you ever felt the muscles of his arm? ever bent
it back? like iron. Deb—I’m sure he’s sworn some gimcrack oath to
himself, not to ever let it reach a kiss—with us, I mean.”
“Because of her.”
“Why shouldn’t we set ourselves to break it down? After all, she
must be a beast. And she should have kept him while she had him.
It’s our innings. Deb, I bet you a gallon of oil for Cora that one or
the other of us gets a kiss from him to-night. I’m mad to-night—mad
—game for anything!... There! I forgot that blooming party next
door. Mad’m’s got a pal in to play her accompaniments; she won’t let
us off; not just for a Chorus meeting.”
A conspirator’s rap at the door; the soldier thrust his head
stealthily round the corner; ascertained with relief that both
members of the Chorus were present; and entered, pulling from his
pocket a smoked haddock by its tail.
“I’ve brought a present for Cora; two presents,” from the other
pocket he extracted a tin of asparagus. “Shall we revel up here to-
night, as a thanksgiving? I don’t know for what; but I’m in the
mood.” His brick-coloured face was impassive; his voice slow and
toneless; his entire personality redolent of beef decently roasted and
eaten at the proper time at a proper table. Anyone more obviously
opposed to riotous revels, or to moods of any kind, it would be hard
to imagine.
“H’m ... I believe we shall have to divide the haddock before we
cook it,” Jenny speculated with a dubious eye on Cora’s limitations,
while Deb ruefully explained their evening’s engagement.
“Damn,” said the soldier gently. “Am I invited? I won’t go. I have
to sit at attention when I hear music, or else I don’t look as if I were
listening. And that’s so tiring. Look here, I can’t endure an evening
without you two; honestly I can’t. Why not pretend to be ill, one of
you?” Hastily he amended: “Both of you.”
“I can; I’ve been feeling frightfully rotten on and off lately, since
the ’flue. My heart’s gone funny from too many operations, or too
many aspirin, or something. We could go in next door for about ten
minutes, and then I’ll pretend I’m taken suddenly bad, and slip out
in a I-hope-nobody-will-notice-or-make-a-fuss manner; and Deb will
naturally follow me out, looking—what’s the word, you high-brows?
sol—? sol—? something to do with lawyers.”
“Looking solicitous. Right then; I’ll skulk about on the landing till I
hear you. Say I’m out for the evening. That’s settled. We can always
throw Jenny on the bed, and me under it, if anybody knocks to
enquire. You’d better put the haddock in your wash-basin for the
present, Deb.”
“And please, where am I to wash?”
Ames thought it over. He bestowed on every question, great or
small, exactly the same amount of stolid phlegm. “In Jenny’s room.”
“Not available. Dolph and Manong are spooning in there.”
“Alone?”
“Oh, you bet Mad’m or Miss Marcus or Bobby is with them. Our
precious flapper mayn’t go a second unchaperoned. It’s hard luck on
Dolph.”
“Dear Jenny, your point of view as Dolph’s wife is rather a novel
one.”
“Excuse me, but is Jenny here?” A very aggrieved Carew stood on
the threshold, glaring at his wife through an enmuffling tangle of
beard and eyebrow. He was incredibly like the popular notion of a
bushranger. Actually he had been traveller for a wholesale tobacco
firm in the City. And was now out of work.
“Jenny, you might think of a fellow sometimes, I must say. Bobby
keeps on running out of the room, and I’ve always got to haul him
back. And you know quite well what Mad’m is like about Manong.
Why don’t you sit with us and do some sewing till Bobby’s bed-time?
You’re so selfish.”
Another ferocious glare—and Dolph was gone.
“Charming fellow, isn’t he?” remarked Jenny lightly. She shrugged
her shoulders, and followed him out.
The soldier looked at Deb expressively: “Bit thick, isn’t it?”
“I hate Dolph Carew!”
“He doesn’t count. But she—she’s the pluckiest little soul in
England. One can’t interfere, that’s the worst of it.”
“Why can’t one? Because one might compromise oneself?”
He smiled a little at her passionate scorn, accepting the
implication calmly. “Yes. Partly that.”
“Mostly that.”
“You admire rash impulse, and headlong defiance, and all those
virtues that make a muddle in the world, don’t you?”—From teasing
Deb, he awoke to awful realization that he was alone with her. “I say
—I must be off!”
“Yes, hurry!—a whole half-minute.” Daringly she challenged his
unspoken thought.
“Ridiculous child. Remember to put the haddock in the basin.” He
just touched her shoulder ... all his warmer marks of affection were
reserved for the times when the Chorus was present in full
membership ... and went out.

IV

Deb crossed straight to the long mirror, and made the discovery
that she had not been looking beautiful enough to say what she had
said. She began to dress for the evening with a sort of revengeful
deliberation. The deliberation was necessary to ensure good result.
No wise woman can fly, with spirit aflame, into her clothes, and then
hope to prove seductive. The dash was in her spirit, nevertheless.
She was angry with the big thing for not proving the mellow,
englamoured sanctuary she had every right to expect. This evolution
of a dream into fact was futile; worse than that—destructive—to
herself. A stupid, lop-sided business! Deb was not glad of love now it
had come. Only a troublesome but intelligent honesty kept her from
repudiating it altogether as the big thing; returning to her former
state of silver-misty anticipation.... “One can pretend, I suppose?”—
pretend that the soldier was a mere wayside incident. Only she knew
too much about wayside incidents, to commit that error.
—Well then, since she was so sure, were not the issues worth a
forced initiative on her part? Could she compete with Jenny’s
boldness—if she chose? For with Deb, as with Jenny, the soldier’s
steady, profiting self-control had become a nightmare which had to
be exchanged at all costs, even for his scorn, even for self-
destruction, even for evil....
Her temper resolved itself into action. There was mischief in her
selection of the pure ivory taffeta dress, the golden shoes, and
cobwebby gold stockings that the supple fancy could continue on
limbs straight and slender inside the blown white cup of her skirts.
Deb could wear white and pearl and dove-tints without fear of
looking miss-ish; by contrast with her deep colours, they enhanced
her vivid grace more than the traditional purple or flame. Sufficient
of purple in her sombre twilight eyes; flame enough in her lips. Her
hair she turned inwards, concealing its masses so skilfully, that, sleek
on top and bulging rhythmically into a smooth pear-shape round the
cheeks and the nape of the neck, it gave her somewhat the
appearance of the knave of clubs as pictured in a pack of cards.
Then she went back to the mirror, and scrutinized her looks long
and earnestly, and—like all heroines in every crisis of each love-affair
—reflected how queer it was that just these curves and colours
should have been the haphazard outward accessories to—her soul?
... no, souls were mawkish things!—to her essential Deb-ness.
CHAPTER V
I

The girl who was playing the accompaniments to La llorraine’s


singing glanced aside once or twice from Deb to Jenny, contrasting
mystery and mobility. Jenny attracted her the most; she made up
her mind to speak to Jenny directly the song was over.... And then
she saw Jenny bite her lip, clutch tightly at the arm of the chair ...
after a minute or two of apparent bodily agony, rise and grope an
unsteady way through the edges and corners of furniture, to the
door. Antonia Verity went on with the Aria from “Samson et Delilah.”
She had seen a swift look interchanged between Deb and Jenny, just
before the spasm of pain which drove the latter from the room. Also,
in the instant’s silence before the prima-donna had begun to let
herself go in “Mon cœur s’ouvre a ta voix,” Antonia fancied she had
detected a scraping sound and heavy breathing outside the door.
Stella had also remarked Jenny’s symptoms, and half rose to
follow her out without interrupting the singing; but Deb murmured:
“All right, Auntie, I’ll go” ... and slipped noiselessly in Jenny’s wake.
Dolph was wrapt up in Manon, who was wrapt up in her own
indifference to Dolph. And La llorraine was back in the Paris opera-
house, eyes uplifted to the imaginary tiers of packed faces, voice
soaring resonantly to a non-existent acoustic.... Antonia wondered if
the drum of her left ear were being shattered; she also wondered a
little what was afoot outside the door....

II

“Did you hear me sleuthing?” queried Ames, contentedly lopping


the haddock to fit Cora’s limitations.
“Is that what you were doing? Of course we heard.” The three had
been recently present at a cinema film which portrayed a quantity of
flickering doors, set in a flickering corridor, down which a flickering
procession of waiters, detectives and gentlemen burglars—all
impartially in evening dress—portrayed the diverting art of sleuthing:
they skulked along close to the wall, one arm shielding their eyes to
avoid observation, and at every bedroom door they bent and applied
an ear to the keyhole—then started erect, confirmed in their worst
suspicion, and went to the next keyhole....
“I sleuthed all over the house, till I sleuthed outside Miss Lamb’s
door——” he stopped abruptly.
“And then?”
“Then I stopped sleuthing. It’s an ignoble pastime. Get me my
screw-driver; something’s wrong with Cora.” A minute later he was
completely happy, surrounded by Cora in eleven fragments; while
Jenny, very excitable and talkative, enacted to him exactly how she
had been “taken ill” during La llorraine’s song.
“—There. Now she’ll do.”
“There was nothing wrong with Cora; you wanted an excuse to
pull her to bits,” Deb accused him.
“A man is only a child; he must play.”
“Fiddling at things?”
“Tinkering with things. Pottering over things. That’s a mercy!” as
Dalila, on the other side of the wall, died to silence. “Our invalid had
better be hoisted on to the bed; they’ll be coming in to enquire.”
Just in time Jenny hurled herself among the pillows, and drew the
quilt up to her flushed cheeks. A knock at the door. The soldier
eliminated himself against the wall. Deb went softly to the threshold:
“Is that you, Manon?... Yes, she’s in here.... No, I wouldn’t come in;
she ...” Deb backed the unseen visitor onto the landing. The other
two, listening breathlessly, heard her low, capable, reassuring
explanations: “... be all right presently ... room too hot ... strain of
the last few weeks ... might do her good ... tell them not to worry....”
Jenny inserted a moan of corroboration.
“I’m so vairry sorry——” from Manon.
Deb returned to the room, closing the door. And Jenny cried:
“Little humbug! much she cares!”
“Well, nurse, shall we operate?” demanded Ames cheerily. He
stood at the bedside, assuming a professional manner, one finger on
the patient’s pulse. “Um. Um. This is excellent. We shall soon be all
right. Up to-day and down to-morrow and dead the next day. A
great improvement here, nurse. I should give her ...” he drew the
pseudo-nurse aside to a little distance, dropping his voice to a grave
undertone. Jenny burst out laughing at the foolery—then shuddered
—and laughed again:
“Bravo! It’s the real thing. God—how often I’ve seen ’em do just
that at the hospitals and nursing-homes. I’ve been turned inside out
and put on the table so often, I wonder there’s any of me left
kicking. Like poor old Cora over there—the doctors had all the fun,
tinkering and fiddling.”
“It sounds fun, when you put it like that,” Ames said
appreciatively. And drew a clumsy penknife from his pocket. “Where
will you have it?” he demanded considerately, throwing off his coat
and rolling up his shirt-sleeves.
“Deb! Deb!” shrieked Jenny, in hysterical appeal.
Deb flung herself to the rescue. She and the soldier sleuthed each
other malevolently round the room, he with the penknife and she
with the screw-driver, till they ended up with a neat little burlesque
of a murder in the middle of the carpet; La llorraine, next door,
supplying unconscious atmosphere by the torture scene from
“Tosca.”
“Die!” said Deb lightly.
“With my fingers buried in your raven tresses!”
“Miscreant!”
“Don’t call me names. I’m not.”
“You are.”
“I’m not!” he tried to hoist himself up by the coarse black ropes of
her loosened hair. Deb resisted fiercely. Jenny, tossing from one side
to another, called out petulantly that she was forgotten—it was her
party!—and was half off the bed, before another knock sent her
flying back to the shelter of the coverlid. The soldier lurched into his
special arm-chair and took up the screw-driver—“for a disguise,” he
murmured. And Deb, wildly dishevelled, clutched after her
expression of calm but anxious best friend to the invalid.
Antonia Verity entered, with a glass of tea and a slice of lemon.
“They thought this might do you good,” to Jenny, who extended a
feeble hand, took the glass, raised it shakily to her lips, spilt a few
drops, smiled bravely—then, with a sudden gesture of repugnance,
handed it to Deb. “Presently, dear ... not now.”
Deb was surprised that she did it so well. Usually Jenny was prone
to over-act.
After a single look bestowed upon the perplexing and unexplained
presence of a gentleman in shirt-sleeves cooking asparagus over an
oil-stove, Antonia’s eyes returned to Jenny:
“I thought you were shamming just now, in the next room. But I
was wrong. I’m sorry.”
She lingered a moment, seemingly in expectation. But the
atmosphere was feverish and hostile. “I’m sorry,” she repeated; and
went.
“Jenny, you’re a genius! that bit of bye-play with the glass was
magnificent.”
“I am, I am, aren’t I?—‘I thought you were shamming, but I was
wrong,’” she mimicked triumphantly. “—Oh Hell!” and burrowed her
face sharply into the pillow.
“What is it?” alarmed, Deb sprang forward.
“You taken in too?” Jenny, without lifting her head, broke into
shrill peals of laughter which she seemed unable to repress. “Oh—oh
—oh—I’ve taken you in too!... Dearest—” this in response to the
soldier’s fingers roaming at the nape of her neck—“Don’t pull your
hand away—don’t—it’s heavenly—it soothes me.... What does it
matter? we’re all playing the fool; Dolph is playing the idiot in the
other room; we’re all mixed up, anyway. Deb, give me that tea—I’m
crazy with thirst,” she snatched the glass; gulped down the contents.
“What about those asparagus?”
“They ought to be done enough now; you shall have some if
you’re good. What do you think, nurse? one or two? and the rest for
us.”
Deb nodded professionally. But it struck her that Jenny was rather
making capital out of the privileges of her present rôle. Why had she
not thought to be herself the one who was ill? But Jenny was really
ill so often—it was less likely to cause suspicion.
The soldier removed the tin of asparagus from Cora; and seating
himself on the edge of the bed, began to curl them slowly,
tantalizingly, into Jenny’s mouth. “I’ve never seen you look quite so
healthy; in case any more of the neighbours drop in to enquire, we
may as well cast a dissembling shadow on that blooming cheek,
those brilliant brown eyes. Deb, put out the light.”
Deb obeyed. The asparagus were finished, one by one. A crash of
discordances, as though someone had suddenly sat on the keys of
the piano, sounded from the adjoining room; and La llorraine’s wild,
deep laughter. Jenny lay as though exhausted, nuzzling against
Burton Ames’ shoulder.
“What is it?” he whispered.
“So miserable ... and I’m tired of going on.”
“I am, too. Never mind—it’s not so bad being miserable together.”
“You’re rather nice”—then lower still—“kiss me....”
He laid his cheek down against her’s—no more. But she seemed
content ... and Deb turned away; stood, forlornly enough, with her
back to the bed, looking down at Cora.... “I’m miserable too,” she
whispered. But Jenny heard:
“Deb!—Deb, come over here—come over to me at once. How dare
you not come ... feeling like that? Deb!”
Deb crouched beside the bed, with Jenny’s arms tightly wound
about her shoulders. The soldier’s knee, hard as granite, pressed
against her side. They were all three very near together ... a
magnetic sense of rest was born in this close contact—Jenny’s hot
skin, Deb’s tumble of hair, harsh feel of the soldier’s frayed tweed
coat.... There was no other illumination in the room, and Cora cast
her spells in hard blocks of white light and black shadow.
“Good old Chorus,” breathed Jenny.
“You’re a really-and-truly person, Jenny, aren’t you?”
“Sweetheart, what do you mean?”
“I used to ask about people in stories: are they really-and-truly
real? Somehow I always know that you are; at least you, if nobody
else.”
“Of course she is,” grunted Ames; “considering she’s a Christian,
quite remarkably real.”
“Hush!” quickly Jenny laid her fingers over his mouth; “you must
leave me that at least—my religion.”
“Child, child, religion is a man-made door, blocking all hope of
vistas beyond.”
“Faith is a crystal window,” whispered Jenny, her brown eyes
steadfast.
“Maybe. Nothing so opaque as crystal.”
Deb said reproachfully: “What can you give her to hang on to, for
what you take away?”
“Herself. The courage and pride in her. It’s much more comforting
really than a vague hope that God will come to the rescue in
extremes. You can be definitely certain of the measure of your own
powers; but God is at best a gamble.”
Jenny’s eyes strayed fearfully ceilingward....
“Looking for the thunderbolt that will destroy the blasphemer?”
“I remember looking up in just that way, the first time I said
damn,” Deb murmured reminiscently.
“It’s what we learn at our mother’s knee. We’ve all got mother’s
knees in our system—Jenny here worst of all—and till we learn to
see through it——”
“Your metaphor is in peril, as well as your soul.”
“S.O.S.,” he laughed.
But at this tendency of the conversation to become highbrow,
Jenny’s mood, as usual, flickered to restlessness. “I ought to go and
see if Bobby’s all right; I haven’t been in all the evening.”
“You forget that you’re in a highly critical condition, and mustn’t
be seen dancing about the corridors. I’ll go.”
And Deb wondered, as she closed the door behind her, if, in her
absence, Jenny would contrive to win the gallon of oil for Cora....
Bobby was soundly asleep in his cot; his round, monkey face, so
comically a replica of Jenny’s, snuggled half under the bed-clothes to
meet his huddled-up knees. Deb was compelled to bend and lightly
kiss him, for the sake of her private fondness for all small boys. A
night-light floating on the table beside him was suddenly quenched.
Deb turned to grope her way out of the room. She heard a groan
behind her—and, for Bobby’s sake, bit back a sharp scream of terror

“It’s only me,” came Dolph’s despondent reassurance.
“You? But I thought you were with—with the others.”
“They don’t want me.”
She hung about uncomfortably, her hand on the door-knob.
“Jenny’s better,” she volunteered at last.
“Is she?” quite indifferent. Then he burst out: “Deb, d’you know
that I’ll be rich one day, when my uncle dies. Rich. People will treat
me differently then. I tell you, Deb, money does everything with
some people. Not with a young girl, of course—but with their
mothers. I’m nobody now. Anyone can insult me, give me the sack. I
wish I was dead and buried.... Bobby oughtn’t to be left the whole
evening alone; tell Jenny I said so. That’s why I’m in here; that’s
why; the only reason,” he mumbled. “Else why shouldn’t I be with
the others?”
Apparently some shattering of the next-door alliance had occurred
on this evening of happenings.
“Send Jenny in to me. I won’t sit alone. Why should I? She’s
always shut away with you and Ames, when I want her.—Deb, I’m so
wretched.”
“Yes ... but I don’t like you one bit,” reflected Deb. Aloud she said:
“I expect it’ll be all right to-morrow, Dolph; La llorraine has sudden
moods, like all artists.”
It was queer, this all-round tacit acceptance of unofficial
affections, on the second floor landing at Montagu Hall.
Carew merely groaned again; which Deb interpreted as welcome
dismissal.

III

... Had Jenny won that kiss in her absence?—Deb slid open the
door, in a bewilderment of dread and curiosity. Had Jenny——
Impossible to say. For La llorraine was sitting on the bed, eclipsing
by gesticulation and oratory, a helplessly recumbent invalid. The
soldier was calmly smoking and reading in the armchair at the
farther end of the room, his back to the bed, Cora among his feet.
His presence in the room seemed almost part of the general
acceptance. How funny, Deb thought, if they all suddenly started
questioning and sorting and clearing up....
It appeared that Nadya llorraine, at least, was doing something of
the sort.
“My dee-urr, now listen to me. I tell you how to win back that
husband of yours. I have said to me: it is enough now, it shall end!
Jenny, see how you lie here, wizout a manicure, your hair in a
puzzle, a blouse that has no seduction.... And he, that fool, that
booby,—shall I tell you vat vill happen? he falls into the hands of
adventuresses! My dee-urr, they snap him up from you....” Sincerity
of pity for the abandoned wife dominated any personal association
with the said adventuresses. “They snap him up—and spit him out!”
La llorraine dignified the process by accompanying pantomime,
grotesquely mimicked by the enormous shadow cast on the wall
behind her. “I will tell you that secret, Jenny, my dee-urr, which I
’ave learn: you must be woman to him as well as wife....” She
grasped Jenny’s wrist, swooped forward, and lowered her tones to a
key of thrilling confidence. She breathed in Jenny’s face. She took
possession of Jenny.
Deb and the soldier were cut off to a complete isolation.
“What have you got?” she bent over his shoulder to see the title of
the book he held. “Oh, that’s not fair!” indignantly. For the Chorus
had been half-reading half-acting Shaw’s “Pygmalion” for their
mutual amusement; and he had anticipated that portion of the play
to which Deb had been secretly straining forward.
“You wanted to make sure of being Eliza in that bit where she
throws the slippers, of course. You’re a shocking savage, Deb. And
anyway, the part isn’t fit for any gentlewoman, and naturally falls to
me. You can be Higgins.”
“I won’t be Higgins. I’ll be Eliza. You—you tempt slippers.”
“M’yes—I daresay I do. Slippers are mild. I’ll lend you my trench
boots.”
“Thanks.”
“Why do you hate me so, Deb?” lazily he threw back one hand to
where she was still leaning over his chair, and grasped some of her
hanging hair.
She was exultant at having at last urged him to a personal
reflection. “Because you don’t take enough notice of me,” she
replied, in a freakish impulse of candour.
“Dear Eliza, isn’t my step bent straight for this room, when I enter
the house?”
“That’s because of—Cora. Because we make you comfortable.”
“I suppose it is. Funny hair you’ve got, Eliza; like a strong, stormy
black sea. I thought women’s hair was always fluffy and soft.”
“As one woman’s was? ...” flitted through Deb’s mind. But she did
not say it.
He still examined with minute interest the thick tress which lay
across the palm of his hand. “To a man of ingenuity and resource, it
would be useful for all sorts of things if one were wrecked on an
island; Eliza, I wish I could be stranded on a desert island with your
hair.”
“With ... only my hair?” She was breaking through it now, that
nameless barrier which her nameless creed had set up; useless
barrier, Jenny had shown her.... Yes, but Jenny was different.
Because she was married?—well, because she was different.
Because she let her passions bubble over when and where and how
she chose ... unruly, undisciplined Jenny. But Deb had promised
herself to compete with Jenny this time.... A pulse ticked in each
wrist—two frantic little clocks. On the other side of the wall someone
—Antonia probably—was playing Debussy ... mournful, soul-
flattening discordances ... La llorraine’s rush of inaudible speech still
expounded man and the ways of man:
“And I say to ’im, that minute ago even, my dee-urr: ‘You should
kneel to your wife like a thief to a goddess, for you ’ave r-r-robbed
’er of all ’er gifts!’ Ha! ’e did not like that, Jenny, I tell you. He sulks
now in his room, the booby——”
“Well, it was rude, considering he was your guest,” from Jenny, in
shrill defence of her male property.

... “What should I do with the rest of you, Eliza?”


“Would another man ask that?”
Deb was on a false trail, her manner hectic and unnatural, her
senses over-stimulated. But, knowing all this, she dragged her
reluctance to the gap in the last barrier—plunged through—bent her
mouth to his up-turned, sleepy face——
And suddenly she remembered little Lothar von Relling ... and
pleaded to whatever Justice might be presiding somewhere, that she
had been generous then, had given ardently for a boy’s pleasure....
Would Justice please choose this moment to reward her?
... His fingers slowly loosened grip of her hair; it dropped heavily
against his shoulders. And in swift reaction at seeing it there, Deb
flung back her head, stood upright, pale and ashamed, ... over his
head their eyes met in the mirror which topped the fireplace in front
of them. Reaction ... she had had enough of this cramped, stuffy
room, and all their cramped, stuffy passions; stupefaction of
everyone’s moral sense; a sort of frowsiness; smoke and shut
windows, and unaired emotions.... She wanted, at once and
instantly, a wind blown in with the running tide; sanity and humour
and keenness. Oh, anything but this room, at this moment, and the
necessity of meeting the mirrored gaze of a man to whom she had
just given herself away.
... The moment stretched, an interminable grey length. Then the
music next door trickled away to silence, and it seemed as though
the unsupported moment would have to trickle away with it....
“I’m only human!”—thus to himself the soldier stifled a protesting
loyalty. Heavily he shifted round in his chair towards the girl,
standing now so stiffly and primly erect behind him——
“Deb”....
A rap at the door. The evening had been punctuated by such
staccato interruptions. This time it was Aunt Stella.
“Is Major Ames here? Yes? You’re wanted on the ’phone; trunk
call, the page said. They came to look for you next door. Well, how’s
the patient?” as Jenny emerged wanly from the clutch of La
llorraine’s overpowering personality. “My dear child, surely you would
be better inside your own bed than outside someone else’s. Off with
you! Make your husband attend to the hot-water bottle ... fill it with
his burning tears, if he likes. Deb, being your prying spinster aunt, it
is my duty to inform you that this room has a horribly dissipated
smell of fish and stove-oil and smoke, and one doesn’t put one’s hair
down for the evening till all the visitors have left; I ought to fetch
your grandpapa—only he’d have a stroke. Madame, Miss Verity
threatens to go already, and wants to say good-bye.”

III

Burton Ames, as he lumbered downstairs, was angry with himself


for being angry at the interruption. It was much better; if he once
budged from his safe resolve, the Chorus would become quite
impossible. And he would miss it—would miss them—quite intensely.
They had obviously set out to try him pretty severely this evening.
Why? Sheer mischief? Deb was the more dangerous of the two. One
could feel tenderly, an absurd, almost pathetic tenderness, for Jenny
out-of-bounds ... passionate, ill-used little urchin. But Deb.... Damn
this ’phone call!
“Hello!”...
IV

Deb and Jenny were alone.


“Deb—I saw.”
“Saw what?” said Deb absently.
“When you bent his head back ... just now. And then Mad’m came
between. Deb—did he?”
Deb did not answer. Sitting on the edge of the bed, hands clasped
round her knees, ears straining, straining for his returning tread, she
examined her behaviour of a moment ago, and decided that self-
verdict must wait on subsequent events. If only he made it worth
while....
The room had grown unaccountably darker. Jenny shuddered;
propped herself up on one elbow:
“Deb, old girl, it’s a fool’s game to pretend one is ill when one
isn’t, because——”
“There he is!” burst from Deb’s lips, oblivious of Jenny.
Burton Ames swung into the room, rejuvenated.
“Jenny—Deb—I’m off to-night,”
His voice was still quiet and controlled; but the weary inflexion to
which they were accustomed from him had been replaced by tense
virility; his bent shoulders were squarely flung back; his eyes
snapped and tingled like bright blue fire under the grizzled jutting
eyebrows.
“I’m off to-night.”
“She ... your wife ... she wants you again,” Jenny gasped.
“Yes. I spoke to her on the ’phone. She has taken a house in
London; Campden Hill; just moved in. I’m joining her at once; she
has invited me,” with a quick, whimsical smile. “I wish it hadn’t
occurred to you to be ‘taken ill’ just to-night, Jenny dear; you could

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