Today was Luosi’s fortieth birthday.

The alarm went off at 7 o’clock exactly.

Luosi lay in bed a while, before getting up. Her legs felt heavy. Sitting on the side of the bed, her eyes shut, she swung her legs back and forth until her feet caught hold of her soft-soled embroidered slippers. She dressed, still struggling to keep her eyes open and smothering her yawns. When she drew the curtains the sun was shining brilliantly. Her neighbour, Barbie, was playing with the dog on the lawn. Barbie was so rich that even her dog lived better than most people did. Luosi had heard that they paid their vet more than a thousand dollars a visit. Barbie had several houses in the country, with dozens of staff to look after them.

From somewhere deep within the foliage outside the window, an insect chirruped softly. Was it a cicada? If it was, Kentucky cicadas must be different to Chinese ones. Luosi remembered her old home in Hangzhou, where the cicadas made a powerful hissing noise in the summer. The noise – far less restrained than this – could get you down.

Still in bed, Yingxuan snorted and turned over, burying his face in the sheets. Luosi quickly closed the curtains and quietly opened the door to go to the bathroom. When Yingxuan was asleep, nobody was allowed to wake him up. “Early morning sleep is the most precious,” he often said. For him, though, these days ‘early’ morning could stretch all the way to 10 o’clock.

While brushing her teeth and washing her face, Luosi looked up at the woman in the mirror: she saw a long face, framed with wild, loose hair, and high cheekbones with a scattering of light and dark freckles. Thin eyebrows, swollen eyelids; the bags under her eyes were wrinkled like walnuts. She stared, barely recognising her unmade-up self. She fiercely swept blusher over her cheeks until they gained some colour. She brushed her hair, sighing at her vanity. She was forty, after all.

Luosi walked out of the bathroom and went to get Jimmy out of bed. After knocking a couple of times, she remembered that her son had left home last week to start university in Buffalo.

Luosi looked at the clock on the kitchen wall: still only 7.15am. Slowly, she placed two pieces of bread in the toaster. By this time, Yingxuan would usually be shaving in front of the bathroom mirror. Jimmy would be half-dressed, taking a long piss while he ranted about last night’s softball game with his dad. She would be in the kitchen, ignoring them and getting on with preparing the family’s breakfast. But then Yingxuan’s company had gone through a bad patch and made him redundant, so he no longer had to get up early. And now Jimmy had gone to university. So that left only Luosi at the breakfast table.

When Yingxuan lost his job he confidently set about looking for a new one. But as the months wore on and still nothing turned up, his morale deteriorated. When Luosi came home from work, she’d inevitably want to talk about her day at the clinic. Yingxuan would either ignore her, or say: “I’d like to have a boss that pissed me off”. As time passed, there seemed to be fewer and fewer topics they could discuss.

A decade ago, on Luosi’s first birthday in the States after leaving China, Yingxuan had bought her a birthday card, like a good Western-style husband. Later on, they grew apart and he would forget her birthday altogether. “Another year gone,” Luosi had said to him last night in bed. “I’m nearly 40.” Yingxuan turned over and went to sleep. Luosi tossed and turned half the night. In the end she laughed bitterly at herself: was she making a big deal out of it because her son had just gone to university? But then her heart tightened: what kind of woman doesn’t get a bunch of flowers from her husband on her fortieth birthday?

The wall clock chimed: 7.30am. Luosi put on her high-heeled shoes, picked up her lunch box and briefcase and left the house. When she got to the bus stop, she suddenly remembered that Barbie had called for Yingxuan last night. Luosi headed back to leave a note on the fridge, telling him to ring Barbie when he got up.

Every traffic light seemed to be against her. She could drive to work in 15 minutes, but the bus took her round the back streets for three-quarters of an hour. It was packed with noisy teenagers going to school. Her forehead beaded with sweat; her temples ached.

When she reached the clinic, she noticed three patients waiting outside. None of them had appointments. It didn’t matter how many times you told people they had to make an appointment to see a doctor, some always turned up without one. As the clinic hadn’t been doing too well recently, Luosi didn’t dare turn anyone away; she asked them to step inside.

The phone rang angrily as soon as she’d told them to sit down. Since Kasey, the receptionist, hadn’t arrived yet, Luosi knew she would have to answer it.

The first call was a woman asking if they did pregnancy tests. Luosi explained that it was an audiology clinic, and they didn’t do tests on any organ apart from the ears. The woman hung up, only partly convinced. The other patients sniggered in the waiting area. A second caller wanted the number of the ophthalmologist across the road. After repeating it three times, Luosi still couldn’t make herself understood. She booked him an ear check-up in the end. The waiting patients laughed again, louder this time. When the phone rang a third time, Luosi was about to snap at the caller to ring back in ten minutes, when she realised it was Jimmy. Her son rarely called her at the clinic. Her spirits lifted: he must be ringing long-distance to wish her a happy birthday.

But Jimmy only wanted to tell her that his car had broken down, and he needed $1,500 for repairs. He asked her to send the money quickly – he had to have the car for college – then hung up without waiting for his mother to reply.

Luosi replaced the receiver. Her son was six-foot-four and nearly 18 but relied on his parents for everything. Why can’t he get himself a job, Luosi thought. Even Barbie’s daughter works at a petrol station and does a paper round in the summer holidays. $1,500’s a lot of money. Though Jimmy’s grades were good enough to get into Harvard or Princeton, he ended up choosing the State University of New York because it covered his tuition fees. But paying for all his books, accommodation and meals still added up.

Just before school started, Yingxuan had given Jimmy his Toyota, and Luosi had written him a cheque for $5,000. If she had run into trouble back when she was studying, who could she have turned to for help? When they came to America to conquer the world, she and Yingxuan had just $45 and their dreams. In order to save money they’d stayed in someone’s attic. The ceiling was so low that you couldn’t stand up straight and Yingxuan ended up with a stoop.

One year, there was a sudden cold snap at the beginning of autumn. It snowed heavily, freezing as it fell, making the ground so wet and slippery you couldn’t find your feet. As they left college, Yingxuan said, “Let’s get the bus home today”. Luosi absolutely refused. They fell over countless times on the walk back and, by the time they got home, it was five in the morning.

Their son had never known any of these hardships. Luosi and Yingxuan had left Jimmy in China with her parents for a couple of years when they emigrated and didn’t bring him over to America until they’d finished studying. When they left China Jimmy had been in third grade, and by the time they were reunited he was about to graduate from junior high. When they met him at the airport, he was as tall as his dad, but slouched and silent. His parents were at once happy, ashamed and nervous; they were determined to make it up to their son. From that day on, Luosi spent every cent she had on Jimmy. Any money left over went on Yingxuan, or into their savings account; almost never on her. She’d ended up spoiling her son into absolute dependence.

Kasey finally swanned in, carrying a cup of coffee. Greeting Luosi, she sat down, kicked off her trainers and swapped them for a pair of pink leather heels. Next, she took a mirror from her bag and casually applied her lipstick. When all that was finished, she opened the morning paper. “You know that jewellery store over in the west of the city, the one that was burgled? Well, the owner’s gone bankrupt. And do you know who did it? His own son. Can you believe it?”

Luosi saw it was 8.45am. She tried, and failed, to be patient with the receptionist. “Can you get today’s files ready?” Kasey laughed back. “You’re so uptight. I’ll sort them out when the patients arrive. Have I ever let you down?”

Before they’d hired Kasey, the clinic had gone through a whole string of receptionists. They’d be careful during the probation period but go off the rails afterwards. They were getting someone new every three months, and it was becoming a real disruption. But since Kasey, things had settled down. Kasey had been a nurse for decades until her hospital made her redundant and she’d had to become a receptionist. Because she’d been a nurse for so long she had an inflated sense of her own importance around the clinic.

Since the owner had gone off to Alaska with his wife on holiday, Kasey had become even more full of herself. This morning, Luosi struggled to find a smart reply, becoming irritated at the limitations of her own English. In the end, she just forced a smile; her weak response left her even more annoyed. Fighting her low spirits, she saw a few patients.

About halfway through the morning, Kasey popped her head around the door, and quietly waved her over. “The boss just called to ask how business had been this week,” the receptionist whispered. “He said that when he gets back, he’ll make time to interview some new graduates and hire you an assistant if any of them are any good. Business should pick up with a bit of fresh blood about the place.”

Unemployment had been rising fast over the last couple of years. And since the government had cut benefits, fewer and fewer people were buying hearing aids. The owner had laid off staff and Luosi hadn’t had a raise in two years. Why was he thinking of hiring someone at a time like this? Then she understood. He was going to take on someone new, then get rid of Luosi – he could get away with paying someone inexperienced much less.

Luosi returned to the consulting room in shock. When she got home that evening she’d have to rewrite her CV – it looked like she’d be on the job market soon enough. Yingxuan’s redundancy pay was nearly gone, so if she lost her job now, who was going to pay for Jimmy next term? Her headache got worse and worse, like someone was scraping a saw back and forth across her head. It got so bad she threw up in the bathroom. She went to the chemist to buy some high-strength Tylenol and washed a couple down with cold water, which left her feeling a bit better.

She struggled on until lunchtime, then took her lunch box to the coffee shop on the corner. Luosi got on well with the Korean owner, who never complained when she sat there without ordering anything. She took out her chicken sandwich; it wasn’t that appealing, especially as she’d had toast for breakfast. She gave it a sniff then wrapped it up tightly and put it back in the box. The owner bustled over: “How about a piece of cake?”

She went over to the counter to take a look. She didn’t much care for the chocolate cake. But the golden one had a thin layer of buttery cream, a thick sprinkling of almonds, and was topped with fresh strawberries, emerald-green melon and purple cherries. She was tempted.

Luosi had always had a sweet tooth. After turning 35, she’d started to worry about her weight and had given up sweet things. Today, though, she couldn’t resist. “I’ll have a piece of almond cake, a piece of Boston cream pie and a cup of coffee,” she said to the owner. “With milk and two sugars”.

Luosi waited for the woman to bring them over. She counted her change and winced at how much she’d spent. Then she smiled to herself,You’re only 40 once. And nobody else has remembered. So why shouldn’t I spoil myself this once? This only made her feel sorry for herself again. She bent over her plate, to hide her tears. The owner tactfully turned the radio up and let Luosi eat her lunch in peace. The almonds weren’t as crisp as she’d imagined, and the cream pie tasted oily on her tongue.

“There was a serious crash this morning at about 11 o’clock at the junction of Highway 57 and Wellington Road. A GM truck lost control as it was turning the corner and collided with another car…”

Luosi wondered how anyone could think this was news. In America, someone was killed in a traffic accident every day. And it was always blamed on reckless young drivers. Still, she hoped that Jimmy hadn’t fallen in with a bad crowd and taken to speeding around Buffalo. She realised that she hadn’t even had time to ask him why the car needed fixing.

“The car was a Mazda 323. The driver was seriously injured and taken to the nearby Good Samaritan hospital for treatment, where he is currently in a critical condition.”

Luosi dropped her forkful of cake. Her car was a Mazda 323.

After Yingxuan had given his car to Jimmy, she’d been worried that he would need a car to use in the daytime, so she’d started leaving the Mazda at home and taking the bus to work. Could Yingxuan have taken her car out today? They were nearly out of groceries. This was serious. She stuffed the rest of the cake into a bag and ran back to the clinic.

She rang home several times; no-one answered.

Her nerves jangled every time she called. Eventually, she looked up the number of the Good Samaritan Hospital. The man who answered went off to make enquiries for her. There must have been a mistake, he said when he returned to the phone; nobody had been admitted after a car accident today. They suggested she try the radio station to find out more.

She went through the phone book, searching for the number of the station’s news desk. It took over ten minutes for a reporter to pick up the phone. He happened to be the one who had broken the news of the car accident. The police hadn’t identified the injured man, he said; all they knew was that he was Asian and in his forties or fifties. When Luosi heard this, her head pounded and the ceiling started to spin. She called the police station. The receptionist said that the officer in charge was out at lunch and if she left her number, he would call her back that afternoon.

After she’d put down the phone, her hands started to tremble so much she couldn’t clench them. When she thought about how she’d left things that morning, her left eyelid started to twitch. She wished she could remember the old Chinese saying: was it a twitch in the left eye that brought bad luck, or the right? As she remembered all Yingxuan’s good qualities, she began to cry.

Returning from lunch, Kasey was shocked to find Luosi weeping. Thinking that Luosi’s headache had got worse, Kasey asked if she needed to see a doctor herself. Luosi shook her head.

“Look, I can’t cancel the patients who have appointments before 2 o’clock,” Kasey said. “But I’m going to call and cancel the appointments after that. Then you should go home and rest. You’ll frighten the patients – you look terrible.”

Luosi started getting ready for the first batch of patients. “If there’s a call for me come and get me straightaway,” she said.

Luosi rushed through her appointments. When she closed her eyes, she visualised the blood-stained crash scene. She couldn’t bear to stay at work any longer. She grabbed her briefcase and was about to leave for the police station when Kasey passed her a note. “This is my home number. I’m taking the files of tomorrow’s patients home with me. If you’re not feeling better this evening, just give me a call and I’ll cancel them for you. Try not to worry too much.”

Moved, Luosi took the piece of paper. Maybe Kasey isn’t as annoying as I thought. I’m too hard on people sometimes.

She’d barely left the clinic when Kasey called her back. Turning around, Luosi saw her leaning out of the window, waving her arms and making phone gestures. Luosi ran back to the office as quickly as she could and snatched up the phone. It was Yingxuan.

“I went to Barbie’s house in the country this morning, it’s about half an hour out of the city. She wants to hire me to do repairs and odd jobs, bits of plumbing, that sort of thing. She’ll pay food and lodging – and it’s two thousand a month. I’ll take you there next weekend. They’ve got 45 hectares of meadow – it’s a great place. You haven’t had a holiday in years. Now Jimmy’s grown up, you can start to take it easy.”

She put down the phone and collapsed into a chair, as if someone had removed her spine. Kasey brought her a glass of water but Luosi waved her away. She dragged herself out of her seat, went into the hearing-test room and closed the door, blocking out the noise of the outside world. Reaching behind her, she turned the light off and started to cry.

When she stopped, she leant against the wall. There was no light, no sound – nothing. The darkness rushed over her like a wave. There was something solid, even reassuring about it.

The road ahead was narrow and difficult. But it was, she thought, just wide enough for a 40-year-old woman and her ordinary marriage.