At last, after a steep climb up through the rubble-strewn streets that left Dr Nuñez breathless, we reached the English outpost, securely placed close under an overhanging rock face, protected from the line of fire raining down from above. A group of soldiers came in just ahead of us, their faces patched with dirt, their clothes torn, and their eyes blank with exhaustion and a kind of dumb resignation. They knew that it was impossible for them to take the citadel by force against such superior fire power. All they could do was to try to wear down the garrison by making constant attacks and cutting off their supplies of food. Some of the soldiers carried muskets, the rest crossbows, and I saw that in one corner of their makeshift camp fletchers and smiths were at work making more arrows, quarrels and musket balls. Otherwise, their only attack artillery was some small ordnance the soldiers had sweated to carry up the hill to within the necessary close range of the citadel. Too close for safety. To be sent to man these guns was a death sentence, for the Spaniards could easily pick off the gun crews.

As we had expected, there were wounded men here who had not been able to return to the ships and Dr Nuñez and I were soon at work dealing with direct injuries from arrows and shot, and the many indirect, peripheral wounds from shattered stone flying from the impacts of cannon fire. There were several broken limbs as well, mostly caused by rocks falling from the walls, dislodged by shot, which we were not equipped to treat here in this makeshift camp. Dr Nuñez organised a relay of men to carry the more seriously injured to the harbour, though they would have a hazardous time of it, exposed in places, as we had been, to the guns of the citadel, and not easily able to dart out of the way.

The injuries I dealt with in the camp were similar to those of the soldiers brought back from the fall of Sluys, though, kneeling on the stony ground, with the sound of the cannon overhead, I felt that the crowded ward at St Bartholomew’s was a haven of peace compared with this. My head rang with the constant explosions of cannon fire, so I understood how the sheer unremitting noise must exhaust men in battle and leave them without the will to carry on fighting. At least the wounds we found here were fresh and had not had time to become infected or gangrenous.

When we were done, and had passed the less seriously injured men as being able to continue on duty, Dr Nuñez and I started down through the shattered streets of the town again, accompanying the last stretcher carrying a man with a broken leg. As we drew near the harbour, I stopped. I had caught the sound of sobbing from one of the few quayside cottages which was still partly intact. I laid my hand on Dr Nuñez’s arm.

‘There is someone in trouble there,’ I said. ‘It sounds like a child. I am going to see.’

‘Nay, Kit! You must not! It could be a trap.’

‘There are no Spanish soldiers here,’ I said. ‘They took care to flee to safety. And very few people. How can I come to any harm? When our soldiers have delivered the injured man to the boats, they can come back and protect me.’

He hesitated, uncertain. We could all hear the desolate crying. It was certainly a child.

One of the soldiers, one of the trained men from the Low Countries, said, ‘We’re not barbarians, like that rabble who wrecked the town. We don’t make war on children.’ He turned to me. ‘We’ll be back with you in no time, Doctor.’

Dr Nuñez was persuaded at last and they moved off to the quays where the boats and smaller ships were moored. I did not wait for the soldiers to return, but went to the doorway of the cottage. The door itself had been ripped from its hinges and lay on the ground at my feet.

‘Is someone there?’ I called out softly in Spanish. ‘Do you need help?’

It was a fisherman’s cottage, for there were traps and nets bundled up just outside the door. I could make out little in the gloom within, for we had spent a long time up at the camp and the evening was drawing in. Though I could see not see much, I could still hear the sound of a child crying, though an attempt had been made to suppress it, and it came to my ears now in spasms of gulps and gasps of drawn breath. As my eyes grew accustomed to the dimness, I made out three figures. In front of me crouched a girl in a torn dress, perhaps eight or nine years old, rubbing her face with the back of a dirty hand. In a corner a boy of about three sat on the ground staring vacantly into space, his mouth hanging open like an idiot child. There was another figure lying on the dirt floor behind the girl, and it was clear that she was trying to shield it from view.

I stepped inside the cottage and crouched down until I was in front of the girl, close to her, but not touching. I could see now that it was a woman lying behind her. At first I thought she was dead, but then she gave a low moan and began to writhe. The child uttered a low cry and spread out her arms as if to bar the way to the woman.

‘Is it your Mama?’ I said gently. ‘Is she ill? I am a doctor. I’d like to help you if I can.’

She looked at me with eyes full of mistrust and did not answer.

‘My name is Christoval. What’s yours?’

‘Teresa,’ she whispered at last, reluctantly.

‘And is that your brother?’

She nodded.

‘What’s his name?’ It was like trying to gentle a frightened horse.

‘Carlos.’

‘And Mama is ill?’

Her eyes welled up with tears again. ‘The baby won’t come,’ she said. ‘And they killed Señora Perez, who makes the babies come. I don’t know what to do. I think Mama is dying.’

I slipped the strap of my satchel off my shoulder and unbuckled the flaps.

‘I’m sure I can help.’

Even as I spoke, she shrank away with a cry. Something had darkened the doorway. I glance over my shoulder and saw that the soldiers had returned.

‘No need for you to stay,’ I said in English. ‘It is a woman in labour and two small children. You are frightening them. Go back to the camp.’

‘You’re sure?’

‘Aye, there’s nothing to fear here.’

I did not watch them leave, but the shadows vanished from the doorway and I saw the child Teresa relax a little. The boy continued to sit without moving.

‘Do you have a lamp?’ I asked. ‘Or a candle? I need to see what Mama needs.’

‘There is a lamp.’ She got to her feet and fumbled about on a small table near the little boy. I heard her struggling with the flint and tinder but did not interfere. It was better for her to have something to do. At last she had the lamp lit, a rough pottery cruse with a wick floating in cheap oil, but it would serve. She handed it to me and I found a ledge for it above where the woman lay. I saw she was not directly on the floor but lay on a thin palliasse, not much more than two fingers thick.

‘Now, Teresa, can you find me some water, and a cloth? Then I want you to bathe Mama’s face and give her a drink. See how hot and tired she is? And I will see if the baby is ready to come.’

Once given something to do, the child stopped crying. She brought a bucket of water and a crude wooden cup and a cloth. While she tenderly bathed her mother’s face and lifted her head so she could drink, I turned back the woman’s skirt, which was soaking, and checked to see how far she was dilated. The baby was nearly ready to come, but it was clear the woman was almost at the end of her strength. I had feared that the baby might have been badly presented, but its head was in place. The woman lay inert and flaccid. Perhaps she was already dead. I was afraid I might have to cut the baby free, and I could not do that in front of the child.

Then the woman’s body gave a convulsive shudder. It was still suffering contractions, though the woman seemed barely conscious.

‘When did you last have something to eat?’ I asked.

‘Before the bad men came,’ the girl said.