set my alarm early on Saturday morning, even though I’ve barely slept. Today is an important day and my usual weekend lie-in can wait until tomorrow. Later, I’m meeting Rosie and Vix to go to Dot’s Music Shop. But first, I have something else to do, something that can’t wait.

My doctor’s surgery is in a swanky, modern health centre just off Kentish Town Road, about ten minutes’ walk from my flat. I’ve never been here alone before, and I feel nervous as I walk through the sliding doors. I don’t like doctors’ surgeries; they’re full of sick people. Not that I’ve been here more than a handful of times. Mum prefers to take us to the homeopathic doctor, or the Chinese medicine place on Camden High Street. She says modern drugs are full of toxins and make you sicker than you were to start with.

I march up to the reception desk, trying to look both confident and wan at the same time. Which isn’t easy, especially with the amount of bronzer I’ve applied to my nose to shade it. The receptionist is staring at a computer screen and barely glances at me. ‘Can I see a doctor please? Now?’ I ask.

‘Do you have an appointment? Saturday mornings are by appointment only.’

‘No. Erm... The thing is, I couldn’t call from home and I don’t have any credit on my phone.’

‘What’s the problem? Is it an emergency?’

‘I’d rather not say. Yes, it’s sort of an emergency.’ After I came home from the restaurant last night, I did lots of reading on the internet and, while I know they probably can’t give me a nose job here and now, in my local GP’s surgery, I also know that the sooner I get this started, the better.

‘Name?’ she barks. ‘Address? Date of birth?’

‘Er . . .’ I’m flustered. ‘Sky Smith. Er, 2B Verlaine Court, Paradise Avenue. Fourteenth of January. Er, I’m fourteen. Nearly fifteen.’

‘Right. I’ve found your notes. OK. You can see Dr Buttery. There’s a couple of people ahead of you.’

‘Oh,’ I say, disappointed. I really don’t want to see Rosie’s mum. ‘Can’t I see someone else?’

‘Nah, sorry. She’s the only doctor on duty today. Like I said, it’s appointment only. I can make you an appointment with your own GP for another day – say, next Wednesday?’

‘No . . . I’ve got school . . . I can’t wait till then.’

‘Then I’m afraid it’s Dr Buttery, or nothing.’

I nod. ‘OK, I guess.’ Maybe I should just go home and come back another time. Then again, doctors aren’t allowed to judge you, or tell your mum stuff, are they? I don’t want to take the risk, but I can’t face delaying this either. ‘OK, I’ll see her.’

‘Take a seat in the waiting area. We’ll call you when she’s ready.’

I walk to the bench furthest from the other patients, and sit on the edge. There’s a bunch of really old magazines on the table, and I leaf through them, checking out last year’s fashions. Of course, all the models have beautiful, straight noses, just like they do every season. Big, ugly noses are never en vogue (or in Vogue). And it’s not down to airbrushing, whatever Mum says. At the back of one magazine is a directory jam-packed with adverts for plastic surgery clinics. I had no idea there were so many. When I’m sure nobody’s looking, I tear the pages out of the magazine and stuff them into my pocket. Waiting is making me feel agitated. I want to get this over with.

‘Sky Smith . . . Sky Smith . . .’ There’s my name over the tannoy. I feel a pang of nerves and stand up. ‘Please go to room 3B.’

I walk through the waiting area, aware that everyone is watching me, wondering what I’m here for. Some of them must be seeing me in profile. I cringe, and bend my head forward. I’m starting to regret chopping my long hair off now. Having a fringe is the worst thing you can do when you’ve got a big nose. Why didn’t the hairdresser warn me?

1B . . . 2B . . . 3B . . . I take a deep breath and rap on the door. A few seconds pass and then I hear Dr Buttery say, ‘Come in,’ in exactly the same tone she uses when I go round to her house to see Rosie. I peer my head around, then walk in slowly.

She seems surprised to see me. ‘Ah, Sky. I didn’t know you were coming. So what can I do for you?’

I would have thought that was obvious; can’t she tell just by looking at me? Can’t everyone tell?

‘Um, you know, it’s kind of embarrassing. I need . . . I’m not sure where to start. I need help with something. I’ve got to do something about it now . . . I can’t wait any longer.’

She beckons me to sit down and take off my jacket. ‘There’s no need to be embarrassed, Sky, I’m a doctor. Anything you say in here won’t go any further.’

‘I know . . . it’s just . . . you’re Rosie’s mum.’

‘Not at work, I’m not. Here, I’m just Dr Buttery. Right. Good. Well, first of all, Sky, you are under sixteen. I am allowed to see you alone, but I’d rather your mother were here.’

‘Oh no, she wouldn’t come. She doesn’t approve.’

‘Have you spoken to her about this?’

‘Yes, and she told me not to be so stupid and to forget about it. She said I’m way too young and that if I still want to do it when I’m older, then I can think about it then.’

Dr Buttery frowns. My mum and Rosie’s mum aren’t exactly friends. They’re total opposites. Rosie’s mum is the most sensible woman on the planet and she doesn’t have any time for my mum’s chanting and alternative medicine and herbal remedies. They had an argument once, when Mum said she didn’t want me to get a vaccine at school because she was worried about the side effects. Rosie’s mum said she was being irresponsible. I have a suspicion that Rosie’s mum thinks my mum isn’t a very good mother.

‘That attitude won’t help anyone,’ she says, ‘because you’ll just go ahead and do it anyway, won’t you?’

‘Exactly,’ I say. ‘I knew a doctor would understand.’

‘OK, well, I’m happy to discuss it with you, as you’re being so sensible. But you are only fourteen. Too young, really.’

‘I know, but it’s been bothering me for ages. I have to do something about it. Promise you won’t tell her?’

‘No, legally I don’t have to. But I’d rather you did.’

‘OK, I promise,’ I say, crossing my fingers to guard against the nose-expanding effects of my lie.

‘Right, so let’s discuss your options. I’d hate for you to get into trouble. I know you have a serious, long-term boyfriend.’

What’s Rich got to do with this? ‘Yes, I do . . . But we’re sort of on the rocks . . . We’ve been arguing a lot. I think it’s partly because of my, er, problem.’

‘Sky, you should never, ever do anything just to keep a boy. It has to be your decision.’

‘Oh, it is. It’s totally my choice.’

‘It’s your body. You decide what to do with it and when.’

‘Yes, absolutely. But I don’t think he likes it. He wants me to get rid of it.’

She raises her eyebrows, as if she disapproves, and sighs. ‘All right, then. I’ll help you because that’s the responsible thing to do. But remember, it’s still important to be safe, to use some sort of protection. I’ll give you a leaflet before you leave. There are all kinds of diseases out there, you know.’

‘Oh, you mean like a face mask? To stop germs getting in?’

She peers at me, quizzically. ‘Yes, a bit like that. I’m surprised and rather concerned that they haven’t taught you about this at your school. The leaflet will tell you all you need to know.’

‘Thanks.’

‘OK, so there are several different options. Have you had any thoughts about what you want? What would suit you best? Injection, implant, pill . . . ?’

‘Eh, sorry, but what did you say?’ I stare at her open-mouthed. An injection? A pill? What is she on about? I know science has progressed lately, but even I know that, sadly, they haven’t yet developed a pill to make your nose shrink, Alice in Wonderland style.

‘I was just explaining your options,’ she says. ‘The pill doesn’t suit everyone.’

Oh my God! I cringe so hard I’m surprised she can’t see it. Now I understand – and I really wish I didn’t. She’s talking about the pill. She thinks I want to go on the pill. I can feel my face flushing. ‘No, sure, but . . .’ I begin, unsure how to carry on. This is so embarrassing. I didn’t think it was possible to be more embarrassed about anything than I am about my nose. I guess I was wrong. ‘I . . . I . . .’

But she isn’t listening. She’s gone into autopilot (or rather, doctor) mode. ‘Right, well, whatever we choose, the first thing I need to do is take your blood pressure.’

‘Um, oh, OK. It’s just that . . .’ Try as I might, I can’t find the words.

She swivels around in her chair and takes something out of a drawer. ‘Roll up your sleeve and make a fist.’

I sigh and decide to let her do it, anyway. I’ve never had my blood pressure done before and I’m quite curious about it. And, frankly, giving her my arm is a lot easier than trying to correct our misunderstanding. She attaches a black cuff to my arm and plugs a wire into it. The other end is attached to a little machine. Then she presses a button on the machine and the cuff begins to squeeze my arm, tighter and tighter. It grips so hard that it hurts. Still, this must be less painful than having bits of my nose shaved off.

‘Good,’ she says, approvingly, and the air deflates from the cuff, freeing my arm. I rub it. ‘So have you thought about what you’d like to try?’

‘The thing is . . . I, er, I don’t . . . want . . . the pill or, er, any of them,’ I manage to say. ‘I’m actually here about an operation.’

‘An operation? Isn’t that a little drastic?’

‘Yes, maybe it is. But, um, I don’t think there’s any other way to make my nose smaller. You know – they can shave a bit off, so it’s straighter and not so beaky.’

Dr Buttery’s face changes. The serious look disappears, then, as if she’s unable to stop herself, she starts chortling. She might even be choking. ‘Sky,’ she begins, when she can finally form some words, ‘tell me again, what exactly are we talking about here?’

I feel suddenly self-conscious. I don’t like drawing attention to my problem. ‘My nose, of course. I was trying to tell you, but . . .’

‘Your nose?’ She can hardly breathe for laughing. It feels like she’s laughing at my nose, even though I know she isn’t. I don’t think I’ve ever seen her laugh before, so this is really quite unnerving. She’s shaking so much I think she’s going to fall off her chair. ‘I thought . . . I thought . . . that you wanted contraceptive advice.’

I cringe again. ‘I know you did! God, no! I don’t! No way! I’m here because I want a nose job. A rhino-wotsit. You know.’

‘I’m so sorry, Sky,’ says Dr Buttery, clearing her throat. ‘I just assumed. From what you said. I never actually asked, did I? That’s terribly unprofessional of me. Right, your nose.’ Another giggle escapes. She clears her throat again.

‘It’s not funny,’ I say. I feel like crying. ‘My nose isn’t funny. It’s deformed. Hideous.’

Dr Buttery finally seems to get a grip on herself. She stares at me, her eyes flickering as she scans my face from top to bottom. ‘Sky, dear, there’s really nothing wrong with your nose. It’s a perfectly normal nose.’

‘No, it’s not. It’s ugly and huge and wonky, and I want rid of it.’

‘Really, it’s in perfect proportion. It suits your face.’

‘That’s what everyone says. To make me feel better. I thought at least a doctor would be honest.’

She sighs. ‘I really don’t see how I can help you, Sky. Can you breathe through it OK?’

I nod. My eyes are brimming with tears.

‘Has it been broken in an accident?’

I shake my head.

‘Then really, Sky, there’s nothing I can do for you. You don’t need surgery. Your mum is right: give yourself time to get used to it. Wait a few years. You can make a decision when you’re older. But, until then, no reputable surgeon will touch your nose. You’re still growing, after all. It will probably be fully grown by the time you’re sixteen, seventeen, or so.’

STILL GROWING? STILL GROWING! No way! So my nose is going to grow even bigger? I’ve got to wait until it’s even larger? How much larger? That’s the worst possible thing she could have told me. Ever.

‘O-Oh,’ I stutter.

‘We could chat about counselling if you’d like. Maybe you’d like to talk to someone about how you feel. It seems to me that the problem is in your head.’

My problem isn’t in my head, it’s on my head! ‘I don’t want counselling, I want a new nose,’ I say. I get up and grab my jacket so fast that my chair tips back. Dr Buttery catches it.

‘Sky . . .’ she begins. ‘Let’s talk about this. Stop . . .’ But I’ve already closed the door behind me and fled into the corridor.

What did she say? No reputable surgeon would touch my nose? She must be wrong. I’m just going to have to try to find one for myself.