Angela Cassidy is sitting behind her desk looking hard at a small boy who is hunched miserably on one of her upholstered chairs. "No wonder you've got a stomach ache," she tells him tartly. "It isn't good enough not to eat all day. You are doing yourself real damage."
"Sometimes my mum gives me pound;5. And my dad promised he'd have some money for me next weekI," he falters. Ms Cassidy's expression softens. This stern demeanour doesn't seem to come naturally. The senior welfare officer at Seven Kings high school in the east London borough of Redbridge sends the boy to the medical room next to her office and picks up the phone to call his mother.
The prevailing ambience of the medical centre is far less harsh. A panoply of troubles, major and minor, seems to wash up on its welcoming shores.
Everything from cut fingers to pregnancy, from boyfriend trouble to child abuse, filters through its pale wood-and-glass double doors. A counselling service for pupils operates from here.
The centre is also the base camp for the school's 38 physically disabled pupils. They come here for toilet facilities, for physiotherapy or just for a comfortable place to be. Attempts have been made to rename this light, airy block "the welfare centre", but somehow the name never seems to stick.
And presiding over the whole with a motherly, almost-but-not-quite matronly air, is Ms Cassidy. Her room has a welcoming feel. Drawings of dinosaurs adorn the wall, the work of a vulnerable child who used to retreat here, unable to cope with the hurly-burly of school life. There are goldfish and, in a corner, a comfortable jumble of lost property and other jetsam: a multicoloured fluffy duster, a cricket bat and five metres of electric cable.
Most of the small, lost things in the school wind up here. Sometimes Ms Cassidy will send one of the disabled pupils to round up a child who looks lonely or sad. Frequently, she finds herself wondering how she would feel if the youngster were one of her own four children. "If that was your child, you'd be mortified," she'll say. Or, referring to a child with emotional problems who won't or can't talk to her mother: "If it was my daughter, I'd be happy to know she'd spoken to my sister or one of her cousins."
The day starts with a flurry of activity, then gets busier. Ms Cassidy is always here before 8am, putting the finishing touches to the timetables of the school's 26 learning support assistants. There is usually not long to wait before pupils start to trickle in.
Today's first, at 9am, is a girl with a headache looking for paracetamol.
Although Ms Cassidy is a qualified nurse - she worked as a district nurse and at the Royal London Hospital before coming to Seven Kings 11 years ago - she can't dispense drugs. She has to tell the girl to go out to a chemist. The complaints follow a familiar pattern: "Miss, I've been hit on the nose with a tennis racket." "Miss, I think I might be about to feel sick. Can I lie down for a bit?"
Some attempts are gently rebuffed, but by noon three girls and a boy are sitting in a forlorn row on the narrow bed in the room next door.
Meanwhile, she's simultaneously dealing with a boy who needs to phone his dad because he's missed a dental appointment, and the boy with a sore nose, who has come back asking for a plaster and complaining of a headache.
Are they trying it on? "In there," she says, indicating next door with her head, "one of them is, but I can see why. The other two aren't. When I first came here I used to fall for everything. But you wise up and get to know the regulars. If someone's down here often it proves something's wrong. Though it's often something we can't cure."
Today, the physiotherapist is in, and she drops by for a chat about the pupils' needs. She's just fitted a new leg brace; the old one stands propped up against Ms Cassidy's desk like a discarded shell, worn to the shape of its former owner. Some days the senior teacher in charge of child protection will call in to discuss ongoing cases, and once a week one of the borough's education welfare team comes in. Attendance problems are also dealt with here: one parent is currently facing a court summons for persistently failing to send her child to school.
At lunchtime, a small group of disabled pupils arrives. Many of them could use the canteen, Ms Cassidy explains, but it is big and noisy, so some choose to come here instead. One boy produces a microwaveable burger from a carrier bag and hands it to one of the support assistants. These children are always welcome, she says with an edge, if they behave. Sometimes they don't. Sometimes there are food fights and she throws them out. But usually they're back 10 minutes later and she's happy to see them.
The medical centre will always be a refuge for any pupil who needs it. "I don't know what happens in other schools, but it's a shame if there isn't somewhere like this. It must be the hardest thing for children of any ability to come to school knowing they'll be OK in lessons but feeling there's nowhere to go at break or at lunchtime. I can't bear the thought that any pupil has nowhere to be."
Some pupils' personal details have been changed