Kathy tells the reader that, several days later, Tommy came up to her—in a line for “medical checkups,” which occur weekly for Hailsham students—to apologize for accidentally hitting her, and for being rude when she expressed concern about his shirt. Kathy tells the reader, also, that at this point she, Tommy, and Ruth were all around thirteen years old. Although Kathy is “mildly embarrassed” by Tommy’s public apology in the checkup line, she continues worrying, to herself, about Tommy, who is often the butt of pranks in the school. Many Hailsham students seem to resent Tommy because he is not “creative,” because he does not generate much art in art class, and because he rarely puts the art he does make in the Spring Exchange, where students go around selecting art made by their fellow students.
More clues here about the students status as clones who will have to eventually donate their organs, and about the students' own lack of knowledge about what awaits them. The medical check-ups are to ensure the students remain healthy so they will eventually be able to donate. The focus on being creative and giving away art is a way to condition the students to accept their giving away of their organs as a means of "creating life" in others. Meanwhile, the students continue on with their lives like normal people.
One night, in their large bunk-bed room, Kathy begins talking to the other girls about Tommy and her concerns for his wellbeing. Ruth agrees that the other boys are cruel to Tommy, but says that Tommy himself can change his attitude, and, for example, can begin contributing art to the “donation” exchanges. Kathy then flashes forward to some of her conversations with Ruth, when Ruth is a donor and Kathy her carer. Ruth remembers that a lot of the art created for the exchanges was very good; Ruth and Kathy also note that, apart from the exchanges and the “sales,” there was “no other way for Hailsham students to accumulate personal possessions.”
The Exchanges and the Sales are the students’ only interaction with the world of commerce. As detailed here, the Exchanges conditions the students to be predisposed toward “giving” and “donating” from a young age, and the Sales offer a chance to buy things produced outside Hailsham—although, as is revealed later, these are mostly things that people in the outside world didn’t want, or perhaps have chosen to get rid of (as at a second-hand store).
Kathy flashes forward again, this time to her period of caring for Tommy, who she reveals was also one of her donors. Tommy and Kathy discussed a meeting of art class with a kind guardian (the term for Hailsham instructors) named Miss Geraldine, who took a particular liking to Tommy. Tommy’s art for that class was “intentionally childish,” because Tommy was embarrassed by his lack of talent for painting, but Miss Geraldine continued to praise it, even though others in the class resented Tommy for this preferential treatment.
Another of Ishiguro’s clever and concealed methods for showing the “otherness” of Hailsham students. The classes at the school do not seem to include the “hard sciences” or the humanities so much as a series of sections focusing on creative expression. Creativity, too, is a way for the students to “give” of themselves and share with others. At the same time, as Miss Emily later tells Kathy and Tommy, these art classes were conceived by the creators of Hailsham as a way for the student clones to show their humanity to the rest of the (non-clone) world.
Kathy then remembers how Tommy’s temper tantrums slowly began to disappear, even though his art, around age 13, never really improved. Kathy flashes back to one day, when she was standing in a lunch-line several months after Tommy’s tantrum over football selection. Kathy sees Tommy in line and the two begin talking; Kathy mentions that Tommy has been less visibly upset recently, and she asks him why. Tommy replies that he has “grown up,” and also mentions that he’s had a conversation with Miss Lucy, another of the school’s guardians, who told him that “creativity” isn’t necessarily the most important thing for the students, and if Tommy isn’t creative, this isn’t a big problem. This gives Tommy more confidence—although Kathy is shocked by Tommy’s admission, since creativity is made to be such a big part of their Hailsham education. Tommy tells Kathy he will give her more information when they can talk in private, later that day.
Thus it is extremely shocking to Kathy that Tommy would mention his creativity was no longer of primary concern. It is doubly shocking that this information comes from Miss Lucy, one of the guardians (or teachers) at the school, and someone in whom the students place a great amount of trust. At Hailsham, creativity and personal health and hygiene are unshakeable pillars of the institution—to hear a guardian say otherwise is to contravene almost everything the students have learned, since they were old enough to remember. Thus Tommy and Kathy worry about talking more in public, and must continue their conversation farther away from the other students.