Vicki Ambery-Smith is one of the country’s leading silversmiths, with work in major collections around the world. She specialises in creating tiny, exquisitely beautiful sculptures of buildings that can be worn as jewellery. We discuss how she designs and creates these tiny works of art and explore how her skills in the workshop are an expression of the human relationships she develops with those who commission her work. In the process we uncover unexpected similarities with the world of medicine.