Professor Hook eventually left us in 1989, and I am a generation younger than him. I haven’t sailed as close to the bitter end as he had to do. Nor have I yet had to think of having such an arduous conversation with a physician. But I do remember lying there and looking down at my naked torso, which was covered almost from throat to navel by a vivid red radiation rash. This was the product of a month-long bombardment with protons which had burned away all of the cancer in my clavicular and paratracheal nodes, as well as the original tumor in the esophagus. This put me in a rare class of patients who could claim to have received the highly advanced expertise uniquely available at the stellar Zip Code of MD Anderson Cancer Center in Houston. To say that the rash hurt would be pointless. The struggle is to convey the way that it hurt on the inside. I lay for days on end, trying in vain to postpone the moment when I would have to swallow. Every time I did swallow, a hellish tide of pain would flow up my throat, culminating in what felt like a mule kick in the small of my back. I wondered if things looked as red and inflamed within as they did without. And then I had an unprompted rogue thought: If I had been told about all this in advance, would I have opted for the treatment? There were several moments as I bucked and writhed and gasped and cursed when I seriously doubted it.

It’s probably a merciful thing that pain is impossible to describe from memory. It’s also impossible to warn against. If my proton doctors had tried to tell me up front, they might perhaps have spoken of “grave discomfort” or perhaps of a burning sensation. I only know that nothing at all could have readied or steadied me for this thing that seemed to scorn painkillers and to attack me in my core. I now seem to have run out of radiation options in those spots (35 straight days being considered as much as anyone can take), and while this isn’t in any way good news, it spares me from having to wonder if I would willingly endure the same course of treatment again…

I have come to know that feeling all right: the sensation and conviction that the pain will never go away and that the wait for the next fix is unjustly long. Then a sudden fit of breathlessness, followed by some pointless coughing and then—if it’s a lousy day—by more expectoration than I can handle. Pints of old saliva, occasional mucus, and what the hell do I need heartburn for at this exact moment? It’s not as if I have eaten anything: a tube delivers all my nourishment. All of this, and the childish resentment that goes with it, constitutes a weakening. So does the amazing weight loss that the tube seems unable to combat. I have now lost almost a third of my body mass since the cancer was diagnosed: it may not kill me, but the atrophy of muscle makes it harder to take even the simple exercises without which I’ll become more enfeebled still.