This time around, he knew straight off it was different. Not because he felt sick. Weirdly, he felt fine. Nothing had changed and yet everything had changed. The recurrence meant he had hit stage four, which made things serious. Getting the news a week ago, in a windowless doctor’s office, he had sat there soberly, almost impassively. He had listened and nodded without asking a lot of questions. He didn’t need to ask to know what the news meant: a slow or fast decline, with perhaps a stab at surgery, and the brute use of drugs with decreasing effectiveness. Actually, the news had broken his heart, a quiet event that he had kept to himself, not letting on even to Teena. Aside from having to cancel his trip to District 6-13, he went about his days and found he could function fine. Maybe this was the difference between being twenty-one and thirty-one, knowing that he could live pretty well even with a broken heart.

As much as he thought about his funeral, he didn’t actually want to die. He had briefly thought about suicide but only as an abstract prospect. He had thought about the writer Hunter S. Thompson, who had shot himself in the head rather than endure a slow decline, and who’d then been sent off with a cannon salute paid for by Johnny Depp. In Sebastian’s estimation, this was over the top. Plus, he would not want to do the deed unless it was really time. Even then, he was pretty sure he didn’t have it in him; he didn’t think he could end his life when it came down to it. It comforted him that Teena would know what to do. This was another subject he had not raised with her yet. But he knew she would help him if the situation called for it. She would carry things off with her unfailing competence. He could trust her to kill him – painlessly, efficiently, undetectably.

For the moment, he took some satisfaction in the way he was keeping things together. He had the ability to live with uncertainty, something he came to think set him apart from other people. After that first diagnosis, he had tried seeing a counsellor. It had seemed like the thing to do, plus it made him feel important, sitting on a couch like someone in a film. Ultimately, though, he couldn’t get into it. He could never quite believe that talking did anything. Nor could he warm to the psychologist, a well-heeled looking woman with a thing for beige. She always wanted to circle back to his relationship. ‘And how is your girlfriend faring?’ she would ask with a concerned look, as if she couldn’t believe that Teena was not a teary mess.

‘Teena? Teena’s great,’ he’d answer truthfully.

‘Is she talking to anyone?’

‘You mean as in counselling? About me?’

‘About you or about her… experiences.’