But Dick’s good humour had passed when I next saw him. He had woken after surgery in acute pain, unable to swallow and convinced that another throat had been transplanted into his own. Lowering the loose cotton dressing, he showed me the wound running from ear to ear, held together by a score of metal clips and covered with dried blood. He was discharged three days later, and within a week returned to the specialists to learn the results of the biopsy.

Far from clarifying the real nature of his condition, the operation had only served to confuse it. A specialist had eventually seen Dick, and embarked on an enthusiastic account of the educational benefits of TV medical programmes. Dick described, with grim relish, how his use of the word “cancer” was met with a silent rebuke, followed by a disquisition on the meaninglessness of the term in the context of modern medicine. At last, as an afterthought, the specialist recommended the complete excision of the thyroid gland, reassuring Dick that he would reopen the old scar and so preserve his neck for the TV cameras.

“The remarkable thing,” Dick confided to Cleo and myself, “is that no one will tell me I have cancer. It’s as if they want to hide the news from themselves, just when I’ve been able to face it. Now I feel almost guilty. A brain tumour with lots of secondaries in the lungs and liver would have been the decent thing…”

Cleo and I admired Dick’s courage and humour, which sadly deserted him after the second operation. The complete removal of his thyroid lowered his metabolism, and he became lethargic and dispirited. His appearance radically changed. A long, pointed jaw jutted from his eroded neck, and we both noticed that he no longer glanced at himself in the hand mirror that a nurse had given him.

When we arrived he stared at us as if we belonged to an alien species and his true companions were his fellow patients in the ward. I sensed that he regretted his own self-delusions, of which the greatest had been his apparently sincere attempt to discover the truth about his cancer. This was a bluff that had now been called. His attitude to the nursing staff had also changed. All irony and humour had gone, and he was far more docile and cooperative, like a rebellious prisoner at last accepting the unwritten rules of an institution.

Exhausted by the radiation therapy, Dick lay against his pillows, his bald head covered by the NASA baseball cap that Cleo had found in his computer room at Richmond. He had lost interest in himself, and neither the nurses nor the registrar to whom we spoke seemed to have any clear idea of his real condition. Concerned with its own needs, the hospital moved in a parallel world to that of its patients.

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