However, Nat contradicted my assumption, confiding in me that he and Mark share certain feelings of doom, but that Mark has never seriously contemplated suicide, and cannot fully relate to Nat’s darkest emotions. Was Nat boasting or complaining? A little of both, I imagine. I suggested that he needs an alternative to Mark. He disagreed.

WED AUG 15

When I went to see Nat today, he complained of noises in his left ear. I could not examine him because I didn’t have my black bag with me. He described the sounds as comparable to a thousand screaming serpents slithering in a sea of wax and slime. I have heard tinnitus described in many ways, but never as exotically as this.

I suggested treatment but he refused, claiming that the ear fault made him occasionally angry but not depressed and that he could “handle it”. Anyhow, he had read in a copy of “Harpers & Queen” (of all things) that little can be done about the complaint. He enjoys the aloofness from the world which it gives him.

He looks so very pale. I suggested that anaemia might be the cause of this, but he continually refused my offers to return him to a specialist. Actually, anaemia is a very rare cause of tinnitus. It is, however, the only thing I can think of, given that Nat strenuously denies having subjected himself to any loud noise. This complaint is usually only associated with trigger happy, aged farmers. I told Nat he was old before his time. He seemed to treasure this flippancy, if indeed it was flippancy.

Nat blurted out something about Mark being a “missing person”. He fears his friend will fare badly without his mother’s milk. I could not discern if this was an example of his warped humour or if he was telling the truth: his fictitious constructions and effusions are so elaborate that only he now holds the key to them. His ability to tell reality from fantasy has advanced to such a degree that I regard him as one of the sanest people I know.

TUE NOV 13

Nat seems to have lost all interest in anything, describing his mood as “ultra-atrabilious”. He has totally relapsed into his old nocturnal habits. I am convinced that this is an affectation: it does not follow the sleep pattern ingrained in his childhood and I am inclined to favour the populist attitude that people who prefer to be awake at night do so only because they do not like what goes on during the day.