I came rushing upward out of the blackest sleep to find myself surrounded by doctors . . . American doctors: I sensed their vigour, barely held in check, like the force of the growth of their hair; and the heavy touch of their heavy hands. Although my paralysis was pretty well total, I did find I could move my eyes. Availing themselves of my immobility, the doctors were, I sensed, discussing matters having to do with their copious free time. And the thought came to me, fully formed, fully settled: how I hate doctors. Any doctors. All doctors. Consider the Jewish joke, with the old lady running distractedly along the sea shore: Help! My son the doctor is drowning! Amusing, I suppose. But why the pride in these doctor children (why not shame, why not dread?): intimates of trauma and mortification, of bacilli and trichinae, the routine excruciations of time, with their disgusting furniture and their disgusting vocabulary (the bloodstained rubber bib, hanging on its hook) – life’s gatekeepers.

The doctors around my bed were in leisurewear, a frieze of freckles and shorts, tan, arm hair. Insultingly casual though I found their manner, I was reassured by the very vapidity of these doctors or joggers or weightlifters – something to do with their unsmiling pursuit of the good life. In my sleep I had dreamt . . . No: that sleep had been too dark for dreams. Presiding over that darkness, however, was a figure, a male shape, with an entirely unmanageable aura, containing such things as terror, beauty, love, filth and above all power. This male shape or essence seemed to be wearing a white coat (a medic’s clean white smock). And black boots. And a certain kind of smile. I think the image might have been a ghost-negative of doctor number one – his black tracksuit and powerpack plimsolls, and the wince he gave as he pointed to my chest with a shake of his head.

Over the next few days and nights I moved in and out of consciousness. Great and unceasing struggle, with the bed like a trap or a pit, and the sense of starting out on a terrible journey, toward a terrible secret. The secret was of course inscrutable, but I knew it involved . . . it involved the worst man in the worst place at the worst time. I was becoming stronger. My heavy-breathing doctors came and went (they didn’t do a damn thing for me). There was a nurse, always, night or day. For some reason I kept shaking my head direly at her, whereupon she suggested that I go into hospital. Hospital? No way! She worked the drip (her uniform made a packety sound) and, annoyingly, kept taking my pulse and peering under my eyelids; I stuck my tongue out at her and she checked on that too. Because I was feeling much better now, really tiptop. Sensation and all its luxuries returned first to my left side (suddenly) and then to my right (with exquisite stealth). Deploying my new-found litheness, I could almost turn over in bed – more or less unassisted! I lay there gurgling proudly to myself for however long it was, as time went on by like this in hilarious futility, until the big day: the nurse disconnected me, and packed up her stuff and left; two golfing doctors backed themselves solemnly into the room and attended to me with climbing agitation; and then – if you don’t mind – two young orderlies hurried in, roughly clothed me, and stretchered me out into the garden! Then I must have blacked out.

And when I came to it was with an audible pop in the ears, and a rich consciousness of solitude, and a feeling of love and admiration for this big stolid body I was in, which even now was busy and unconcerned, straining out over the rose bed to straighten an errant swathe of clematis on the wooden wall. The big body worked on, with slow competence – yes, it really knows its stuff. I kept wanting to take a good look at the garden but something isn’t quite working – this body I’m in won’t take orders from this mind of mine – and I had to make do with peripheral vision: the swooping and trembling flora, like pulses or soft explosions in the side of the head. And a circumambient pale green, barred and embossed with pale light, like . . . like American money. I worked on out there until it began to get dark. Is it dusk coming? Or is it dawn? I put the tools in the hut. Wait a minute. Why am I walking backward into the house? What is the – what is the sequence of this journey I’m on? What are its rules? Why are the birds singing so strangely? Where am I heading?

A routine, in any event, has certainly established itself. It seems I’m getting the hang of things.

I live, out here, in washing-line and mailbox America, innocuous America, in affable, melting-pot, primary-colour, You’re-OK-I’m-OK America. My name, of course, is Tod Friendly. Tod G. Friendly. Oh I’m there, I’m there at the produce store, at the Post Office, with my ‘Hi’ and my ‘Bye now’, my ‘How are you?’ and my ‘Good. Good.’ But it doesn’t quite go like that. It goes like this:

‘Dug. Dug,’ says the old guy in the car park.

‘Dug,’ I join in. ‘Dug. Oo yah owh?’

‘Aid ut oo yah owh?’

And then I walk away, backwards, with a touch of the hat. I speak without will or volition, in the same way that I do everything else. My head translates it, out of interest. There’s a third language in here too: hiding. I sometimes dream in it.

But, yes, silver-haired, thick-skinned, with the Gazette under my arm, past the little driveways (thickly settled), the lettered mailboxes (Trilling, Cohen, Meleagrou, Rezika, Bzinski and I don’t know what-all), the quiet ambition of every homestead (Please Respect Owner’s Rights), the child-filled squares of green and the yellow sign saying slow– children and the silhouette of that precipitate youngster with his schoolbag, tearing, tearing. When the kids squeeze by me in the supermarket I give their mops the chaste old tousle. Tod Friendly. Each pair of eyes, even as they narrow in ingenuous greeting, draws a bead on something inside me, and I feel the heat of fear and shame. Is that what I’m heading toward? This fear, when I stop and think about it, has to do with my own mutilation. (I can’t explain.) Who will commit it? How can I avert it?

Because I’m getting younger. I am. I’m getting stronger. I’m even getting taller. My mind follows this body around. Everything is familiar but not at all reassuring. Far from it. All the other people are getting younger too. They don’t see the oddity of it. They don’t find it faintly disgusting, as I do. I’m the only one who really notices. The others, they’re not important in this. It’s all for me, and I watch like the first-person onlooker in my own dream. They’re lucky. I bet they don’t have the dream I have. The figure in the white coat and the black boots. In his wake, a blizzard of wind and sleet, like a storm of human souls.

I mean, is it just me, or is this some kind of weird existence? All life, for instance, all sustenance, all meaning (and a good deal of money) issues from a single household appliance: the toilet handle. At the end of the day, before my coffee, in I go. I lower my pants and make with the magic handle. And there it is: the humiliating warm smell. The toilet paper comes up into your fingers, you clean it on your rear end and then deftly wind it back on to the roll. The other transaction occurs. You pull up your pants and wait for the pain to go away. The pain, perhaps, of the whole transaction, the whole dependency. Glance down at the clear water in the bowl. I don’t know, but it seems to me like a hell of a way to live. Then the two cups of decaf before you hit the sack.

Eating is a drag too. First I stack the clean plates into the ‘dishwasher’, which works OK, I guess, like all my other appliances, except when some fat bastard shows up in his jumpsuit and traumatizes them with his tools. All right: then you take a soiled dish from the machine, collect some scraps from the garbage can, and settle down for a short wait. Various materials are gulped up into my mouth, and after I’ve massaged them into shape with tongue and teeth I transfer them on to the plate and sculpt them up with knife and fork. That bit’s quite soothing at least, unless you’re eating soup or something. Next you get the laborious business of cooling, of reassembly, of storage, before their return to the store, where, admittedly, I am promptly and generously reimbursed for my trouble.

Another thing that really disappoints me about this life I’m living through: the reading. Of course I have no choice about any of my activities, and that I can more or less accept. But the reading! I get out of bed each night to start the day – and with what? Two or three hours of the National Enquirer. I begin at the bottom of the column and fight my way up the page to find each story summarized in inch-high type, man gives birth to dog. Or girl raped by mother’s ghost. Merle Oberon is reborn as a cat. All this stuff about twins. A Nordic super race will shortly descend from the cosmic ice-clouds. All this stuff about Atlantis. Appropriately, it is the garbage people who bring me my reading matter. I bring in the bags – which issue, it would seem, from the monstrous jaws, the industrial violence, of the garbage truck. And so I sit here drooling into my glass and soaking up all that moronic dreck. The eyes of Tod Friendly, they sometimes wander, as he moves solidly around the room. The dusty bookcase; beyond its glass, the dusty spines of books all standing to attention. The Sorrows of Young Werther. The Philosophy of Right. But no. my father married a pig. i am greta garbo says monkey. Siamese quins!

There are certain pluses now, though, as the years lurch past, at their chosen stop-start rhythm. Physically I’m in good shape: never better. My ankles and spine and neck no longer hurt when I get out of bed. All of a sudden my bearing is superb. My hair is getting thicker, even though my visits to the barber are no more frequent than before: I trudge along there every couple of months. I’m feeling so great that I’ve even taken up tennis. Perhaps prematurely. Because – to begin with, at least – it made my knees hurt like a bastard. It’s a pretty dumb game, I’m finding: you go out there, all sweaty from the shower; the ball jumps out of the net, or from the chicken wire at the back of the court, and we bat it around for a while until it is arbitrarily pocketed by the server. Yet we leap and snort away, happily enough. All the matches finish dead even. Pap say the rackets. The four of us josh and kid: our trusses, our elbow supports. The guys seem to like me. Why do I hate them for it? Why do I think they are fools, dupes? I can feel Tod Friendly’s glands burning with some unguessable mixture of envy and contempt . . . Now, in the supermarket, the eyes of Tod Friendly linger on the bodies of the local Fräuleins as they pull their carts. I have long been hoping that Tod’s eyes would start doing this. The calves, the join of the hips, the inlet of the clavicle, the eyes. It turns out, too, that Tod has a blue tin with photographs of women in it. Gay old broads in party dresses and tan pants suits. Letters, lockets, the remnants of love. Further down in the chest, where Tod doesn’t often burrow, the women get quite a lot better-looking and start to wear things like swimsuits. If this means what I think it means, then I’m impatient. I really can’t wait. I don’t know how much sense it makes to say that I am tiring of Tod Friendly’s company. We are in this together, absolutely. But of course he doesn’t know I’m here. His isolation is complete; and it is left for me to sense the inordinate heaviness of his every thought and feeling. So each night we stagger to our feet and pick our clothes off the floor, and then sit and drool into our glass, staring at the tabloid and all its gruesome crap.

I can’t tell – and I need to know – whether Tod Friendly is kind. He takes toys from children, on the street. He does. The kid will be standing there, with flustered mother, with big dad. Tod’ll come on up. The toy, the squeaky duck or whatever, will be offered to him by the smiling child. Tod takes it. And backs away with a grin. The child’s face turns blank. Both toy and smile are gone: he takes both toy and smile. Then he heads for the store, to cash it in. For what? A couple of bucks. Can you believe this guy? If there’s fifty cents in it, he’ll take candy from a baby. Tod goes to church and everything. He plods along there on a Sunday, in hat, tie, dark suit. The forgiving look you get from everybody on the way in – Tod seems to need it, the social reassurance. But it’s clear what he’s after. Christ, he’s so transparent. He always takes a really big bill from the bowl.

It’s strange to me. I know I live on a fierce and magical planet, which weeps or sweats rain or even flings it off in whip stroke after whip stroke, which fires off bolts of electric gold into the heavens at 186,000 miles per second, which with a single shrug of its tectonic plates can erect a city in half an hour. Creation . . . is easy, is quick. There’s also a universe, apparently. But I cannot see the stars even though I know them to be there, because Tod sees them and at night is always cooing upward like everybody else, and pointing. The Plough. Sirius, the dog. I wonder why I can’t see them, why the stars just aren’t there for me. Maybe – for me – light is travelling the other way and my eyes will take a million years to find them in the night. Of the stars, two alone I see. The sun. And the planet they call the evening star, the morning star. Intense Venus.

There are love letters – I know it – in that blue tin of Tod’s. I tell myself to be patient. Meanwhile, sometimes, I fold up and seal and send off letters I haven’t written. Tod makes them, with fire, over in the grate there. Later we stroll out and pop them in the mailbox. They are letters to me, to us. For now, there’s just this one correspondent: the same initials at the foot of the page. The letters seem very bland to me. Repetitive, too. They offer vague reassurance, in the vaguest terms. But Tod has a different take on them. All night his physiology speaks of alerted fear, of ignoble relief.

These developments all came one after the other. Things have really been buzzing around here. A new home. A career. The use of an automobile. And a love life.

The move was a perfectly symmetrical operation: lucid, elegant. Big men came, and loaded all my stuff on to their pickup. I rode with them (we tossed the one-liners back and forth) to our destination. Which was the city. South of the dividing river, over the tracks, beyond the stockyards and their rusty corsetry, their arthritic cranes. The actual property is smaller than what we’re used to; it’s in a low row of terraced cottages, with a little back yard. I’m delighted with the new place because there are people everywhere here, but Tod is definitely in two minds about it. I can tell. For instance, just before we moved, while the men were still lurching around with their crates and cardboard boxes, Tod slipped out into the garden; he lowered himself to his knees, and, sniffing hungrily, richly . . . It was weird. Dew-like drops of moisture formed on the dry grass – and then rose upward through the air as if powered by the jolts in our chest. The moisture bathed our cheeks, deliciously, until with our tickling eyes we drank it in. Such distress. Why? I assume he was crying for the garden and what we’d done to it, over the years. The garden was heaven when we started out, but over the years, well, don’t blame me is all I’m saying. It wasn’t my decision. It never is. So Tod’s tears were tears of remorse. At what he’d done. Look at it. A nightmare of wilt and mildew, of fungus and black spot. All the roses and tulips he patiently drained and crushed, then sealed their exhumed corpses and took them in the paper bag to the store for money. All the weeds and nettles he screwed into the soil (and the earth took this ugliness, snatched at it with a sudden grip). Such, then, are the fruits of Tod’s meticulous vandalism. Greenfly, whitefly, sawfly are his familiars. And horsefly. He seems to summon them to his face with a slow flick of the wrist. The muscle-bound horseflies retreat and return; they rest, rubbing their hands together in anticipation and spite. Destruction – is difficult. Destruction is slow.

Creation, as I said, is no trouble at all. Like with the car. One of the first things we do, after settling in – we show up at this raggedy little garage-cum-breakers’-yard, about eight blocks south, past the gap-toothed projects, the flattened warehouses. Tod certainly gets my respect for the way he seems to know his way around. I’d call this garage a hole-in-the-wall operation – but there’s no wall to hack a hole in. The buildings are right down on their knees. That’s evidently the thing with the contemporary city. No one is seriously expected to live or work in it. Content, meaning and content, are all stored uptown, in the notched pillars of the skyscrapers. Well, the car looked OK. It looked like any other car. But Tod just stood there shaking his head at it. The garage guy stood beside him, wiping an oily rag with his oily fingers. Next, Tod goes and gives him 800 bucks. After that they argue for a while, Tod saying 900, the guy saying seven, then the guy saying six while Tod holds out for a thou. Left alone, Tod contemplated the car doubtfully; he ran his fingers along the bodywork. Searching for what, I didn’t know. Scar tissue. Trauma . . . Every day we returned; and every day that car of ours was in sorrier shape. Eight hundred dollars! And you could actually see them at it, the grease monkeys, with their hammers and spanners, about their long chore of patient wreckage.

Needless to say, by the time we went along to ‘claim’ it (elsewhere: uptown), Tod’s car was a total heap. The transaction also included a most unwelcome preliminary. Hospital. Yeah: a look-in at Casualty. We made our own way there. Somehow Tod knows this town backward. And we didn’t stay long, thank God. We answered the questions put to us by the smocked orderly; we took off our shirt and got prodded and tapped. We kept our head down and barely sensed the strangled roar of indecipherable confusion, shame, pain, humourless atrocity. I tell you, hospital is some scene. I knew that. Always I knew it. The paramedic drove me uptown to the scene of the accident. My car, as I said, was a ruin, and I didn’t feel too great myself as the police officer helped wedge me into its driving-seat and attempted to shut the warped front door. Thereafter I sat back and let Tod handle everything. There were all kinds of people staring in at us, and Tod himself seemed a little fazed at first. But then he got on with it. He rammed his foot down on the brake, and sent the car into a fizzing convulsion of rev and whinny. With a skilful lurch he gave the bent hydrant on the sidewalk a crunchy shoulder-check – and we were off, weaving at speed back up the street. Other cars squealed in to fill the sudden vacuum of our wake.

Minutes later: the first whispers of a love life. The idlest coincidence, I assume. We came home, Tod flooring the accelerator to bring about a violent halt. He hurried inside, obviously still pretty shaken up, and made a snatch for the phone. After the dialling tone there was a long silence before a woman’s voice said, ‘Durtsab!’ I tried to concentrate. I think I got most of it. It went like this.

‘So tell,’ he said ‘Tell who? God?’

‘I’m going to tell on you.’

‘Irene.’ (That’s her name.)

‘I know you’re evil,’ she said. ‘I know you’re the worst man.’

‘You don’t know my secret,’ he said. ‘You just know I have one.’

‘I knew it the way you made love.’

‘Oh yes?’

‘You say it in the night. In your sleep.’

‘Oh yes?’

‘I know your secret.’

‘What is it?’

‘I want you to know something.’

‘Irene, you’re drunk,’ he said, and sighed.

‘Hello there, lover man.’

Then Tod hung up on her. He put the phone down and listened to its ringing – its machine warble. His feeling tone was blank, was clear. But the sound spoke to me of exhaustive disenchantment – absolute and mutual – as if love and sex were there, but all used up, and used up long ago. It’s funny. Tod was nervous before the call. I was nervous after it was over. Love in some form or other is approaching nearer. I hope it’s all going to come natural. Of course I’m nervous. This will be my first time, after all. I hope it will be with someone I love.

I wished Tod would go and dig out that blue tin of his, so I could get a proper look at this Irene. But he didn’t, of course. Fine chance.

Maybe love will be like driving.

‘Pop? Your driving days are over.’ So said the mechanic in his oily dungarees. So said the hospital orderly in his cool white smock. But they were wrong. On the contrary, our driving days have just begun. I think Tod must be hankering for the old house, over to Wellport, because that’s where most of our trips end up. He’s kept a key. We go in and look it over. It’s empty now. He sizes things up. He appraises things. It’s done with love, this measuring. More recently we’ve started looking at other properties in the general neighbourhood. But none of them is worth measuring, like our old place. The people in the other houses are extremely pleased to see us, but Tod just looks right through them.

We’ve started finding love letters in the trash, letters from Irene. Maybe love will be like driving. When people move – when they travel – they look where they’ve come from, not where they’re going. Is this what the humans always do? Then love will be like driving, which doesn’t appear to make much immediate sense. I mean, you have five reverse gears and only one for forward, which is marked ‘R’, for Reverse. When we drive, we don’t look where we’re going. We look where we came from. There are accidents, sure, and yet it all works out. The city streams and pours in this symphony of trust.

My career . . . I don’t want to talk about it. You don’t want to hear about it. One night I got out of bed and drove – very badly – to an office. I then had a party with my new colleagues. At six o’clock I went to the room with my name on the desk, donned a white coat, and started work. What at? Doctoring!

Tod’s dreams are full of figures who scatter in the wind like leaves, full of souls who form constellations like the stars I can’t see. He is conducting a long argument, and he is telling the truth, but the invisible people who might hear and judge luckily refuse to believe him and turn away with infinite weariness and disgust. Sometimes he is stoically mutilated by painfully fat burgers and aldermen. Sometimes he glows with great power, power lent by the tutelary maker who presides over all his sleep.

He is travelling toward his secret. Passenger or parasite, I am travelling there with him. It will be bad. It will be bad, and not intelligible. But I will know one thing about it (and the certainty is comforting): I will know how bad the secret is. Already I know this. I know that it is to do with shit and trash, and that it is wrong in time.

As life speeds up like this I move among the urban people, in the urban setting, the city’s metal and mortar, its sharper interactions, with more grit and bite in its gears. The city – and there are bigger cities than this – does things to the people who live in it. Does most things, perhaps, to the people who shouldn’t be in the city. Tod Friendly, I think, shouldn’t be in the city. Oh, he quite likes it, in some ways; he’s stopped driving out to Wellport but I bet he misses our time there, its vigourlessness so safe and morally neutral, when he wore the venerable uniform of old age. (The old aren’t cruel, are they. We don’t look to the old, to the stooped, for cruelty. Cruelty, which is bright-eyed, which is pink-tongued.) Together with Tod’s growing vigour I sense also a growing unease. I have no access to his secret. His secret moans down there in Tod’s gut. I have no access to his thoughts. And what would his thoughts say, anyhow? I get the impression that sequentiality, for instance, is not a big thing with people’s thoughts. These thoughts would swoop and jabber, coming from all directions. Like faces with mean little mouths. With mean little teeth.

This is more than city. This is inner city. And despite his new-found professional status, Tod lives among the underclass. Under, inner – how does the condition express itself? . . . Jesus, how do cities get here? One can just about imagine the monstrous labours of the eventual demolition (centuries away, long after my time), and the eventual creation of the pleasant land – the green, the promised. But I’m awfully glad I wasn’t around for the city’s arrival. It must have just lurched into life. It must have just lurched into life out of a great trodden stillness of dust and damp. My colleagues at Associated Medical Services, they tend to live, prudently and intelligibly enough, up on the Hill or in the western suburbs, toward the ocean. But perhaps Tod Friendly has need of the city, where he can always move among others, where he is never considered singly.

As for my career move, it began like so. One night about a month ago, I woke up in unusually poor shape, half clothed, in fact, and with the bedroom intolerably slewing around me as if tethered to a loosening capstan inside my chest. I got out of bed and put the rest of my clothes on. Jesus: no wonder I felt so awful yesterday (for yesterdays are always awful, when Tod really hits the tea). Then we did a weird thing. It felt ‘significant’: coyly significant. We went into the living room and seized the brass clock which has for so long adorned the shelf above our fireplace, and violently enclosed it in the wrapping paper and ribbons that we found in the trash. Tod stood there for a moment, staring at the mirror with a grin of contempt. The room was still reeling. Counter-clockwise. In the car we shimmied our way to the welcoming party at Associated Medical Services, on Route 9. Tod, incidentally, unloaded the clock on one of the nurses, little Maureen, a fair and freckly type whose large amorphous mouth seemed designed to express only powerlessness. Powerlessness: hope and no-hope, both at the same time.

Well, I can’t claim that this doctoring business came as a total surprise. For a while now the narrow house has been filling up with medical paraphernalia, with doctoring tackle. Books about anatomy, born from fire in the back yard. Prescription pads. A plastic skull. One day Tod took from the trash a little framed certificate and went and hung it on the nail in the toilet door. With amusement he surveyed it – for several minutes. And of course I’m delighted when something like this happens, because words make plain sense, even though Tod always reads them backward. Some snippets from the certificate:

I swear by Apollo Physician, by Health, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgement, this oath and this indenture . . . I will keep pure and holy both my life and my art. In whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrongdoing and harm . . .

Tod had a good laugh at that, as well he might . . . Also, the characteristic black bag, swung out of a closet. Inside, a world of pain.

The actual doctoring I’m pretty stoical about. Not that I have any say in the matter. I don’t give the orders around here; really, I’m just along for the ride. So stoicism, I figure, is my best option. Tod and I seem to be on top of the work, and nobody complains. Up until now we’ve been spared any of the gorier stuff they do here – and some of this stuff you just wouldn’t believe. Surprisingly, Tod is known and mocked and otherwise celebrated for his squeamishness. I say surprisingly because I know Tod isn’t squeamish. I’m squeamish. I’m the squeamish one. Oh, Tod can hack it OK. His feeling tone – aweless, distant, scornful – is quite secure against the daily round in here: the routine mortifications, the constant sense of anxiety and tenderness poised against a puerile esprit de corps, the sounds of grief, the stares of vigil, and the smell of altered human flesh. Tod can take all this – whereas I’m harrowed by it. For me, work is an eight-hour panic attack. I’m trying hard to understand the question of violence, to understand that violence is necessary, salutary, that violence is good. But I can find nothing in me that assents to its ugliness. I was always this way, I realize, even back in Wellport. A child’s weeping calmed by the firm slap of the father’s hand, a dead ant revived by the indifferent press of a passing sole, a wounded finger healed and sealed by the knife’s blade: anything of that kind made me flinch and gag. Christ, I couldn’t see an aspirin without wanting to throw up. But the body I live and move in, Tod’s body, feels nothing.

We seem to specialize in the following things: paperwork, gerontology, maladies related to the central nervous system, and what they call talkdown. I sit there in my white coat, with my reflex hammer, tuning forks, small flashlight, tongue blades, pins, needles. My patients are even older than I am. It has to be said that they usually look pretty cheerful on their way in. They turn, and sit, and nod bravely. ‘Good,’ says Tod. The old party then says, ‘Thank you, doctor,’ and hands over his prescription. Tod takes the scrap of paper and does his little stunt with the pen and pad.

‘I’m going to give you something,’ says Tod, ‘that will make you feel better.’ Which is pure bull, I know: any moment now, Tod’s going to stick his finger up the poor guy’s ass.

‘Scared,’ says the patient, undoing his pants.

‘You seem fine to me,’ says Tod. ‘For your age. Do you feel depressed?’

After the business on the couch (a rotten deal for both of us: how we all whimper), Tod’ll do stuff like palpate the carotid arteries in the neck and the temporal arteries just in front of the ears. Then the wrists. Then the bell of the stethoscope is deployed, low on the forehead, just above the orbits. ‘Close your eyes,’ says Tod to the patient, who, of course, immediately opens them. ‘Take my hand. Raise your left arm. Good. Just relax for a while.’ Then it’s talkdown, which will typically go like this:

Tod: ‘It might start a panic.’

Patient: ‘Shout fire.’

Tod: ‘What would you do if you were in a theatre and you saw flames and smoke?’

Patient: ‘Sir?’

Tod pauses. ‘That’s an abnormal response. The normal response would be: “Nobody’s perfect, so don’t criticize others.”’

‘They’ll break the glass,’ says the patient, frowning.

‘What is meant by the saying: “People in glass houses shouldn’t throw stones”?’

‘Uh, seventy-six. Eighty-six.’

‘What’s ninety-three minus seven?’

‘1914-1918.’

‘What are the dates of the First World War?’

‘OK,’ says the patient, sitting up straight.

‘I’m now going to ask you some questions.’

‘No.’

‘Sleeping OK? Any digestive problems?’

‘I’ll be eighty-one in January.’

‘And you’re . . . what?’

‘I don’t feel myself.’

‘Well, what seems to be the problem?’

And that’s it. They certainly don’t look too cheerful on their way out. They back off from me with their eyes wide. And they’re gone. Pausing only to do that creepy thing – knocking, quietly, on your door. At least I can say that I do these old guys no real or lasting harm. Unlike nearly all the other patients at AMS, they go out of here in no worse shape than when they came in.

The social standing enjoyed by doctors is of course impressively high. When you move, as a doctor, through society, with your white coat, your black bag, the eyes of others seek you upward. Mothers express it best: their postures seem to say that you have the power over their children; as a doctor, you can leave the children alone, and you can take them away, and you can bring them back, if you choose to. Yes, we walk tall. Us doctors. Our presence chastens others, renders others serious. The tilted eyes of others gives the doctor his smileless nimbus, his burnish of godlike might. And for what? For this shit . . . One thing that’s helping me through it (and I guess there’s an irony here) is that Tod and I are feeling so damn good these days: physically. I can’t think why Tod doesn’t seem to appreciate the improvement. When I think back to how things were out in Wellport, man, we were still walking, but only just. It was taking us twenty-five minutes to cross the room. We can bend over now with barely a groan, barely a knee-crackle. We’re up and down those stairs – Jesus, where’s the fire? Occasionally we get bits of our body back, from the trash. A tooth, a toenail. Extra hair. And sometimes, and sometimes for hours on end, nothing hurts.

I say that Tod doesn’t appreciate the improvement. Well, if he does, he’s pretty cool about it, mostly. But there is one thing. As if in celebration – or maybe it’s a form of training – Tod and I have started doing a sexual thing with our self. Not very enthusiastically, and not at all successfully either, so far as I can ascertain. Tod? I don’t know. How is it for you? Any good? Because from my point of view it’s a total flop.

I puzzle at the local economy, the commerce, the sad arrangements of the ignored city. And this I get plenty of opportunities to do – to puzzle at it, I mean. I puzzle a lot, if the truth be known. In fact I am forming the impression that I am generally a little slow on the uptake. A real lunk, sometimes. Possibly even subnormal, or mildly autistic. It may very well be that I’m not playing with a full deck. It’s certainly the case that I appear to be hitched up with Tod like this, but he’s not to know I’m here, and I feel unique and alone, uniquely alone . . . Tod Friendly, stocky, emollient Tod Friendly, moves around freely in the city’s substructures, the shelters, the centres, the halfway houses, the flops. He isn’t one of the entrenched busybodies or Little Annie Fixits who serenely police these mysterious institutions, where abuse is the buzzword. He comes and goes. He suggests and directs and recommends. He’s one of grief’s middlemen. For life here is junkie, is hooker, is single-parent, is no fixed abode.

Hookers have this thing for mature men. They do. You hardly ever see them bothering with guys their own age. Watchfully the johns back their way into the significant rooms, the little apartments of the low tenement on Herrera, a building which basks in its own brand of dampness and dread. An act of love occurs, for which the John, or the ‘trick’ as he’s called, for some reason, will be quickly reimbursed. I once witnessed such a transaction: the girl took the bills from the crux of her brassiere and laid them out among the dresser’s rubble; with trembling hands the John then discreetly pocketed his pay. Afterward, the couple will fondly stroll back on to the street, and part. The men slope off, looking ashamed of themselves (doing it for money like that). Ravenously the hooker will remain, on the sidewalk, in tank top, in hot pants, killing time before her next date. Or hitching rides to nowhere with the additional old stiffs who cruise by in their cunning old cars. Tod is quite often to be found in the tenement of whores. He’s a senior citizen, so the girls are forever putting their moves on him. But Tod’s not there for the sex and the dough. On the contrary. He shells out, and always keeps his pants on. Basically it seems that Tod scores drugs there. The deals are conducted mostly on paper, though sometimes he will take his syringe from the black bag and draw a shot of tetracycline or methadone from arm or rump. Sometimes too there are physical injuries to be tackled, over there in the tenement on Herrera, with its twisted sheets, its stained bidets.

Halfway houses are places at which people stop by on their way to prison, where they are trained for serious crime (with dumb-bells, boredom, the low grumble of the exercise yard). At the flops, the guys all eat the same thing. Unlike a restaurant or the little cafeteria at AMS. It’s not good, I think, when everyone eats the same thing. I know that none of us has any choice about what we eat; but I get a woozy feeling when I watch them spoon away, and the plates – twenty or thirty of them – all fill up with the same thing. Junkies sell blood. The women at the refuges and the crisis centres are all hiding from their redeemers. The crisis centre is not called a crisis centre for nothing. If you want a crisis – just check in. The cuts, the welts, the black eyes get starker, more livid, until it is time for the women to return, in an ecstasy of distress, to the men who will suddenly heal them. Some require more particular treatment. They stagger off and go and lie in a park or a basement or wherever, until men come along and rape them, and then they’re OK again.

It’s lucky that the city is getting better, and getting better so fast.

I am naturally much buffeted by Tod’s responses to these exhausting and unwelcome stimuli. And I have to say that he strikes me as typically perverse and mean-minded in his attitude to the pimps. The pimps – these outstanding individuals, who, moreover, lend such colour to the city scene, with their clownishly customized clothes and cars. I would like to ask Tod the following question. What on earth would become of the poor girls without their pimps, who bankroll them, who shower money on them? All right, so the girls blow it all on the old men. So what! Oh, I suppose they’d be better off left to Tod’s tender mercies, would they? All he does is go round there and rub dirt in their wounds. And gets out quick, before the long-suffering pimp shows up and knocks the chick into shape with his jewelled fists. As he works, the baby in the cot beside the bed will hush its weeping, and sleep peacefully, secure in the knowledge that the pimp is come.

Mothers bring Tod their babies in the night. Tod discourages this – but he’s usually pretty sympathetic. The mothers pay him in antibiotics, which often seem to be the cause of the babies’ pain. You have to be cruel to be kind. The babies are no better when they leave, patiently raising hell all the way to the door. And the moms crack up completely: they go out of here wailing. It’s understandable. I understand. I know how people disappear. The little children on the street, they get littler and littler. At some point it is thought necessary to confine them to pushchairs, later to backpacks. Or they are held in the arms and quietly soothed – of course they’re sad to be going. In the very last months they cry more than ever. And no longer smile. The mothers then proceed to the hospital. Where else? Two people go into that room, that room with the forceps, the soiled bib. Two go in. But only one comes out. Oh, the poor mothers, you can see how they feel – during the long goodbye, the long goodbye to babies.