Sometime over the winter of 2010–11 I began to be gorged with blood – or, rather, my blood itself began to be gorged with red blood cells, with haemoglobin. I didn’t pay it much attention – mostly because I didn’t realize it was happening, the only perceptible symptoms being a certain livid tinge to my face and to my hands, which, I joked to family and friends, had started to resemble those pink Marigold washing-up gloves. When I took my gorged hands out of my jeans pockets the tight denim hems left equally vivid bands smeared across their backs – these, I facetiously observed, were the colour of those yellow Marigold washing-up gloves.

I had no intention of doing anything about my pink-and-yellow-striped hands. This is not, I stress, because I’m especially neglectful of my health – at times I can verge on hypochondria – but rather because they didn’t strike me as obviously cancerous. I was on the lookout for the crab – but then I always am. It scuttled away my father and mother, the latter at sixty-five, an age she would’ve described herself – also facetiously – as ‘getting younger’. And during the preceding year it had been nipping at my forty-seven-year-old wife, trying to drag her down the sable strand and into the salt, chill waters that lap against life. She had been diagnosed with breast cancer in June of 2010, had a mastectomy in August, followed by a gruelling autumn then winter of chemotherapy and a silent spring of radiation.

My wife bore her illness in a manner that demanded nothing but admiration. As we walked down the grotty staircase of Guy’s Hospital Tower from the consultation where she’d been informed of how radical her surgery would need to be, she turned to me and said, ‘I’m so lucky. If it was twenty-five years ago, or I was somewhere else in the world, I’d’ve just received a death sentence.’ I imagined that if they had cut out her heart instead of cutting off her breast they would have found ‘devoid of self-pity’ written on it. I was less sanguine – metaphorically speaking. I felt distracted and doomy; I was a dilatory carer – and at times seemingly wilfully inept. I could just about manage the basics: the feeding and dressing of our two younger children, and the forcing upon her of increasingly unwanted cups of tea.

It didn’t help that we seemed to be at the epicentre of a cancer cluster: one friend was dying of leukaemia in the Hammersmith Hospital, another was in the process of being diagnosed – a third had had half his throat and jaw chopped out. Cancer? I hear you ask. Yes, of course it was fucking cancer, what else could it be? I fully expected cancer myself. To paraphrase the late and greatly pathetic roué Willie Donaldson, you cannot live as I have and not end up with cancer. There was the genetic factor to begin with, and then there’s been the toxic landscape of carcinogens – the yards of liquor, the sooty furlongs left behind by chased heroin, the miles driven and limped for over a decade to score crack which then scoured its way into my lungs. The prosaically giant haystacks of Virginia tobacco hardly bear mentioning – being, in contrast, merely bucolic.

No, I was on the lookout for the crab – not a pair of lobster’s claws. It was my wife who eventually sent me across the road to the GP, a shrewdly downbeat practitioner who in the past had declined to check my cholesterol levels (no need, you’ve cut your smoking right back, you’re thin and fit, and your blood pressure’s low) or send me for a prostate-cancer biopsy (too many false negatives so there’s hardly any point), but now took one look at the human-into-crustacean transmogrification and sent me straight down to St Thomas’s for a blood test. The results came within a couple of days, and when I saw him in person he confirmed what he’d told me over the phone: ‘Your haemoglobin is right up, and your white blood cell count is also elevated. I can’t be certain but I think there’s a strong possibility it’s –’

I pre-empted him: ‘Polycythaemia vera?’

‘Aha,’ he said. ‘Been googling, have you?’ I conceded that I had. ‘Well,’ he continued, ‘the Wiki entries are pretty thoroughly vetted – if you stick to that you’re on safe ground.’

I inwardly congratulated myself for having done just that. But still, polycythaemia vera – what was that? A disease that sounded like a Greek goddess spliced with an East End pub landlady, a disease that resulted from a single gene mutating and instructing your bone marrow to indulge in a mindless overproduction of red blood cells. A disease that was rare, chronic, incurable and, while no one yet understood the exact reasons for the mutagenesis, disproportionately present among Ashkenazi Jews. I liked that – in my transgenerationally facetious way: my mother had passed a generous dose of Jewish anti-Semitism down to me, and along with it this Jewish disease had been bred in the bone.

José Saramago: a celebration
Your Birthday Has Come and Gone