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Most people, he believed, would have thought of him as square. As a young man, he'd thought of himself as square, so conventional and unadventurous that after art school, instead of striking out on his own to paint and to live on whatever money he could pick up at odd jobs – which was his secret ambition – he was too much the good boy, and, answering to his parents' wishes rather than his own, he married, had children, and went into advertising to make a secure living. He never thought of himself as anything more than an average human being, and one who would have given anything for his marriage to have lasted a lifetime. He had married with just that expectation. But instead marriage became his prison cell, and so, after much tortuous thinking that preoccupied him while he worked and when he should have been sleeping, he began fitfully, agonizingly, to tunnel his way out. Isn't that what an average human being would do? Isn't that what average human beings do every day? Contrary to what his wife told everyone, he hadn't hungered after the wanton freedom to do anything and everything. Far from it. He hungered for something stable all the while he detested what he had. He was not a man who wished to live two lives. He held no grudge against either the limitations or the comforts of conformity. He'd wanted merely to empty his mind of all the ugly thoughts spawned by the disgrace of prolonged marital warfare. He was not claiming to be exceptional. Only vulnerable and assailable and confused. And convinced of his right, as an average human being, to be pardoned ultimately for whatever deprivations he may have inflicted upon his innocent children in order not to live deranged half the time.

Terrifying encounters with the end? I'm thirty-four! Worry about oblivion, he told himself, when you're seventy-five! The remote future will be time enough to anguish over the ultimate catastrophe!

But no sooner did he and Phoebe return to Manhattan – where they lived in apartments some thirty blocks apart – than he mysteriously fell ill. He lost his appetite and his energy and found himself nauseated throughout the day, and he could not walk a city block without feeling weak and woozy.

The doctor could find nothing wrong with him. He had begun to see a psychoanalyst in the aftermath of his divorce, and the psychoanalyst attributed his condition to envy of a fellow art director who had just been promoted to a vice presidency in the agency.

"It makes you sick," the analyst said.

He maintained that his colleague was twelve years his senior and a generous coworker whom he only wished well, but the analyst continued to harp on "deep-seated envy" as the hidden reason for the malaise, and when circumstances proved him wrong, the analyst appeared unperturbed by his mistaken judgment.

He went to the medical doctor's office several more times in the succeeding weeks, whereas ordinarily he saw him only for a minor problem every couple of years. But he'd lost weight and the bouts of nausea were getting worse. He'd never before felt so rotten, not even after he'd left Cecilia and the two small boys and the court battle ensued over the terms of the separation and he was characterized to the court by Cecilia's attorney as "a well-known philanderer" because of the affair he was having with Phoebe, who was a new copywriter in the agency (and who was referred to in court by the plaintiff on the witness stand – aggrieved, overwrought, as though she found herself bringing charges against the Marquis de Sade – as "number thirty-seven in his parade of girlfriends," when in fact she was looking too far into the future and Phoebe was as yet number two). At least back then there'd been a recognizable cause for all the misery he felt. But this was his turning overnight from someone who was bursting with health into someone inexplicably losing his health.

A month passed. He couldn't concentrate on his work, he gave up his morning swim, and by now he couldn't look at food. On a Friday afternoon he left work early and took a taxi to the doctor's office without having made an appointment or even a phone call. The only one he phoned was Phoebe, to tell her what he was doing.

"Admit me to a hospital," he told the doctor. "I feel like I'm dying."

The doctor made the arrangements, and Phoebe was at the hospital's information desk when he arrived. By five o'clock he was settled into a room, and just before seven a tall, tanned, good-looking middle-aged man wearing a dinner jacket came into the room and introduced himself as a surgeon who had been called by his physician to take a look at him. He was on his way to some formal event but wanted to stop by first to do a quick examination. What he did was to press his hand down very hard just above the groin on the right side. Unlike the regular physician, the surgeon kept pressing and the pain was excruciating. He felt on the verge of vomiting. The surgeon said, "Haven't you had any stomach pain before?" "No," he said. "Well, it's your appendix. You need an operation." "When?" "Now."

He saw the surgeon next in the operating room. He'd changed out of the evening clothes into a surgical gown. "You've saved me from a very boring banquet," the surgeon said.

He didn't wake up until the next morning. Standing at the foot of the bed, along with Phoebe, were his mother and father, looking grim. Phoebe, whom they did not know (other than from Cecilia's denigrating descriptions, other than from the telephone tirades ending, "I pity this Little Miss Muffet coming after me – I honestly do pity the vile little Quaker slut!"), had phoned them and they'd immediately driven over from New Jersey. As best he could make out, a male nurse seemed to be having trouble feeding some sort of tube up his nose, or maybe the nurse was trying to extract it. He spoke his first words – "Don't fuck up!" – before falling back into unconsciousness.

His mother and father were seated in chairs when he came around again. They seemed still to be tormented and weighed down by fatigue as well.

Phoebe was in a chair beside the bed holding his hand. She was a pale, pretty young woman whose soft appearance belied her equanimity and steadfastness. She manifested no fear and allowed none in her voice.

Phoebe knew plenty about physical misery because of the severe headaches that she'd dismissed as nothing back in her twenties but that she realized were migraines when they became regular and frequent in her thirties. She was lucky enough to be able to sleep when she got one, but the moment she opened her eyes, the moment she was conscious, there it was – the incredible ache on one side of her head, the pressure in her face and her jaw, and back of her eye socket a foot on her eyeball crushing it. The migraines started with spirals of light, bright spots moving in a swirl in front of her eyes even when she closed them, and then progressed to disorientation, dizziness, pain, nausea, and vomiting. "It's nothing like being in this world," she told him afterward. "There's nothing in my body but the pressure in my head." All he could do for her was to remove the big cooking pot into which she vomited, and to clean it out in the bathroom, and then to tiptoe back into the bedroom and place it beside the bed for her to use when she was sick again. For the twenty-four or forty-eight hours that the migraine lasted, she could not stand another presence in the darkened room, any more than she could bear the thinnest sliver of light filtering in from beneath the drawn shades. And no drugs helped. None of them worked for her. Once the migraine started, there was no stopping it.