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Sad sex is when she is sober, you both desire one another, you know that you will always love her regardless, just as she will always love you regardless, but you – both of you, perhaps – now realize that loving one another does not necessarily lead to happiness. And so your lovemaking has become less a search for consolation than a hopeless attempt to deny your mutual unhappiness.

Good sex is better than bad sex. Bad sex is better than no sex, except when no sex is better than bad sex. Self-sex is better than no sex, except when no sex is better than self-sex. Sad sex is always far worse than good sex, bad sex, self-sex and no sex. Sad sex is the saddest sex of all.

At college you meet Paula – blonde, friendly, direct – who has switched to law after a short-service commission in the Army. You like her handwriting when she shows you a case summary from a lecture you missed. You invite her for coffee one morning, then start having sandwich lunches in the nearby public gardens. One evening you take her to the cinema and kiss her goodnight. You exchange phone numbers.

A few days later, she asks, ‘Who’s that madwoman who lives in your house?’

‘I’m sorry?’ Already there is a chill spreading through you.

‘I rang you up last night. A woman answered the phone.’

‘That would have been my landlady.’

‘She sounded as mad as a hatter.’

You take a breath. ‘She’s a little eccentric,’ you say. You want this conversation to stop, immediately. You wish it had never started. You wish Paula had never phoned the number you gave her. You very much don’t want her to be specific, but you know she is going to be.

‘I asked when you’d be back, and she said, “Oh, he’s very much the dirty stop-out, that young man, you can’t rely on him from one moment to the next.” And then she came over all genteel and said something like, “If you will excuse me while I fetch a pencil, I shall pass on any message you may choose to leave.” Well, I put the phone down before she came back.’

She is looking at you expectantly, sure that you will provide her with an explanation that will satisfy her. It doesn’t have to be much; a joke might even do it. Various extravagant lies cross your mind until, preferring the quarter-truth to the self-interested obfuscation – and also feeling stubborn and defensive about Susan – you repeat,

‘She’s a little eccentric.’

And that, unsurprisingly, is the end of your relationship with Paula. And you realize that such a pattern is likely to repeat itself with other friendly and direct girls whose handwriting you admire.

Around this time, you stop thinking of her family by their nicknames. All that Mr Elephant Pants and Miss Grumpy stuff was fine and funny at the time, part of the first silliness and proprietoriness of love. But it was also a facetious minimising of their presence in her life. And if you are beginning to think of yourself as grown-up – however forcedly and prematurely – then they should be allowed their own maturity as well.

Another thing you notice is that you no longer fall easily into the private, teasing love language that used to pass between you. Perhaps the weight of what you have taken on has temporarily crushed out love’s decorativeness. Of course, you still love her, and tell her so, but in plainer terms nowadays. Perhaps, when you have solved her, or she has solved herself, there will be room again for such playfulness. You can’t be sure.

Susan, however, continues using all the little phrases from her side of the relationship. It is her way of maintaining that nothing has changed, that she is fine, you are fine, all is fine. But she, you and it aren’t, and those familiar words sometimes cause a prickle of embarrassment, more often lurching pain. You let yourself into the house, deliberately making enough noise to alert her, and as you come down the short flight of stairs into the kitchen, you find her in a familiar pose: red-faced by the gas fire, wrinkling her brow at a newspaper as if the world really does need to sort itself out. Then she looks up brightly and says, ‘Where’ve you been all my life?’ or ‘Here’s the dirty stop-out’, and your cheerfulness – even if briefly assumed – drains like bathwater. You look around and take stock of the situation. You open the store cupboards to see if there is something you can make into something. And she lets you get on with it, while offering occasional remarks designed to convey that she is still well capable of understanding a newspaper.

‘Things seem to be in a frightful mess, don’t you agree, Casey Paul?’

And you ask, ‘Where exactly are we talking about?’

And she replies, ‘Oh, just about everywhere.’

At which point you might throw the emptied tin of plum tomatoes into the bin with some force, and she will chide you,

‘Temper, temper, Casey Paul!’

By months of manoeuvring, you get her first to a GP and then to a consultant psychiatrist at the local hospital. She doesn’t want you to come with her, but you insist, knowing what will probably happen otherwise. You turn up at a quarter to three for a three o’clock slot. The waiting area already contains a dozen other patients, and you realize it is the hospital’s policy to book everyone in for the same time, which is when the consultant’s session begins. You can see their point: mad people – and at your age you use the term pretty broadly – are presumably not among the world’s most punctilious timekeepers: so it’s best to summon them all en bloc.

She makes what might be an attempt to escape, heading off to the ladies. You let her go with a fifty–fifty expectation that she won’t return. But she does, and you find yourself reflecting cynically that she probably went to the hospital shop to check if they stocked booze, or maybe asked a few nurses where the bar was, only to receive the annoying news that the hospital doesn’t have one.

You realize how sympathy and antagonism can coexist. You are discovering how many seemingly incompatible emotions can thrive, side by side, in the same human heart. You are angry with the books you have read, none of which have prepared you for this. No doubt you were reading the wrong books. Or reading them in the wrong way.

You feel, even at this late, desperate stage, that your emotional situation is still more interesting than that of your friends. They (mostly) have girlfriends and (mostly) have peer sex; some have been inspected by their girlfriends’ parents, receiving approval, disapproval, or judgement suspended. Most have a plan for their future life which includes this girlfriend – or, if not, one very similar. A plan to become furrow-dwellers. But for the moment, they have only the traditional clear-skinned joys, sane dreams, and inchoate frustrations of young men in their mid-twenties with girlfriends of the same age. Yet here you are, in a hospital waiting area, surrounded by mad people, in love with a woman who is being characterized as potentially mad.

And the strange thing is, part of you feels exhilarated by it. You think: not only do you love Susan more than they love their girlfriends – you must do, otherwise you wouldn’t be sitting here among all the nutters – but you are having a more interesting life. They may measure their girlfriends’ brains and breasts, and their future parent-in-laws’ deposit accounts, and imagine they have won; but you are still ahead of them because your relationship is more fascinating, more complicated, and more insoluble. And the proof of this is that you are sitting here on a metal stacking chair, half-reading some discarded magazine, while your beloved dreams of – what? Escape, no doubt: escape from here, escape from you, escape from life? She too is staggering beneath the weight of extreme, unbearable and incompatible emotions. You are both in deep pain. And yet, aware as you are of the stupid, bolloxy world of male competitiveness, you tell yourself that you are still a winner. And when you get to this point in your thoughts, the next logical stage is this: you’re a nutter as well. You are obviously one stark staring, complete and utter nutter. On the other hand, you are the youngest fucking nutter in the whole waiting area. So you have won again! Former under-12, under-6-stone school boxing champion becomes Hospital’s under-26 nutter champion!