For me, no word comes without prior thought. No sentence is generated without effort. No formulation is made automatically. I am faced continually with a mystery that other people have no conception of, the mystery of the generation of speech. There is no command situation, it goes back and back and back. Where the self lies at the heart of the utterance, the speaker generating the word, is always clouded. This is true for everyone, but for most people this is not something to think about. The generation of words is automatic. For me, that automatic link is broken. Word generation involves strain, guesswork, difficulty, imprecision.

This cockroach-like existence is cumulatively intolerable even though on any given night it is perfectly manageable. “Cockroach” is of course an allusion to Kafka’s Metamorphosis, in which the protagonist wakes up one morning to discover that he has been transformed into an insect. The point of the story is as much the responses and incomprehension of his family as it is the account of his own sensations, and it is hard to resist the thought that even the best-meaning and most generously thoughtful friend or relative cannot hope to understand the sense of isolation and imprisonment that this disease imposes upon its victims.

I realized that the biggest obstacle was my mind. It was the biggest obstacle, and if I could get out of the way of myself, I would grow. So every time I had that attitude, I changed it, and I’d say, “You can. Today you can, and take it one day at a time, and today, I’m going to get up and I’m not going to think about the other six days of this week. I’m going to get up right now, and I’m going to go to the gym, and I’m going to learn about my boxing, and I’m going to be in the moment.” You know, in anything, you hit a wall, and then you have to break through it, and I just had to get out of my own way.

Myself, I love the imagery of struggle. I sometimes wish I were suffering in a good cause, or risking my life for the good of others, instead of just being a gravely endangered patient. Allow me to inform you, though, that when you sit in a room with a set of other finalists, and kindly people bring a huge transparent bag of poison and plug it into your arm, and you either read or don’t read a book while the venom sack gradually empties itself into your system, the image of the ardent soldier or revolutionary is the very last one that will occur to you. You feel swamped with passivity and impotence: dissolving in powerlessness like a sugar lump in water.