It’s already happened – HRT.

Having my family in closer proximity, but that’s what comes with living in another country.

To move like I did in my early 20s. I’ve had knee and hip surgery, and my toe joint fused since.

I have a great quality of life, there is nothing that I want for.

Deprivation of the ability to speak is more like an attack of impotence, or the amputation of part of the personality. To a great degree, in public and private, I “was” my voice. All the rituals and etiquette of conversation, from clearing the throat in preparation for the telling of an extremely long and taxing joke to (in younger days) trying to make my proposals more persuasive as I sank the tone by a strategic octave of shame, were innate and essential to me. I have never been able to sing, but I could once recite poetry and quote prose and was sometimes even asked to do so.

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.

Before I was diagnosed with esophageal cancer a year and a half ago, I rather jauntily told the readers of my memoirs that when faced with extinction I wanted to be fully conscious and awake, in order to “do” death in the active and not the passive sense. And I do, still, try to nurture that little flame of curiosity and defiance: willing to play out the string to the end and wishing to be spared nothing that properly belongs to a life span. However, one thing that grave illness does is to make you examine familiar principles and seemingly reliable sayings. And there’s one that I find I am not saying with quite the same conviction as I once used to: In particular, I have slightly stopped issuing the announcement that “Whatever doesn’t kill me makes me stronger.”

There is an even longer shot that I do propose to attempt even though its likely efficacy lies at the outer limits of probability. I am going to try to have my entire DNA “sequenced,” along with the genome of my tumor. ... So perhaps I will be able to contribute a little bit to enlarging the knowledge that will help future generations.

Instead, I am badly oppressed by a gnawing sense of waste. I had real plans for my next decade and felt I’d worked hard enough to earn it. Will I really not live to see my children married? To watch the World Trade Center rise again? To read—if not indeed write—the obituaries of elderly villains like Henry Kissinger and Joseph Ratzinger? But I understand this sort of non-thinking for what it is: sentimentality and self-pity.

And even if my voice goes before I do, I shall continue to write polemics against religious delusions, at least until it’s hello darkness my old friend. In which case, why not cancer of the brain? As a terrified, half-aware imbecile, I might even scream for a priest at the close of business, though I hereby state while I am still lucid that the entity thus humiliating itself would not in fact be “me.” (Bear this in mind, in case of any later rumors or fabrications.)