The stroke cut out a lot of my external trips: my sports car and golf and my cello. This [ points to hand ] is just not much use with a cello, and I was—forced inside, and finding myself living in my inside. And that has made me be part of my soul. And that's perceiving my incarnation from here [ points to heart ], rather than from here [ points to head ]. And since this is words, I start from here, go over there.

When I was a child the mailman came once a day. Now the mail arrives every moment. I used to believe it was preposterous that people could fall in love online. Now I see that all relationships are virtual, even those that take place in person. Whether we use our bodies or a keyboard, it all comes down to two minds crying out from their solitude.

Part of what separates us from the other creatures on earth is that we make up stories. We are storytellers. And we can tell bad stories and we can tell good stories. We can tell stories that lead to division and hate and war. Or we can tell stories that lead to cooperation and peace and progress.

I was forced to think very hard about what it meant to be me, what it means to be a person who is only a brain. Pascal's 'thinking reed' really does capture it, because I'm just a bunch of dead muscles thinking.

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.)

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.

The chief side effect of this pain is numbness in the extremities, filling me with the not irrational fear that I shall lose the ability to write. Without that ability, I feel sure in advance, my “will to live” would be hugely attenuated. I often grandly say that writing is not just my living and my livelihood but my very life, and it’s true. Almost like the threatened loss of my voice, which is currently being alleviated by some temporary injections into my vocal folds, I feel my personality and identity dissolving as I contemplate dead hands and the loss of the transmission belts that connect me to writing and thinking.

I have more than once in my time woken up feeling like death. But nothing prepared me for the early morning last June when I came to consciousness feeling as if I were actually shackled to my own corpse. The whole cave of my chest and thorax seemed to have been hollowed out and then refilled with slow-drying cement. I could faintly hear myself breathe but could not manage to inflate my lungs. My heart was beating either much too much or much too little. Any movement, however slight, required forethought and planning.

My chief consolation in this year of living dyingly has been the presence of friends. I can’t eat or drink for pleasure anymore, so when they offer to come it’s only for the blessed chance to talk. Some of these comrades can easily fill a hall with paying customers avid to hear them: they are talkers with whom it’s a privilege just to keep up. Now at least I can do the listening for free. Can they come and see me? Yes, but only in a way. So now every day I go to a waiting room, and watch the awful news from Japan on cable TV (often closed-captioned, just to torture myself) and wait impatiently for a high dose of protons to be fired into my body at two-thirds the speed of light. What do I hope for? If not a cure, then a remission. And what do I want back? In the most beautiful apposition of two of the simplest words in our language: the freedom of speech.

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.