The bumpy skull beneath the skin

During the weekly upper neck, face and cranial examination, I discover a huge, disfiguring lump on the back of the head. Situated two inches to the left of centre, and parallel with the ear lobe, it is almost ovular in shape, a little tender but unyielding to the touch.

Why I ever request a second opinion from my wife I've no idea, but I do. I always do. 'It's nothing,' decrees the queen of diagnostic nihilism, after feeling the growth. 'Quite common.' 'Ah yes, of course,' I reply. 'In fact, it's because this type of growth is so common that they never bothered to make a film starring John Hurt about a man with a grotesque cranial disfigurement.' Rebecca's lips contract markedly, but it is only when I make the tactical error of suggesting we send out the search party that silence descends once again upon the marital home.

Having grown dramatically overnight, the lump is now joined by a smaller twin on the other side. When I mention this, Rebecca mutters something about not talking to me until I prove my mood has improved by saying 'something cheerful'. She claims I am ill-tempered due to a new health regime - on Saturday, I gave up smoking, drinking and eating - which she now says is too draconian. 'That's complete cobblers,' I explain, 'and anyway, if these lumps are what I think they are, you won't have to worry about my moods for much longer.' This appears to qualify as 'something cheerful', and the marital frost begins to thaw.

The head lumps have enjoyed another growth spurt, and have also changed shape so that they now feel like small watermelons. Meanwhile, persistent faintness allied to a tinnitus-type buzzing at the temples suggests the disease may be undergoing the process of metastasis.

The faintness intensifies, the buzzing worsens and a trip to the scales reveals the loss of three pounds since Monday. 'That's it,' I tell Rebecca, 'that's the clincher.' 'Remind me,' she says, falling back on her favoured Socratic mode of questioning, 'what you've eaten since Tuesday.' 'Six kiwi fruit, two ounces of brown rice, a pear, two prunes, three tomatoes, a lemon sole, one Cadbury's Rich Tea biscuit and 23 green olives.' 'Well that can't have anything to do with these symptoms,' she says, embarking on her bangers and mash, 'So I guess it must be cancer.'

I awake feeling drained and jittery having passed a troubled night. In the dream, I am strapped face down to a bed in what must, from the nurses' uniforms, be a Victorian hospital. A white-coated man enters, leading a pair of pantomime cockney rascals.

'Gentlemen, here he is,' says the doctor, 'is he not a truly piteous sight?' 'Gor blimey, guv'nor, he's 'orrible and naw mistake. I'll give yer five sovereigns for 'im.' 'Done,' says the doctor, 'for the fresh air that comes with freak show life will do him a power of good.' Looking in the bedside mirror, I notice that the doctor is John Merrick. 'And yet I shall be sad to see the pathetic wretch leave,' continues the Elephant Man, pocketing the coins. 'What a burden it must be to have such a visage, men such as we cannot imagine. And yet he bears his disfigurement with great nobility.'

During my traditional Sunday lunch (two boiled leeks, a baked parsnip and 11 mangetout), Rebecca sidles upstairs with the portable phone. 'I hope you weren't ringing Sarah Jarvis,' I say when she comes back down, 'I told you, I will not be pressured into consulting her until I am ready.' 'She'll see you tomorrow at 6.20pm.' 'Thank God.'

In Room 19, Dr Jarvis seems keen to move to business, so I tell her about the twin tumours and she begins her examination. It is blood-chillingly brief. 'You know what it is, don't you?' I say as she removes her fingers and sits down. 'I'm afraid I do, yes,' she says, looking at me intently, 'there is something there.' Here it is, then, at last, the moment I knew would come one day. 'Well, go on then. What it is?' 'It's what we doctors,' she goes on, no longer able to hold my gaze, 'call "a skull". I'm afraid it's much more common than you'd think.' 'My God, doctor, how long have I got?' 'Three seconds,' says Dr Jarvis, rising and opening the door, 'five at the outside...'

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