“I shall not waste my days,” said Ian Fleming, quoting Jack London, “in trying to prolong them”. The studied loucheness of the epigram would grate had he not lived a life so unwaveringly faithful to it. Gonorrhoea at 19, death at 56, the uncountable Morlands that he smoked in between — the Rake of Oracabessa mastered the lost art of what we can only call unwellness. Oh, for its return.

In the 1970s, medical researchers evolved the concept of quality-adjusted life years. What mattered was not how much longer a treatment would keep someone alive for, but whether that extension was free from pain and distress. The hard-won reprieve was meaningless if it entailed a living hell.

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