The ‘journey’ — at least the one played out in public — begins with an announcement that you are incurable. Patient waiting follows, described in monthly essays written for a respected publication. Jenny Diski (non-small cell adenocarcinoma, London Review of Books) calls this personally singular but culturally familiar experience the race from ‘the Big C to the Big D’. Surely the hope is not to reach the end in the fastest time. But if you take too long, your audience’s sympathy might tinge with suspicion, as Clive James (B-cell lymphocytic leukemia, the Guardian) recently described, now a survivor of several years.

Claiming a title for your cancer memoir has also become competitive. Oliver Sacks (metastasised ocular melanoma, New York Times) chose Gratitude for the beautiful and moving volume released after he died last August. Diski’s In Gratitude concedes that Sacks got there first, but she has no intention to follow the genre passively, nor recount stoic tales of something ‘learned or earned’. She disturbs the space in her title, daring to bring up her ingratitude too.

The ‘great slog of getting on with cancer’ is the starting point from which Diski reflects on a lifetime of incident and inspiration, stripped of smoothed clichés and what ‘the Poet’ (Diski’s partner, Ian Patterson) would call ‘whimsical dishonesty’. ‘Negativity is my inclination,’ Diski writes, ‘whether biochemical and/or environmentally produced,’ a disposition goaded on by ‘chemo-brain’. When that ‘liquidised metal’ is in your blood, she says, ‘Schindler’s lift, the world’s slowest elevator’ en route to the oncology waiting room in Addenbrooke’s, feels like a personal insult, and the fishless aquarium once you get there strikes a depressing note, its imagined inhabitants presumably long dead.

Diski knows she has much to be thankful for, particularly her two saviours: Doris Lessing and the NHS. Half a century ago, Lessing, on the suggestion of her son Peter (a classmate of Diski’s who admired her intelligence), opened her home to this difficult 14-year-old, who was in the grips of ‘borderline personality disorder’ and troubled parents, themselves in dire need of care. From Foucault to the ‘secrets of good and bad sex’, conversation at Doris’s kitchen table enjoyed a rolling cast of Ted Hughes, Alan Sillitoe and R.D. Laing among others. Diski, with her gift for bathos, made notes on the minor characters too, like Laing’s wife, who would drop ‘into sleep every time he started to speak’.

Four years living with Doris were book-ended by periods in psychiatric facilities. Diski graduated from being ‘the baby-of-the-bin’ on her first admission, to nine months in the Maudsley, which she now calls her ‘alma mater’. By the time her teens were over, she knew well the ‘inner seethings of loss’ when your ‘time as part of a system runs out’, no longer someone else’s charge.

To be the beneficiary of Doris and the NHS’s care, both free at the point of delivery, was a stroke of luck. But neither was always an easy object of affection. Diski once made the mistake of seeking reassurance that Doris really liked her, which prompted Lessing to march out of the house, livid at this ‘emotional blackmail’. She seemed unaware ‘how painful or disastrous her actions or pronouncements could be’, Diski remembers, a resentment Diski was conscious of into adulthood and which sometimes felt like ‘a heart attack from the anger’.

Her more recent caregiver — alias ‘Onc Doc’ — is differently infuriating. Diski suspects that this hospital consultant’s ‘studied neutrality’ remains unruffled even when he is ‘going over the top on a rollercoaster’. In radiotherapy, Diski was only sometimes told what was happening as the bulk of the Elekta Linear Accelerator was moved into place. She became ‘a loose component, a part the machine lacked’.

‘Falling on my feet’ is how Diski describes her deliverances. Yes, falling on your feet is better than falling on your face, but it’s still falling. An emotion which suggests how gratitude and ingratitude interweave is embarrassment. To feel embarrassed can be a mark of humility and indebtedness, or displacement and protest. Social ritual has always left Diski ‘beside myself with embarrassment’, as if she were having an out-of-body experience (which might explain why she can describe her thoughts in such moments with critical vividness). On being told her diagnosis, she is mortified, realising there is no retort which hasn’t already been spoken in countless movies and daytime soaps.

Diski’s acceptance that she has ‘no choice but to perform and to be embarrassed to death’ scorns the pernicious yet fashionable idea that death is a lifestyle choice of sorts; that it has the power to speak eloquently about character, or worse still, about a writer’s work. Diski’s line is simple: ‘I want to die easily.’ This deeply human wish bears no resemblance to the rich messiness of Diski’s life, nor the challenging delight of her writing.