Even happy situations can easily start to feel miserable. So, I think that people who consider themselves sophisticated or who are in fact sophisticated have come to distrust stories that are uplifting or simply stories in which the characters get what they want in the end. Because in life, what you want is never the end.

Death is a big theme in the book, illness. What is that? It's a fact that human beings - no matter who they are, no matter how healthy or strong or beautiful they are - are going to age and become weak and ugly by a certain standard, and die. And I think that's a terrifying idea for people to get their minds around.

Somebody once said to me if you want to be understood, don't write fiction.

I can be very in my head, but I don't trust my head all that much. My head is crazy. My head will talk to itself all day and all night if I let it. And my heart is less nutty, but it's kind of like an overexcited child. I don't trust my heart all that much either. My body is like a good horse. I trust my body.

He had lunch with Cecilia that afternoon. They ate their corned beef on rye and cream cheese with lox in a diner peopled by waiters who looked like they´d met with utter disappointment and become attached to it.

She disapproved, but part of her seemed secretly to sympathize with the sickness. It was like she thought everybody had it, and the best you could do was to cover it up, and sometimes it would just come boiling out anyway. Then you had to point at it and condemn it, even though you knew you had it too.

The art of integrating the ego and the impulse for empathy in a dynamic call and response.