Possession

They sit across the desk from me, the young couple, both tense and distracted. I am very new to family practice, and John is almost exactly the same age as I am. We are the same height and shape, and we have the same style of moustache. We are even dressed in a similar way. But there's a pinched, sallow look about his face, as if the mirror I am peering into is blurred and slightly dusty.

John and Bridget live with their 2 young children in an outer suburb of London. It's an area of small, identical, semidetached houses, each with its own tiny garden in front. On a previous house call there, I had noticed that their house was trim and immaculate; the indoor surfaces were as shiny and polished as the colored illustrations in a mail-order catalogue. Outside, the tiny garden was also neat and ordered. Its hedges, flower beds, and climbing roses were all carefully trimmed, because John is a keen and dedicated gardener. He is the manager of a small company, but there is also something military about his bearing, an upright air—although he is not prepared, at all, for the battle to come. Usually, he is fit and healthy; he plays squash each week at a local gym and swims regularly in the pool. His wife, thin and tremulous, is as neatly dressed as he is. Every wisp of her hair is carefully lacquered into place. However, at the end of each sentence, her voice rises in an anxious question mark.

She does most of the talking. She says that recently John has seemed “not quite himself.” He is easily fatigued, often constipated, and looks rather pale. He has lost some weight, and he occasionally passes some bright red blood in his stools. He …