The other day, I discovered an alarming possibility. No, worse: an alarming fact.

I have an old friend, a consultant radiologist, who for years has been sending me clippings from the British Medical Journal. She knows that my interest tends towards the ghoulish and the extreme. In my memory – that place where degradation and embellishment overlap – I have filed away cases of patients who exploded when a heated scalpel ignited their bodily gases, and others from the early days of the MRI scanner when internal metal stitches were shot like shrapnel into soft flesh. These stories are sometimes accompanied by photos: for instance, of a man who grew his toenails to such a curling length - several metres, as I recall - that for years he had been unable to walk. Then there is the medical profession’s everyday task of removing unexpected objects which have been swallowed – like bags of nails - or forcibly indulged up the rectum. (In the old days, popular anal self-implants were miniature busts of Napoleon, a habit which doubtless added patriotism to pleasure.) And a case I particularly remember, of a man who had been fitted with a tracheostomy tube. When he went for a check-up, doctors were baffled by yellowish stains around the hole into which the tube was fixed. It turned out that the patient was a desperate smoker who, unable to inhale through his mouth any more, discovered that if he took out his tube, the cigarette fitted perfectly in the hole; all he had to do was light up and inflate his lungs. Men (and most of these bizarre activities were undertaken by men) can be most ingenious, even - or especially - when it goes against their own best interests.