Peake’s own medical history was tragic in the extreme. During the war he had a couple of breakdowns, and did once consult a Harley Street specialist, an experience that might have been the inspiration for the Harley Street episode in Mr Pye. In his 40s, Peake began to develop symptoms of Parkinson’s disease, and then dementia. Of great charm and good humour, an accomplished draughtsman and painter, a poet and novelist, he spent the last few years of his life in institutions, unable to write, draw, or speak. (He was subjected to both electroconvulsive therapy and surgery that proved useless or worse.) His wife’s memoir, A World Away, published in 1970, is almost too painful to read.

The manner in which Peake’s doctor at the National Hospital, Queen Square, London, breaks the news of the diagnosis to Mrs Peake is an object lesson in medical insensitivity. Mrs Peake asks to meet him but is told that he is too busy at the moment; perhaps he might be able to see her on his way out if she waits in the entrance hall for him. There, in the middle of the busy hallway, he says to her, “Your husband has premature senility.” Peake was 46; she was 39.

She addresses a postscript of her memoir to Peake, describing a visit to him before his death, when he is completely immobilised by the disease: “We sit silently, and then you are restless. You want to move and cannot. You want to speak and cannot, and the silence no longer has peace in it.” Then: “When I leave you, I say ‘Goodbye,’ but goodbye was said many years ago, before we knew we were saying it.”

I have made a resolution never to complain again, but I know that I shall not keep it.

It often seemed to me during my clinical career that some people were called upon (by what, or by whom?) to bear more suffering and loss than was their fair share, or more than could be explained by anything that they, or indeed anyone else, had done. Tragedy followed them around like an obedient dog; mostly they bore it unprotestingly. They made me feel guilty because I was in the habit of complaining so vociferously about the minor inconveniences of life.

The American writer Peter De Vries (1910–1993) was in general known for his comic novels and for his wit—he once said that he enjoyed being a writer, except for the paperwork. But one of his novels, The Blood of the Lamb, published in 1961, was bleak and tragic—and autobiographical.

De Vries was born of Dutch Calvinist stock to whom (as he later put it) everything was forbidden except heaven. In the novel, his narrator-protagonist’s older brother, a medical student, dies of pneumonia; a girlfriend dies of tuberculosis; his father goes mad and dies in an asylum; his wife commits suicide; and his daughter dies aged 12 of acute leukaemia. Quite a lot of this happened, more or less; and though De Vries was famously antireligious, it is clear that he was still wrestling with his own religious upbringing 50 years after his birth.

There are some countries that, once visited, retain a disproportionate hold on your imagination. Among them, for me at least, are Haiti and Liberia, two small states that are known to the world at large principally for their political, and sometimes for their natural, catastrophes. They are marginal from the point of view of the world economy, I need hardly say, and yet their history has something about it that makes it seem significant beyond itself. No one, I think, can study the early history of either country without being moved by it; and just as the biography of a single person can also be a portrait of an age, so the history of an otherwise insignificant country can tell us something important about the human predicament as a whole, for example our tendency to turn liberation into a new form of servitude.

North Korea is another country that, once visited, is not easily forgotten. Its hold on the imagination, however, has nothing of affection in it, as does that of Haiti or Liberia. This absence of affection is no reflection upon the Korean people, but rather upon the political system that reigns there. Spontaneous contact with Koreans is precisely what the regime attempts at all costs to prevent, and succeeds to an extent unique even for the communist, or formerly communist, world. Compared with North Korea, Hoxha’s Albania was a free country. In short, North Korea has all the fascination of sheer horror.

Dalrymple writes in the new edition of the New Criterion about how a visit to a photographic exhibition in Arles has caused him to discover, for the first time, the power and profundity of photography: