More and more often I hear my friends say: it’s not death that scares me but illness. And I, too, repeat the phrase. When I try to unpack it to understand it a little better, I discover that for me it means: I’m frightened not by the idea of ceasing to exist, but by the invasiveness of treatments, by the oscillation between the illusion of recovery and disappointment, by death throes. It’s as if I were confessing that what truly worries me is the end of good health, along with everything that that entails: debilitation, progressive inactivity, pleasure diminished to the simple assertion that I am still “I”, and that for now, somehow or other, I’m still alive.

As a result, the idea of death itself seems increasingly pallid. What is terrifying, instead, is the end of enjoyable life, of a full life. And for me that’s because the belief in some kind of beyond, acquired during childhood, has faded over time.

When I was a child, my grandmother was the most active person in the house; then she had a stroke and was paralysed for years. She sat in a corner of the kitchen and I, as a girl, didn’t experience her suffering and humiliation, nor did she signal it to me, even with her eyes, as something intolerable. Death came suddenly, and I grieved within the religious framework in which I’d been raised. Death meant that she had gone away, leaving a body reduced to a cold, rigid thing. Her dying had very precise features: I felt it as a terrifying immobility and a very mysterious movement. My grandmother had crossed over into an elsewhere.

Later, every form of religious belief seemed absurd to me, and death was as if disfigured. The immobility remained, the movement vanished. The dead body became simply the sign of the end of life in a specific individual. Today I would never say: he has gone away. I’ve lost the sense of the crossing over: nothing goes up to heaven, we don’t move to another world, we don’t return, we aren’t reborn. We remain definitively immobile; death is the last point on the segment of life that has chanced to be ours.

Thus my attention, like that of many others, is concentrated not on dying but on living poorly. We hope that life is as long as possible, and yet that it will end conclusively when we have declined to the point where no treatment can make it tolerable. I don’t know which is better: this adult belief or the belief I maintained until adolescence. Beliefs aren’t good or bad; they serve only to bring order, at least momentarily, to our anguish.

Translated by Ann Goldstein

• Elena Ferrante is the author of The Days Of Abandonment, Troubling Love and the four Neapolitan novels