I live in Fussa, a bland dormitory suburb about forty kilometres from central Tokyo. The place has two claims to fame: it is the site of the American base where US presidents touch down on their visits to Japan and home to a livestock research centre that produced TOKYO-X, a superior crossbred pig incorporating genetic material from American, British and Chinese animals.

Similar ideas of hybridisation lie behind the title of the final volume of David Peace’s Tokyo trilogy, Patient X. The patient in question is Ryūnosuke Akutagawa, the early 20th-century Japanese short-story writer whose works inspired Kurosawa’s film Rashomon. The X represents the various competing identities tearing Akutagawa apart and driving him to madness: his roles as son, father, husband, friend, lover and writer and the fissures within them (faithful husband versus adulterer, Eastern versus Western man); and his multifarious fictional selves, ranging from simple human alter egos to quacking frog-like creatures called Kappas.

It is Patient X himself who narrates the twelve short stories that constitute the book. These take us through a partially fantastical version of Akutagawa’s life, including his childhood in a poor part of Tokyo, his first encounters with books, his jobs as a teacher and as a roving