Joshua Cody's title, a flashy pun, is also a declaration of intent. With wordplay and quirky digression, it renders a unique and serious story in terms comfortable to its author, but probably to no one else. The literature of illness has become a contemporary genre with its own conventions and tropes. [sic] understands this and tries to breathe new life into a familiar diagnosis. This American cancer memoir is witty, knowing and strangely heartless, perhaps because, despite some sensational revelations, Joshua Cody himself is either too evasive or too shy/ arrogant (a familiar combination) to let his story speak for itself. Even allowing for his ironic self-presentation, it's hard to warm to a man who tells us that he sees himself as "an early 21st century, darkly brooding, edgy, raw postmodernist". The fundamental coldness of [sic] is all the more remarkable because, if you can stand to be in his company for more than a few pages, Cody does have an extraordinary tale to tell.

A brilliant young composer from midwestern Milwaukee, who has "no memory of not knowing how to read music", Cody was about to receive his doctorate when he was diagnosed with an aggressive cancer. When his first course of chemotherapy failed, his doctors prescribed a bone marrow transplant and radiation. The latter comes with excruciating pain. Chemo and radiation, writes Cody, are "as different as night and day, pagans and Christians, Laurel and Hardy". [sic] becomes his riposte, the narrative journal of a young man raging against the dying of the light, told through a collage of words and pictures. It's a story that lacks a beginning, a middle or an end because its "postmodernist" author is too busy showing off (or possibly, too deeply in extremis) to have time to satisfy the mundane considerations of How, When, Where and Why?

Part of the essential vanity of this publication is that Cody has been horribly overindulged, and allowed to lard his manuscript with illustrative material. [sic] is a book about sickness that should have been sent to the script doctor. It's a mess; worse, it's a pretentious mess. Descended from that great Victorian exhibitionist, "Buffalo Bill" Cody, it's almost as if he's genetically programmed to perform to the crowd. Amid a blizzard of name-dropping, WG "Max" Sebald is not mentioned, but I'd be willing to bet that part of Cody's undeclared literary baggage is a more than passing familiarity with the author of Vertigo and Austerlitz. Even the layout of [sic] owes something to Sebald.

Part of Cody's trouble is that, although he declares "I'm not really a writer", [sic] is a masterclass in that well known literary-debut genre "Look, Mum, I'm dancing". His publishers have linked the book  fatally, in my opinion  to Jean-Dominique Bauby's The Diving Bell and the Butterfly and James Frey's A Million Little Pieces. Actually, Cody's other not-so-secret influences are really the two Daves: Eggers and Foster Wallace.

The author of Infinite Jest and A Supposedly Fun Thing I'll Never Do Again, who committed suicide on 12 September 2008, has a lot to answer for. To Cody, Foster Wallace is "our greatest writer", but his malign influence on [sic] has been to persuade Cody that some 250 pages of sophomoric free association, loosely connected to the via crucis of contemporary oncology in which Cody's immune system became "basically that of a patient with late-stage Aids", adds up to what the publisher describes as "a heartbreaking work of brilliance". Sorry; it doesn't.

There is, however, plenty to admire in [sic]. Usually, the implicit transgression that appeals to readers in the so-called misery memoir lies in the harrowing reportage from the front line of terminal illness. But Cody, too cool for school, chooses a rather more entertaining transgression: exploiting his condition to pull women. We have barely reached page 30 before a smiling Asian girl asks Cody "whether I would like to have sex with her". Not long after this, Cody, described by the publishers as "ruthlessly grasping for life", meets the beautiful Ariel in a Manhattan restaurant and scores both cocaine and a blow job before the hors d'oeuvres. Then, a few pages further on, we hear about another woman, Daria, "not the first stripper I'd dated", which opens up several pages on the psychosexual issues surrounding prostitution.

"Why relate all this?" Cody asks at one point, a killer question to which he really has no adequate response. Perhaps if he had not flirted with narrative riffing a la Foster Wallace, he might have made his terrible experiences speak to the world of the well. His hallucinatory chapter "Sister Morphine" almost makes up for this omission. As it is, [sic] reads like a sick joke, a prolix epigram on the death of a feeling. When, at the end, the reader remains unsure whether Cody is fully cured, or still fatally ill, we neither know nor care.

Joshua Cody issues a warning to readers who pick up [Sic], his cleverly entitled memoir of cancer and recovery. "I'm not really a writer," he writes. "I'm just writing this one thing and that's it." Later, he suggests that writing is too grand a word for what he is doing; "frapping" is better.

This coyness of style, heavily influenced by his hero David Foster Wallace, is contrived to seem throwaway and encompasses bracketed asides, paragraph-long sentences, footnotes, diagrams, algebraic formulae, an inevitable deadpan analysis of Buffy the Vampire Slayer and stretches of regular narrative through which the story is good enough, just, to survive.

Cody was finishing a PhD in music composition at Columbia University when he felt a pain in his neck from what he thought was a pulled muscle. The first doctor said it was a virus. The second doctor said it was probably a virus but to be safe did a biopsy and discovered a malignant tumour. Cody started an aggressive course of treatment: high-dose chemo followed by a bone marrow transplant, which the doctor described to him, chillingly, as "relatively endurable". There followed months of hell, a near-death experience, the fluctuating involvement of various girlfriends and Cody's attempt to make sense of what was happening to him, or as he puts it, "how different the meanings of things were then  even the meanings of things as simple as water, or taxonomy, or, indeed, what it means to mean". If there is a rationale for the book's endless diversions  the first few pages alone take in Debussy, how the ear works, the history of Manhattan's 59th Street Bridge and a reading of Raiders of the Lost Ark  it is this question of significance, the sudden value of all things in a life reframed by death.

According to his account, at the time of diagnosis Cody was enjoying a busy social life hanging out in bars, dating models and excusing himself periodically to do coke in public bathrooms before returning to his apartment in Tribeca  not a lifestyle most graduate students can afford and an anomaly that is never quite explained. He makes the sly observation about his version of Manhattan that it's a city "where everyone is over-educated and overpaid and broke at the same time, and everyone wears basically the same clothes and has a book deal about to go through". Beyond that, Cody and common experience diverge.

There is his girlfriend the dominatrix; there is his girlfriend the model ("will the felicity of her Nabokovian exquisiteness finally flinch once and forever, like Eurydice slipping away  despite the lyre, the frantic fretwork, and the song  " it goes on) who has a plaster cast of her own breasts on the wall, taken just before her double mastectomy. A veteran of cancer, she comforts him after diagnosis.

There is the woman he meets on the street, several weeks into treatment, who, after falling into step with him, asks if she can come up to his apartment, whereupon they have the kind of sex you can apparently only have while facing death and with someone whose name you don't know. She cries when he tells her about his illness. It is passages such as these that make you wonder at the publisher's decision to invoke, as a comparison, James Frey's discredited memoir A Million Little Pieces.

Two strands carry the book: Cody's moving and mercifully unmannered account of his parents; and the misfortune he has to fall in love with a medic at the hospital who turns out to be crazy. It was Cody's parents who introduced him to the writers and artists he turns to for comfort during his illness. In the cancer ward, he holds on to an old book on Paul Klee like a security blanket. He rereads his favourite writers, Eliot, Auden, Pound, searching for consolation and explanation. He considers the meaning of Mahler. You get the feeling that Cody, by training a composer, is trying to push through to a kind of non-referential language that mimics the effect of music  "the joy of letting meandering thoughts meander".

It is only when he drops all this that his skill as a writer becomes evident. When he is in the chemo ward, he reports on the cheerfulness of staff and patients and how, although sincere, it triggers a deep revulsion in him. There is, he writes, "something exceedingly grotesque about it all, as if everyone were sitting around (I hesitate to use this image, but it did come to mind repeatedly) defecating while making affable conversation".

There are vivid passages about his childhood: a trip to a diner with his mother when he is a child; conversations with his father about music they both admire; the poignancy of his parents' separation and his father's early death. His mother is a fierce advocate for Cody in the hospital, but it's the flashbacks to her quiet, sad collapse during the breakup of her marriage, when she couldn't bear to listen to "serious music" any more because it was too painful, that jump from the book.

When Cody falls in love with the doctor on his pain management team, he subtly indicates that something is wrong, signs his friends see but which, in his "infatuation with her salt-bright beauty", he is blind to, right up to the point when "she walks into the restaurant with an uncanny smile" and says something so jaw-droppingly awful that you gasp. Stripped of contortions, the book comes suddenly to life.