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The three friends initially meet to have a discussion about their various illnesses. One can and does infer that they are hypochondriacs, thus, thir problems are imagined..... not real.
J.'s tone in the first chapter reveals that he clearly understands that he does not suffer from so many diseases, and yet he continues to progress as though it were true. Throughout the novel, Jerome revels in illustrating the illusions that men and women construct, usually fooling themselves most of all. Even though the novel remains rooted in everyday concerns, Jerome sees a regular absurdist vein that runs throughout them.