the pretense that was the worst thing
the pretense—to himself, too, the pretense, was the worst thing—the pretense that he was just going to check on poor old Fackelmann
Context
The anatomy of a relapse, told from the inside with no mercy: the desire "that blots out all bother" rises "so automatically" that Gately is up out of the bed and lumbering toward the corner before he's registered a decision, wrapped in a cover story pitched not at anyone else but at himself. The worst part isn't the using — it's the pretense of tending a sick friend, and worst of all that he believed it. This is the self-deception the program spends its whole apparatus trying to strip out: the addict as the one person he can always con, the story that lets the hand pick up the works.