This article presents an analysis of Jean-Luc Nancy’s essay L’Intrus (2002), a personal reflection on illness and the experience of heart transplantation. The analysis combines two approaches (though the first of them is given more prominence). Firstly, L’Intrus is treated as philosophical-literary pathography, where the reader’s attention is engrossed by the lived experience of illness and its linguistic representation – a sophisticated, elliptical, metaphorical style which exposes the altering intrusiveness of both the med-ical condition and the treatment (implanting an ‘alien’ organ). Secondly, L’Intrus is read in the context of Jean-Luc Nancy’s philosophical reflection proper. The essay’s linguistic manipulation of singular and plural are interpreted as an echo of his philosophical position put forth in Être singulier pluriel. The totally individual experience of illness and suffering exposes the underlying ontological validity of ‘being-with’ others. The in-sight that there is no being (Dasein) without ‘being-with’ (Mitsein) leads in effect to a revision of a number of key philosophical concepts like the Self / the Other, the subject, identity, nature and technology (ecotechnology).