Draw a square. That was all Dominic Matteo had to do. Yet when pen met paper to complete the seemingly simple task, Matteo created a circle.

His therapists repeated the instructions. His wife, Jess, lovingly willed him on. He drew another round shape. “I just couldn’t do it,” Matteo says. “I was embarrassed. I was so frustrated. I was really, really struggling at that point. It was so bizarre.”

Faced with that adversity, with having to learn to read, write, and talk again, Matteo drew on the “self-discipline” and “structure” that earned him 276 Premier League appearances for Liverpool, Leeds and Blackburn.

“You’ve got to really focus on what is right in front of you: ‘Right Dom, what can I do to improve my way of life?’ And that was to do the hard yards again. It was just like being a young footballer – relearn this, relearn that. It was horrible, it was hard, and it was frustrating. But I think my sport – and I’m lucky to have my sport – has carried me through.”

Matteo, 49, is sitting with Jess reflecting on his recovery from November 2019 surgery on a cancerous brain tumour. The day their lives changed forever began relatively calmly. Matteo had experienced a headache here, a bout of sickness there, but it was all easily attributable to other sources.

His GP had referred him for an MRI scan. It was scheduled for after a trip to Singapore with Liverpool Legends, but a cancellation opened up a pre-flight slot. He drove himself to hospital. Jess headed to the dance school she runs.

Matteo the footballer had many scans. “Usually, they take a while, but I was in for what felt like a minute,” he says. “They must have seen something straight away.” He was not allowed to leave hospital that Monday night. By Wednesday, he was in a wheelchair, his vision blurred and his face distorted.

Jess takes up the story here – Matteo remembers little of it. With Friday surgery scheduled, she took his parents home. But Matteo had a seizure, and Jess remembers the hospital’s call vividly: “They said: ‘We’re doing everything we can, but you need to get here as quickly as possible.’” Jess’s voice breaks. Matteo tenderly takes her hand. They had dated briefly during his Leeds days, separated, married other partners, before reuniting after a chance meeting. “My only thought was: ‘Make sure he knows you’re there before he goes.’”

Fortunately, Matteo stabilised and went for surgery. Jess refused a full prognosis: “I didn’t want to put a sell-by date on my husband.” After 10 torturous hours the surgeon, Ryan Matthews, emerged to give her “the most wonderful news” – he had removed 90 to 95% of Matteo’s tumour; a tumour that had sat dormant in his skull since childhood, in part calcifying and morphing into an anaplastic ependymoma. “So basically, I played my whole career with a brain tumour – I might have been a decent player without it!” Matteo jokes. Jess rolls her eyes and playfully bashes his leg.

Surgery, and subsequent radiotherapy, were the first steps in Matteo’s rehabilitation. Therapy was twice daily, and he was wrapped in football’s warm embrace. Liverpool prevented publication of a tabloid story about his condition, and former teammates and managers formed a revolving door of visitors. Eddie Gray, David O’Leary, Steve McManaman. Robbie Fowler and Neil Ruddock were FaceTime regulars.

Matteo is visibly humbled by the love shown to him – by the football community, by Jess, by his best friends Jason and Shorty who snuck fast food into his neurology ward at night. He believes those interactions created the electricity that got his brain dancing again.

On day trips home, Jess would film him doing simple household tasks such as making tea. “Find the cup. Find the spoon. Things we do without thinking, were massive for him,” she says.

Therapists would take him to supermarkets to practise buying a meal deal. “I still don’t get that right,” Matteo says, laughing. “A meal deal costs me about £50 now! It’s all that kind of stuff – I’m thinking: ‘Why can’t I do this?”

Eventually, the hospital deemed discharge safe. That day, according to Jess, Matteo – who scored for Leeds at the infamously hostile San Siro – “looked frightened. That really worried me – I didn’t want Dom to be scared in the real world.”

Matteo admits he was “not used to asking people for help” but now advocates for it firmly. His initial anxiety has been eroded by the “confidence I get from getting little tasks done”.

And now? “The difference is night and day. I’m always aware – I never want to get ahead of myself. I can’t afford to become complacent. But yes, I live in the moment, and have some good days.”

Life for the family – their son Luca lives with them, and Matteo’s daughters from a previous marriage are nearby – will always be different. He can never drive again. Each day begins with at least a dozen tablets. Reading even a few sentences drains him.

Scans – and the accompanying “scanxiety”– are six-monthly. “A stable scan result is the best we can ask for,” Jess says. “That means the remaining tumour is behaving itself.”

Despite this, the Matteos are pushing forward. He has returned to punditry, regularly holding court as a match-day speaker at Leeds. And together they give motivational talks organised by the Soccer Speaker agency. It happened by accident, by dint of Jess initially having to do some of Matteo’s explaining for him. But receiving positive feedback on their candid accounts of life events inspired them to continue.

As well as Matteo’s cancer, the couple speak of the dark days years earlier when he would go awol after all-night drinking sessions. “Suddenly it’s four in the morning the next day,” he begins.

Jess interjects: “It’s now Tuesday – let’s not sugarcoat it, Dom.” Matteo agrees. Was it loneliness? “You are lonely,” he says. “But you don’t know you’re lonely at the time. There’s a lot of sides to that. You don’t know how many addictions you have.”

After injury curtailed his career when at Stoke, compulsive betting sunk Matteo to “rock bottom”.

“It’s an epidemic in football,” he says of gambling. “I believe that. I don’t know that – I can just tell; I can smell it. I know it’s happening. You might have lost a 100 grand, 50 grand, but you can hide that. In your head you’re thinking: ‘Shit, what have I done?’ But you can still mask it. The money increases and before you know it, you’re on the chase. And the chase, in a way, is what we all liked.”

Matteo draws breath. “I didn’t realise the destruction I was creating. You’re pressing self-destruct, but you’re destroying everyone else. I realise that now. They are the mistakes. Jess had to live with it. My friends and family had to live with it. But as a person you’re very good at masking stuff like that.”

Jess is open about how close they came to divorce. Her professional dancing career, she feels, gave her some insight into the addictive tendencies of high-achieving athletes. That is what saved them: “I think I had some understanding of it – not much,” she says. “Not much, because he pushed it to the absolute extremes. But I heard him, I heard him. Whereas in a lot of marriages the spouse can’t hear. They think it’s outrageous. There’s no comprehension to it.”

The square comes more easily to Matteo now. The shape of life, though, remains unpredictable.