He visited the United States, collaborated on a stage adaptation of "Mister Johnson", and was offered an appointment as a CBE, which he refused. Meanwhile, he continued work on the three novels that make up the Second Trilogy (Prisoner of Grace -1952, Except the Lord -1953, and Not Honour More -1955). In 1952, Cary had some muscle problems which were originally diagnosed as bursitis, but as more symptoms were noted over the next two years, the diagnosis was changed to that of motor neuron disease (known as Lou Gehrig's disease (ALS) in North America), a wasting and gradual paralysis that was terminal. As his physical powers failed, Cary had to have a pen tied to his hand and his arm supported by a rope to write. Finally, he resorted to dictation until unable to speak, and then ceased writing for the first time since 1912. His last work, "The Captive and the Free" (1959), first volume of a projected trilogy on religion, was unfinished at his death on 29 March 1957, aged 68.