“You can tell a lot about a doctor by the chairs in his waiting room,” said my friend Laura. Dr. Lenneth’s chairs were hardwood and armless. His coffee table held a lobster-trap lamp, stacks of Yachting Magazine, Ducks Unlimited, and pads and pens with the names of best-selling anti-psychotics.
Laura had driven me forty miles along icy New Hampshire roads because, earlier that day, I had called my insurance company and told them I needed to see a psychiatrist as soon as possible. Laura sat for fifty minutes, waiting, and thinking about her father, who was dying in New York. My fifty-four-year-old mother had died of pneumonia three winters before.
My mother died of Marlborough Reds. A husband who slept around and threw her against walls and left her to raise four traumatized children. Pink packets of Sweet’n-Low. A paranoid schizophrenic sister. A puzzle-piece melanoma and the six-inch circle doctors cut from her back to save her. Too many antibiotics. No health insurance. A misdiagnosis: Your mother is an artist. She has a rare inflammatory lung disease, probably caused by paint fumes.
My insurance company called Dr. Lenneth a “Crisis Intervention Physician.” With his dense, gray, semi-circular beard and L.L. Bean Duck Boots, he looked like the Gorton’s Fisherman. He swiveled side-to-side in his office chair next to a large brass ship’s wheel that hung from his wall. His brown wide-wale corduroys were faded at the knees. I wanted to believe him when he said he could help me by the end of the session.
YOUR MOTHER IS AN ARTIST. SHE HAS A RARE INFLAMMATORY LUNG DISEASE, PROBABLY CAUSED BY PAINT FUMES.
I told him that every night for the past month I had walked for hours along dark, rural New Hampshire roads, hoping to see a light in a window. I would stand outside the houses of friends, wondering if it was too late or early to ask them to feed me and sit with me while I ate. My hairstylist told me she was worried. I made appointments until I had no hair left to cut. I was hungry, but it was painful to swallow. My stomach had shrunk to the size of a walnut. I had a medical chart that said, “History of depression, which was unresponsive to multiple medication trials in the past.” When I spoke to my students, I felt like my face was going to crack off.
“Have you tried drinking Ensure?” Dr. Lenneth asked.
I studied in England during my junior year of college. My tiny room was at the top of a staircase. In the afternoons, I would sit at a card table, drinking tea, and writing papers longhand. I remember the sound of the mailman dropping letters through the mail slot, whap as they hit the tile floor. My housemate Natasha and I would sprint down the stairs. My mother sent a letter every day, sometimes one for Natasha, who she had not yet met. Envelopes filled with bright cartoons that depicted the goings-on since I had left. Sometimes, there were Days of Our Lives plot summaries or clippings from Long Island Newsday. Jim Henson had died of pneumonia at age fifty-three. How is that even possible? I thought as I sat on the bottom stair, fewer than five years before my mother succumbed to the same fate.
The doctors did not initially recognize that my mother or Jim Henson had pneumonia. In my mother’s case, they misdiagnosed a rare inflammatory lung disease and prescribed massive amounts of steroids. The steroids ripped a hole in her stomach, through an ulcer they did not know she had.
A GEYSER OF BLOOD SHOT FROM OUR MOTHER’S MOUTH, AND THEN, I WAS IN THE HALLWAY, BACK SLIDING DOWN THE WALL, UPRIGHT FETAL POSITION. MARIN AND PETER PILED ON TOP OF ME, A BALL OF ANNE REILLY’S CHILDREN.
“Your mother seems agitated,” Amy, the nurse, kept saying. Agitated: a hospital word. My mother was squirming, rubbing her head back and forth against the pillow, pointing to her abdomen. A respirator tube blocked her words. Suddenly, we could see her stomach growing. The nurse ran out of the room. “Amy is coming back,” I said, but my mother’s eyes told me, Amy is not enough. Amy returned, moving quickly and efficiently around the tubes and wires. She held a large bag of saline with ice cubes floating in it and began shooting the solution through the feeding tube in my mother’s nose. My small-boned mother looked nine months pregnant.
“We’ve called the doctor,” Amy said, and then, quite forcefully, “You need to leave the room.” My siblings, Marin and Peter, had gone out to the hallway. Brigid was standing near the door. My mother gripped the front of my shirt and twisted it in her fist. I was not going to pry it away. A second nurse began to pull me from behind. A geyser of blood shot from our mother’s mouth, and then, I was in the hallway, back sliding down the wall, upright fetal position. Marin and Peter piled on top of me, a ball of Anne Reilly’s children, trying not to fly off the face of the earth. Brigid was pacing, and we all started saying the same things over and over. “What the fuck just happened in there?” “Do you know what I just saw?” “It’s okay, it’s okay.” “Jesus.”
THAT NIGHT, I PULLED A FUCHSIA-WRAPPED DOLL FROM THE BOX AND DID EXACTLY WHAT THE OWNER HAD TOLD ME TO DO. AN HOUR LATER… THE STAPLE THAT HELD THE DOLL TOGETHER HAD PIERCED MY SKIN.
The nurses ran my mother’s gurney past us and through the swinging doors of the operating room. After hours of surgery, she looked even more dead than when she actually died two weeks later. The surgeon said my mother’s heart was the last organ to give out.
I am trying to understand how, over the course of a fifty-minute session, Dr. Lenneth went from suggesting I drink Ensure to convincing me to undergo a course of outpatient electric shock treatments. I wonder how many times he had performed that eureka moment. Trust me. I wanted to trust him. Worked wonders for a colleague. I pictured a colleague, pressed button-down, Lucite clipboard, alert, and smiling. Nothing like the cuckoo’s nest. I had lost twenty percent of my body weight. You strike me as the homeopathic type. I felt like my body was trying to destroy itself. ECT is like a natural remedy. I frequented a shop called The Mustard Seed. It causes the brain to produce its own chemicals. The glowy owner used a special camera to take an up-close photograph of my eyeball. She pointed to red cracks and called them signs of a sensitive disposition. She told me to “Take Vitamin E with selenium. Do not put anything on your face you wouldn’t eat.” I went to see the in-house psychic who called me “the doormat of the universe.” At the register, the owner handed me a small yellow box of Guatemalan Worry Dolls, each one armless, the size of a matchstick wrapped in colorful hand woven fabric. “At night,” she said, “tell your worries to a doll then place it under your pillow. The doll will hold your problems so you can sleep.” That night, I pulled a fuchsia-wrapped doll from the box and did exactly what the owner had told me to do. An hour later, I felt like a wasp was stinging my temple. I had rolled over, and the staple that held the doll together had pierced my skin. Bleeding, I pried the doll away and flung it across the room.
MENTAL STATUS EXAMINATION
Revealed a tall, thin woman who looks depressed in terms of overall presentation. Her speech, however, was goal-directed and without abnormality. There were no unusual psychomotor behaviors during the interview except that she cried spontaneously several times. There was no evidence of delusions, hallucinations, or cognitive defects.
In the early 1980s, Nill’s Store still had an antique cast iron shock machine. It sat to the right of the swinging screen door. Hold the handle on the left. Put a penny in the slot to release the lever on the right. Crank it down to start and crank it down further to increase the electric shock. How far can you crank it? How long can you hold on?
SOMETIMES, I THINK ABOUT SANDRA PAYING MONEY TO BE SHOCKED. THEN, I THINK OF ALL THE SHOCKS SHE DID NOT ANTICIPATE OR CHOOSE. HER BROTHER’S SUICIDE. THE DEATH OF … JEFF… HER BREAST CANCER DIAGNOSIS.
My friend Sandra Ross and I would fill our pockets with change and ride our bicycles through the oldest neighborhood in Islip, past the houses with the very low roofs, to Nill’s for penny candy. Swedish Fish, Tootsie Rolls, Mary Janes, Atomic Fireballs. Old John Nill was nearly blind. He rubbed the coins between his fingers to distinguish among them. Brave Sandra always saved a penny for the shock machine. I was too afraid to try it and too afraid to admit I was afraid. “I spent my last penny,” I said every time, Tootsie Roll stuck between my molars. But Sandra gripped the handle and cranked and held on a little longer each time, doubling over after she let go, the ends of her honey-colored hair nearly grazing the dark floor.
Sometimes, I think about Sandra paying money to be shocked. Then, I think of all the shocks she did not anticipate or choose. Her brother’s suicide. The death of her brother’s best friend Jeff when a truck bomb crashed through his barracks in Lebanon. Her breast cancer diagnosis.
Arcade shock machines became popular in the early 1900s. They were made for entertainment and competitive purposes, but doctors also recommended them for people with headaches and poor circulation. Humans have a long tradition of shocking those who suffer. Pliny the Edler wrote Naturalis Historius before Mount Vesuvius erupted in 79AD. In it, he recommends placing electric fish on the foreheads of pregnant women. The jolt and ensuing numbness, he claims, will ease the pain of childbirth. Also, in Italy in 1937, scientist Ugo Cerletti observed that pigs who were shocked with electricity appeared to be calmer before they were slaughtered. So, he began running currents through the brains of patients with schizophrenia and called the amnesia a bonus: patients did not complain about the treatments because they could not remember them.
Lost glasses. I do not remember writing this on a piece of loose-leaf paper I still have. My sister Marin’s handwriting is also on that page. On one of the several trips from Virginia, she made a list of numbered questions for the ECT practitioner. I lived alone, and Marin could not stay for long. Six months before, she had given birth to a premature boy who dipped below two pounds in the incubator, ears the size of dimes, soft blue veins brushed across his temples.
- Can we change the ECT schedule to fit with Kerry’s?
- Memory loss permanent?
- (brain function?)
- Kerry doesn’t always have someone to stay with her after treatments. Can she stay in the hospital for 24 hours?
- How many more treatments will she need?
I continued to teach during ECT, black and blue IV hand writing reminders on the board. I did not tell the students, whom I worried I would not remember, so I led them outside to pose for a picture on the white steps of the English Department. It is overcast, and there are puddles on the ground. The students are squinting. My face is tense, and my legs are toothpicks in black tights. “I want my old mind back,” I wrote that day in the green hard-covered sketchbook I carried everywhere.
“Lost laundry.” “Lost way home.” “Read and forget. Read and forget.” “They tell you not to drive on the day of your treatment, but it is hard to remember this.” “Is my car outside the hospital?” “Man standing behind me at ATM: ‘Come on, Miss! Why are you taking all day?’”
THE GOAL OF ECT IS TO INDUCE A GRAND MAL SEIZURE, STRONG ENOUGH TO BREAK A PERSON’S SPINE. THE PATIENT IS UNDER ANESTHESIA, VENTILATED WITH OXYGEN, AND GIVEN… A DRUG THAT PARALYZES ALL MUSCLES… WHERE DOES ALL THAT ENERGY GO?
As I turn the pages, my handwriting becomes bigger and wild. “Hit the wall of my garage. Twice.” “Forgot what is in my basement.” “I am afraid to look at my calendar book to see the things that Marin and [my dear friend] Micheline have written down. Afraid to know the details of this nightmare.”
All patients must undergo a pre-ECT MRI. My report says, “The cortex and underlying white matter appear unremarkable.” A brain that looks unremarkable is perhaps the most mysterious kind.
My students kept submitting essays. One wrote, “A person’s brain is about the size of his two fists pushed together.” I copy this into my sketchbook, press my fists together and stare.
The goal of ECT is to induce a grand mal seizure, strong enough to break a person’s spine. The patient is under anesthesia, ventilated with oxygen, and given succinylcholine, a drug that paralyzes all muscles used to breathe or move. The amount of electricity used in ECT usually ranges between 3-100 joules. A joule will lift an apple three feet in the air. Where does all that energy go? Neurosurgeon Frank Vertosick compares ECT to “repairing a computer with a chainsaw.”
“Mustard carpet, wood panels, windows with bars, green curtains, plaid chair, two wooden dressers, two hard hospital beds.” “My roommate Jennifer says she is here because she is afraid terrible things will happen to her family. She is right. At some point, they probably will.”
My memories are a dark glass of water with a few clear drops in it. I remember jaw aches. Headaches. The sting of the solution the nurse shot through the IV catheter in my hand because it would “dry up secretions.”
JOHN HULL KEPT AN AUDIO-DIARY WHILE HE WAS GOING BLIND. “COGNITION IS BEAUTIFUL,” HE SAYS. “IT IS BEAUTIFUL TO KNOW.” SOMETIMES, IT DOES NOT SEEM BEAUTIFUL TO KNOW.
The doctor ordered eight treatments, said we should continue “until I was no longer depressed.” After six, I told him I wanted to stop. “He thinks I am a fool,” I wrote in my sketchbook.
I called my friend Clark, who picked me up from the hospital and drove me home. For weeks, I stayed under a white down comforter and watched Lawrence of Arabia over and over on my ten-inch television screen: “The trick, William Potter, is not minding that it hurts.” I cooked dinner and ate it in the warm bathtub. Late one afternoon, I went to my office. A student was sitting on the floor in the hallway, waiting for me. His sixteen-year-old sister, he said, had been killed in a car accident this week the year before. He had gone to her grave and seen fresh grass growing on it.
Writer and theologian John Hull kept an audio-diary while he was going blind. “Cognition is beautiful,” he says. “It is beautiful to know.” Sometimes, it does not seem beautiful to know. That is, perhaps, until you have unknown. I do not remember some of the kindnesses people bestowed on me: “Ellie brought four bottles of Poland Spring.” “Sandy visited. She climbed into bed and held me until I fell asleep.” “Jonah [my tiny nephew] is here.”
Kitty Dukakis said, “shock therapy saved my life.” Hemingway wrote: “It was a brilliant cure, but we lost the patient.” I struggle with the concept of what it means for ECT “to work.” It did not make me feel better like it did for Sherwin Nuland, Carrie Fisher, and countless others. It made things so much worse that I could no longer pretend.
I sat in the Sunrise Grill in Kittery, Maine, staring at the gingham curtains. I quietly told my friend Mekeel that a year before, I had undergone a course of ECT. We were surrounded by regulars, old men with mesh baseball hats perched atop their heads:
25th INFANTRY DIVISION
The word infantry comes from ancient Greece. It refers to the youngest, most inexperienced soldiers, the ones who had no horses and were sent to the front of the battle.
'I WANT MY OLD MIND BACK,' I WROTE THAT DAY IN THE GREEN HARD-COVERED SKETCHBOOK I CARRIED EVERYWHERE.
“No one with a history of trauma should undergo shock treatments,” said Mekeel. “They are another form of violence.”
I look for studies. They are controversial and few, and most do not consider what happened—what made someone so vulnerable—that he or she would agree to undergo such a treatment. ECT can steal the entire show.
Weeks after my last treatment, I flew to Marin’s for Christmas and held my nephew. I stood by the fireplace, balancing a small, crowded paper plate, and spoke with a family friend, whose daughter overdosed when she was in college. For fourteen years, Gladys had kept Lily’s unwashed sock under her mattress, the sock she had been wearing when she died. The week before, Gladys looked for the sock and did not see it. Frantically, she raked through the laundry and found it had gone through the wash. Molecules of Lily were no longer there.
“It was time,” she said to me.