I Killed Hemingway, a story

I Killed Hemingway (Opening)

(The complete story is available in the collection Seven True Lies, and in the collection Two Dark Truths, which you can buy, either in trade paperback or as an Acrobat download, from my bookstore.)

July 6, 1961

What I dislike the most about electric shock is the smell. That, and the little sound it makes which I didn’t hear at first. What with the humming of the machine, the doctors talking, and the patient moaning and even screaming sometimes, it was hard to hear, but once I did, once I heard this sound, distinct from all the other sounds in the room, now I can’t stop hearing it.

What it is is a tiny sizzle—as if you were frying a very small egg in not much butter, or in hardly any oil—that’s the little sizzle the electrodes make where they meet the skin. Of course, it’s usually just the jelly frying, but sometimes, if the patient needs a lot of juice, or if the helmet slips a bit, the skin fries too and then it leaves little marks that stay a while before they go away.

When the skin fries it makes a drier sound, a bit like lean bacon but not as loud of course, and not the same smell. Bacon in the pan smells just fine, but the electric smell, the smell of the electrodes sizzling the jelly or the skin, smells of burning—of tiny deaths.

They say it doesn’t smell, but that’s not true, it does. It smells of electricity searing through the skin, then through bone and into the brain. It smells of voltage. And of many little deaths, rushing in, anxious to get to him. And that is what I dislike the most.

You can tell the little deaths. You can tell them by his face, by the arch of his spine and by the way he bites down on the bit. They’re in his grimace, those little deaths. They hurt him badly. It’s written all over him, and I don’t mean that as a pun or anything.

My name is John, and I work at Saint Mary’s. Saint Mary’s is part of the Mayo clinic here in Rochester. That’s in Minnesota, of course.

Let me tell you about the equipment, and how I fit in.

The machine itself looks a little like a modern radio. Something you might buy at Sears if you could afford it. It has a white metal front and white metal sides too. The back of it is black. It stands on four small, round rubber feet which are screwed into the bottom, at the corners, and it has an oak top. I know it is oak, for I asked. They showed me the manual, or maybe it was the brochure that came before they bought it, and not the manual. It’s darker than oak though, looks more like mahogany, I think, or teak even. But no, it’s oak. An arrow pointing to it said “oak top.”

One of my jobs is to clean it every day and to polish the oak top twice a week, which I do on Tuesdays and Fridays.

The front of it has a big dial which you turn clockwise, but not to find a good station, like a radio, it’s to increase the voltage. It starts at 100 volts at the lower left and goes all the way around to 500 volts at the lower right, almost full circle. We usually gave him 440, which is kind of high.

Then, to the right of this dial—which is pretty much centered—there’s a little round meter that shows the output voltage, as a kind of double check to make sure you get what you set on the dial. Then there’s the on-off switch at the lower right. When you flick this switch up to “on,” the machine starts humming. Above the on-off switch there is little lamp that turns yellow when you turn the machine on, and above it, almost in the upper right hand corner, is a large red button labeled “current” which you press to send the electricity through to the electrodes. We call it juice. You can hold that button down for as long as you want.

The electrodes attach to the back of the machine and that’s where the power cord comes out as well. I’d say it weighs about 10 pounds. It looks harmless enough.

At the other end of the electrodes, the end that attaches to the patient, are two small metal disks, each about the size of a quarter, but a little thicker. They are built into a leather band which we wrap around the patient’s head to keep them in place. It looks a little like a headband when it’s on, like the Indians wore. We call it “the helmet.” One nurse pronounces it “helmit.” I think she’s from England somewhere. We had a patient once whose name was Helmut. That was a good one.

Then there’s the jelly jar. We put jelly on the temples before we fit the helmet on and then we have to make sure that the electrodes touch the temples exactly where the jelly is. The jelly shines when it goes on and smells fresh, like a forest actually, pine I think. I normally rub some in to make sure the skin absorbs it real well and then I put on a little more, makes the skin good and shiny. This helps with the connectivity, kind of lets the electricity in easier. Like putting a door there, allowing it in. The jelly also helps prevent the skin from burning. I think I mentioned that. It works fine most of the time, unless the helmet slips or the patient gets too much juice, for then the skin burns and it leaves a mark.

We have four sizes of rubber bits. As if there were only four sizes of mouths, but there you have it. They’re for the patient to bite down on. They go in the mouth of course and are held in place by an elastic strap that goes around the back of his head. The bit is to prevent him from hurting his teeth when he convulses. It also keeps the tongue out of the way so he doesn’t bite it off. I’ve seen the bit come out and that’s a real mess, let me tell you.

The bit has to go in first, before the helmet, or you won’t get the elastic strap in place, the electrodes get in the way. There’s a right sequence to everything.

The special gurney we use has padded leather straps attached to it, to tie the patient down with. Arms and legs and thighs and a big fat strap for the chest. This is so he won’t break any bones, or heaven forbid, which happened once, the spine, during the convulsions, or “the dance” as we call it. Sometimes, with women, or kids, or smaller men, we don’t use the straps, for although they are padded the straps can still cut the skin if they dance a lot and that can make a real mess. If we don’t use the straps we just hold them down with pillows instead. It takes more people, but we prefer the pillows. With him we had to use the straps. All of them.

I am the only nurse assigned specially to Electro. That stands for the Electro Convulsive Therapy Unit, which is the official name. The doctors refer to it as the ECTU most of the time, though the rest of us prefer Electro, or even, but we don’t say this so the doctors can hear it, the “ballroom.” From all the dancing they do in there. The other nurses who come here are not assigned specially, but bring the patients from their rooms or wards and then stay to give a hand if needed and to take care of revival.

I also keep the rooms clean and shipshape.

We have three rooms at Electro. One is for preparation, or preps, which we call “the cleaners” for some reason I have never been able to get a good explanation for. It’s not like we clean them. One is for administering the ECT, which we call “the juicer.” And the last one is for recovery after treatment, which we call “revival,” which is a good word for it, for it means to make live again, and that’s what they do in there, come alive again from all those little deaths.

So first we take them to the cleaners, then into the juicer. And once done, it’s into revival. That’s our special lingo. What we do in the ballroom.

I clean all three rooms every day. I also keep the machine clean and polished, I think I mentioned that already.

I do checklists. This is the most important part of my job. We have quite a few of them. First there’s the preps checklist I run through for each patient before he’s juiced. Goes something like this:

No food for eight hours. To make sure there is nothing there to vomit. Check.

Recently voided. That means gone to the bathroom, both number one and two. That’s an important one, it gets ugly if they don’t, comes out real stinky if they dance too much. Check.

No water for four hours. That’s an important one as well. Once a woman, she was Scandinavian something, she had a very thick accent, snuck into the bathroom just before they rolled her down here and had a glass of water, she was so thirsty she said after. Well, she almost choked to death during the dance when the water all came up from her stomach and into her mouth and from there into her lungs. Kinda bubbled up and all over her face and into her nose and she looked like something come out of a lake. Then she coughed a lot and then she stopped breathing for a while. It was a real mess. She had lied to me. They brought her back though. Talk about revival. So that’s important. No water for four hours. Check.

Temples shaved. Check.

Temples jellied. Check.

Rubber bit sized. Check.

Rubber bit selected. Check. I don’t know why that has to be two steps. If I’ve sized the bit, then of course I’ve selected it too. I’ve brought that up to Dr. Solti more than once, he’s in charge of ECTU, but he says that’s the way it has to be. Once I’ve selected the right size rubber bit for his mouth, I place it by the pillow, ready to go.

Straps required. That’s a yes or no. If yes, go to straps applied. Check. If no, go to pillows ready. Check.

Patient ready. Check.

Then there’s the machine checklist that I do each morning before the show. We call it “the show” sometimes, what we do in the juicer, the ballroom show. Goes like this:

Machine cleaned, which has its own checklist. Check.

Electrodes attached. Check.

Electrodes tested. I feel a little like an engineer when I do this. We have a meter that attaches to each electrode with an alligator clip. I then set the voltage at various levels and press the juice button. Hold it down for two seconds, one thousand one, one thousand two, same as what we give the patients most of the time. The meter registers the voltage which checks both that the juice is coming through fine and at the right strength. I have to test eight different voltage settings:

120. Check.

160. Check.

200. Check.

240. Check.

300. Check.

360. Check.

400. Check.

440. Check.

Those are the eight levels I have to test. And when they’re all tested there’s an overall check for Electrodes tested. Check.

Electrode strap cleaned. Check.

Electrodes firmly in place. I think of that as “helmet ready,” almost like we were taking off for somewhere in a plane. Check.

Machine ready. Check.

Then there are the cleaning checklists. We have them for each of the three rooms, and one for the machine. I won’t bore you with those.

During administering hours, which are from ten to noon each day, except Saturday and Sunday, I work both the cleaners and the juicer.

When I first started at Saint Mary’s, six years ago now, I only did the cleaners. I’d prep one patient while the one I had just done was getting juiced and so on, keeping a good flow going, like a conveyor belt. Then it got kinda slow for a while and we didn’t have so many patients anymore, so they thought it was a good idea for me to work both the cleaners and the juicer, and that’s the way it still is. Sometimes it gets quite busy and I wish I had some help, but the doctors say it’s good for the patients to have the same person prep and help administer, they say continuity is good, calms them, so there you have it. Still works out okay, it’s not as if we have long lines or anything.

In the cleaners I make sure that the patient is good and prepped. Check. Check. Check. Then I roll him into the juicer and help the doctor with his checklist. Although I’m officially in charge of revival as well, that’s taken care of by the nurse who brought the patient. I think I mentioned that.

So, that’s who I am, what I do. I’m the ECTU nurse. Electro nurse. Ballroom nurse.

The complete story is available in the collection Seven True Lies, and in the collection Two Dark Truths, which you can buy, either in trade paperback or as an Acrobat download, from my bookstore.

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