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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 did hear this sound, distinct from all the other sounds in the room, now I hear it all the time, I can’t stop hearing it.

What this sound is, is a tiny sizzle—as if you were frying a very small egg in not much butter, or in hardly any oil, in a small pan—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, sometimes quite some time, and some I’ve seen are there to stay.

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, that smell of tiny deaths.

You can tell them, 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, black, 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, I don’t remember. It’s darker than oak though, the top, looks more like mahogany, I think, or teak even. But no, that’s what it said, it’s oak. An arrow pointing to it in the manual, or the brochure, 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 the machine 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 the juice 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, like pine after the rain. 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. I think I mentioned that, too.

Sometimes I rub left-over jelly on my hands to soften the skin and make them smell good.

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 that goes on in there. I mean the patients, of course.

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. The next is for administering the ECT, which we call “the juicer,” for the juice we give them, and this room is really what we think about when we say the “ballroom” so the doctors can’t hear. The last room is for recovery after treatment. We call it “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 after 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 here.

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 is and that’s the way it stays. 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.

:

To keep it out of the papers, they admitted him under a different name. This was toward the end of November last year. I’m not exactly sure of the precise date, it really was hush-hush. Even so, word did get out, you can’t keep something like this a secret. Funny thing was that whenever he was mentioned, everyone said yes, they had read his books. I said I had too, that I had read his books, although I never had. I think there was a lot of lying going on about that.

He was a large man who looked worn out. Big and gray. Big beard, like a sailor, but worn out, I can’t think of a better word for it. You know, hunched over a little, as if his head was too heavy for his neck and shoulders. Clinically depressed was the whisper.

Even though it was soon common knowledge that he was at the hospital, no one knew that he was here to be juiced. That morning’s list of patients (which we sometimes call “the menu”) didn’t give it away either. “G. Saviers,” it said. Third and last one for the day. A pretty slow day.

But this was not a Mr. G. Saviers. It was a Mr. E. Hemingway. That’s who it was. Big and gray and hunched. He didn’t say anything. He didn’t look at me, and mostly he kept his eyes closed. He did answer my questions, though, the ones from the checklist, but just barely. He sounded tired, kind of pissed off, if you ask me. His voice was not as boomy as I would have expected from such a large man. Maybe because he didn’t feel good.

“Had anything to eat in the last eight hours?”

“No.”

Check.

“Anything to drink in the last four hours?”

“No.”

Check.

And so on. Just enough of an answer for a check.

He took the number three bit, second biggest. Too large for pillows, so I applied the straps. Got him all good and secured to the gurney. Checked the last few items and wheeled him into the juicer where I took up my position by the head of the patient.

Dr. Jacobsen, our balding German or Dane, I’m not sure which, Europe somewhere, asked if everything was checked off and I said yes. Good, he said. Stand by. I remember being surprised that Dr. Solti—he’s the one in charge of ECTU, I think I mentioned that—wasn’t there, Hemingway and all. Dr. Solti was not one to stay out of any sort of spotlight. Not in my experience anyway.

I asked him to open his mouth, which he did, and then I placed the bit between his teeth and slipped the strap around his head. I then picked up the helmet from the machine cart and fit that on as well.

That’s when he looked up and straight at me. He didn’t say anything, just looked. Up and straight at me.

I know that look. I know it real well. It doesn’t matter if you’re a Mr. Anderson or a Mr. Smith or a Mr. Hemingway, I know that look. Is it going to hurt? it says. They’re afraid, that’s what the look says. What’s it going to do to me? Their eyes kind of plead like, beg you not to hurt them. They don’t understand, of course, that this is the best thing for them, for their own good. They’re sickos. Even Mr. Hemingway, or else he wouldn’t be here, would he? The best thing for him. It’s how cows look at you when you come to get them for the butcher and his gun. Done that many times back home. As if they knew. They don’t know, of course, the cows, but they look like they do. And perhaps they do. I don’t know.

Pleading not to hurt them.

That’s how he looked at me, like his eyes couldn’t let go, holding on to mine like a life line. In the end I couldn’t stand it, and had to look away.

I adjusted the helmet and tightened the strap. It’s very important that the quarters fit tightly against the temples, smack in the middle of the jelly, I think I’ve said that. By now he had closed his eyes, which was a bit of a relief to be honest, but that lasted only for a second or two because then he looked up at me again. And wouldn’t stop looking. He was afraid now, really afraid, I could tell, and I doubt he saw me, or understood what he saw. Same as the cows don’t understand what they see, but keep looking anyway when they’re led away to be shot.

Dr. Jacobsen was running through his own checklist, and asked me if the rubber bit was in place. Yes, I said. Check. Electrodes in place? Yes, I said. Check. Straps in place? Yes, I said. Check.

He then looked over the machine and the settings and finished the list. Looked over at me. All set to go.

At this point there were only two people in the room, not counting Mr. Hemingway. Myself and Dr. Jacobsen. Nurse Wilheit, who had brought Mr. Hemingway down, was over in revival, waiting for her patient. I could see her by the door, which wasn’t closed all the way. Curious I think.

And then, just as Dr. Jacobsen was about to start, in came Dr. Solti to make it three. He didn’t say anything. Just walked in and stood a ways to the side, looking things over, making sure. I don’t think he was meant to be there, because I noticed Dr. Jacobsen frown when he saw him.

Mr. Hemingway had closed his eyes again. Just waiting now. Kinda steeling himself for the juice.

Most of the doctors will say something before we juice them, like “all right,” or “here we go,” something like that, kinda get everybody in sync, maybe even to give the patient a heads-up, you know. Not Dr. Jacobsen. He just presses the button. Just like that. 440 volts. One thousand one, one thousand two. A little over two seconds.

It’s odd, but at first nothing happens. It’s just the sizzle and the smell. I’m not even sure the others notice them, but I stand the closest to his head and I notice. And as I said, these days I can’t help but listen for the sizzle and smell for the smell, and when you do, you notice them all right. I don’t like the smell, and I don’t like the sizzle, but there’s no getting away from them, not once you’ve noticed them.

Then all hell breaks loose. When the juice hits the brain, and the brain finally gets the idea that it’s been hit by so much electricity, it goes berserk and begins to send out all kinds of signals in all kinds of directions with all kinds of commands and the result is what we call “the dance.”

Mr. Hemingway almost bit through the rubber bit, his convulsions were so hard. His chest rose like a bridge and almost broke the chest strap. Thank God it didn’t come loose or I would have been in trouble with Dr. Jacobsen. Not to mention with Dr. Solti.

He arched for a good ten, fifteen seconds and then went pretty spastic. Arms, legs, feet shaking. Then another arch. Then he was still. Everything fell quiet, but for the hum of the machine.

“And again,” said Dr. Solti.

Dr. Jacobsen turned to look at him. He didn’t say anything though.

“Do it again,” said Dr. Solti.

“Not so soon,” said Dr. Jacobsen.

“Do it again,” said Dr. Solti for a third time.

“We can’t do it again so soon.”

This time Dr. Solti didn’t reply. Instead he walked up to the machine and without as much as a word or a look at anyone, he pressed the juice button. One thousand one, one thousand two, one thousand three. I counted by reflex. This time Mr. Hemingway’s eyes flew wide open at the jolt, as if he’d seen a ghost. He didn’t see anything though, I can tell you that. Empty eyes, wide open onto nothing.

This time the chest strap did break. Lucky for me it didn’t work loose, it clean broke. Not my fault it broke. Bad strap. Besides, Dr. Solti went longer than he should have. Good thing the other straps held fine, and that Mr. Hemingway didn’t break any bones or anything or heaven forbid his spine.

Once he stopped dancing, Dr. Solti looked at him for a little while without any expression at all on his face—sometimes Dr. Solti scares me, I swear, if there were such things as aliens, Dr. Solti could easily be one of them—then he turned and left the room. Just like that.

Dr. Jacobsen watched him leave. Then he wrote something down on his clipboard. His face was not expressionless. He was angry.

I unstrapped the helmet and removed the bit. I then rolled Mr. Hemingway over to nurse Wilheit in revival. She was the one who brought Mr. Hemingway down that morning, I think I mentioned that. That woman could be anywhere between thirty and fifty, really hard to tell. Thin as a broomstick and about as attractive. She has a very high-pitched voice that makes me think of magpies.

The revival nurse cleans the patient up, you know the jelly and such. Then she checks his vital signs and makes sure he comes around okay, you know, revives. Gives him water, helps him up and into the wheelchair and then rolls him back to his room, or ward, depending on how much money he has. Mr. Hemingway had a private room.

Revival is normally a walk in the park, but if there’s been a mess, it can be hell.

Mr. Hemingway was somewhere in between that day. I noticed blood on his wrists from straining, and he was also bleeding from his mouth. The bit had stayed in place though, so the tongue should be okay, I figured. He must have bit his lip or something.

I left him with nurse Wilheit and went back into the juicer to pack things up.

By now Dr. Jacobsen had left. There was just the machine and me. I gathered up the electrodes, cleaned the quarters and stowed the whole thing away in the cart. The machine was still humming so I turned it off. Normally the doctor turns it off, but Jacobsen must have forgot. He was still upset about Dr. Solti, I think. I took another look around to make sure all was as is should be, and it was.

I then had to collect the gurney from revival and roll it back into the cleaners. So I walked over there but had to wait a while for nurse Wilheit to finish cleaning up Mr. Hemingway. In fact, I had to help her get Mr. Hemingway off of the gurney and into the wheelchair. He was real heavy, like something not alive is real heavy, and not very cooperative. But we got him into the wheelchair and the broomstick, after thanking me with a rare nod, wheeled him out and away.

I rolled the empty gurney back into the juicer, but before I rolled it all the way to the cleaners I took a look out the window that sat high in the wall above the machine. It’s what they call mullioned and was set deeply in the wall. Eight small panes, four wide, two high. And very clean. I should know.

On the other side of it was a beautiful day. I couldn’t see a single cloud from where I stood. I walked over to it and looked up. At a sharp angle. One, two, small ones. That was it. Dabs of cotton way up high on clear blue. A great day. And we were done here. Just the final cleaning to go, rooms and gurney and bits, and then I was off for the day.

:

Then I didn’t see Mr. Hemingway for six days. He returned on the seventh, exactly a week later. Again he was the last patient of three. And again he was listed as this Mr. G. Saviers. Didn’t fool me this time though.

And again it was a beautiful day outside.

I was surprised to see they didn’t bring him down in a wheelchair, that’s the policy. Has to do with lawsuits. You have to roll patients around between departments either on a gurney or in a wheelchair. I was told later that he had insisted, insisted so hard, that they let him walk on his own, though barely. I recognized one of the two nurses who led him in, Cuthbertson is his name. Big fellow. They held him, each with a firm grip around the elbow.

Mr. Hemingway was trying to work his arms free, but only halfheartedly, protesting like. The cow struggling. Irritated at being led, at being touched.

They helped him up onto the gurney.

“All yours,” said the one who wasn’t Cuthbertson, and then he left the way he’d come. Cuthbertson said, “I’ll be waiting over in revival,” either to me or to Mr. Hemingway, I’m not sure which. Probably me, since Mr. Hemingway doesn’t know about revival, but he was not looking at me when he said it, so I’m not sure.

“Okay,” I said. Just to be on the safe side.

Again, Mr. Hemingway only answered me with yeses and nos, and softly. Twice, I had to ask him again. I couldn’t hear him. He wasn’t paying much attention.

He did not resist the straps nor the jelly.

Then I rolled him into the juicer. Dr. Jacobsen, who had administered the first two patients, had left. Dr. Solti stood at the machine.

“Is he ready?” he asked.

“Yes,” I said.

“Straps been checked?”

“Yes,” I said.

“We don’t want anything to break this time,” he said.

“I’ve replaced the chest strap,” I said. “It’s brand new.”

He didn’t answer. Instead he checked both the wrist straps and the leg straps, which I wasn’t too happy about. As if I hadn’t done my job. “Tighter,” he said.

Had it been anyone but Solti, I would have asked why, for any tighter than they were would cut blood circulation, and that was against our policy. Instead, I pulled them each one notch tighter. Mr. Hemingway winced at one point and looked at me, scared again it looked like.

“Okay,” I said when I was done. “They’re tighter.” I returned to my station by Mr. Hemingway’s head.

Dr. Solti didn’t answer. He didn’t even look at me, just down at his checklist. Then he said, “Bit.”

I applied it. “In place,” I said. Check.

“Electrodes.” I fit the helmet in place. “In place,” I said. Check.

Mr. Hemingway did not open his eyes, not even once.

Without another word, Dr. Solti pressed the juice button. One thousand one, one thousand two, one thousand three. I always count to myself, it’s a reflex, I think I’ve mentioned that. The dial said 440.

These few seconds it takes for the reaction to set in once the button is released is the best parallel I know to the calm before the storm. It is eerie. It’s only three or four seconds, if even that, but it feels a lot longer. A lot. Mr. Hemingway lay like dead, seemed all at peace, not a care in the world, then he got the message.

His eyes shot wide open as if he had just remembered something terribly important, and then he did his best to break all the straps. For almost a minute he danced, or at least it seemed that long. The straps held fine, though.

I was about to remove his helmet and bit, when Dr. Solti said, “No. Leave him.” Then he pressed the juice button again: One thousand one, one thousand two, one thousand three.

The calm did not last as long this second time. It was as if his brain stood by at the ready, and he took off almost at once. This time he screamed around the bit and I wondered whether it would work its way out despite the strap, for that would be a real mess. To my relief it didn’t, and the straps all held fine as well.

Once Mr. Hemingway calmed down again, Dr. Solti left without a word and without as much as a glance in my direction. His white coat was unbuttoned and flapped behind him as if it were windy, then he stepped out into the hallway and disappeared. I don’t like Dr. Solti one bit. He scares me. I think I’ve mentioned that.

Mr. Hemingway lay rock still, staring at the ceiling. I don’t think he saw it though, his eyes were still remembering something terrible. He was wet with perspiration and I think he had soiled himself, number one. Maybe it was that extra juice Dr. Solti gave him. Well, that was Cuthbertson’s problem.

I removed the helmet and bit and unstrapped him, then rolled him over to revival. There was no blood this time. That’s the one benefit of pulling the straps tighter, of course, even though it cuts the circulation. Maybe that’s why Dr. Solti asked me to tighten them. Perhaps he doesn’t like blood.

:

Officially, we were still to pretend that he was not at the hospital. Even though the Post-Bulletin, that’s our local paper, one day in December reported that Mr. Hemingway had been seen taking escorted walks just outside town, we were still to say he wasn’t here. In fact, it was not until early January that they officially let on that he was a patient here, which is also when we all saw the confidential notice they had posted in the staff rooms. “What to say if asked,” was the title of it in pretty large letters. Then it went on to say that we had to know it by heart.

I learned it and still remember it well. This is how it went: “Mr. Ernest Hemingway is a patient at the Mayo Clinic. He is receiving treatment for hypertension, and his condition is satisfactory. He has received no surgical treatment and none has been prescribed. It is important that his right to privacy be respected and that he have the benefit of undisturbed rest and quiet.” That’s what it said and what we were supposed to say when asked about him.

It’s funny how you can say something true that is also a lie. No surgical treatment, they said. Sure, juicing wasn’t cutting, so by definition, I guess, it was not a surgical treatment, but it was cutting nevertheless. It was cutting with a thousand little deaths. Not that it mattered, though. No one I knew was ever asked about him. And then he was gone anyway.

:

Mr. Hemingway’s first visit with us lasted nearly two months. We administered to him four more times during this stay for a total of six treatments. But it was really more than six treatments total because Dr. Solti gave him longer than usual doses, and twice each time. So it was more like twelve, or fifteen normal treatments, if you compare them to what other patients got. I don’t know why Dr. Solti did this, but you don’t ask him questions. He’s in charge, and they say he’s an authority, so he knows best.

Mr. Hemingway left us on January 22nd and then I didn’t see him for a little over three months.

It was on a Tuesday, April 25th, when I heard he was back. He had arrived that morning. It was a gray day, I remember, and quite warm for that time of year. The snow was all gone.

Two days later, Thursday morning, I saw his name on the menu. They used his real name this time. He was the last patient, as usual, the last one of four this time. At ten-thirty they came, two nurses and him. Big nurses, one on each side, firmer grips, this time, I could tell. And it seemed to me that he was tense, and quite alert. The nurses looked tense, too, and alert as well. They led him into the cleaners and he looked straight at me, and he recognized me. Then all hell broke loose. As if seeing me had scared him. I don’t think “scared” is the right word, though, and I’m not scary by any stretch, but seeing me set something off, that’s for sure.

He twisted violently and threw the two nurses off of him and spun around, took off. They both recovered quickly enough (they’re trained for these kinds of things) and set out after him. I stayed where I was, stunned, to be honest. Awed, I think, that I had had such an effect on him, even if I kind of knew that I hadn’t.

I’m not sure how long it was I just stood there. Then someone hit the bell and that meant all hands on deck. It meant someone needed manhandling. It meant major trouble.

I don’t like all hands. It’s basically an everyone against one, each one grabs what they can of the patient gone wild: a leg, an arm, hair, chest, feet, anything that won’t come off, and then you get as good a grip as you can and you hang on. When enough people have enough good grips on enough parts of the patient and hang on well enough, he is usually still by then and down on the floor. Still screaming though, usually.

Mr. Hemingway was still screaming. And very loudly. Like some gray, trapped, two-legged lion. He had made it all the way to the end of the hallway before they caught up with him, and now I made my way there to watch the spectacle. I counted three nurses on top of him and several more arriving. Surely, they would have no need of me, plenty of hands already. I stopped a ways off.

“What the hell do you think we pay you for?” Dr. Solti came up behind me. Scared me half to death. “Get in there and help them,” he yelled, his face pink and angry. I got the point and ran over to the fracas, looking for something to grab hold of. With five nurses now competing for body parts, there was nothing immediately available for me that I could see. Mr. Hemingway, the lion, was down on the floor, on his back. Someone had a hold on his head, another nurse had his right leg, another his right ankle, another his left leg. Yet another had his left arm, and one, make that six, lay on top of him, holding down his left shoulder and upper arm. With more on the way: I could hear many feet around the corner and behind me.

Someone else arrived and seized his right arm, but he struggled it free and suddenly his hand came unclaimed. I kneeled down and simply took it in the two of mine. Took it and held it. I was going to do my bit for King and Country and subdue this hand but it got to me first. It was as if it was startled to find other hands around it, others of its kind, and suddenly it clung to mine for dear life. Mr. Hemingway’s hand was larger than mine by far, and should have been the mature one, but even so his was the child hand who had finally found his parents after thinking he had lost them, and now he seized my hand, I think it was my left, and would not let go, not for anything. I squeezed back, to sort of reassure him I was there, papa hand to child hand, it’s going to be all right, and damned if he didn’t calm right down. The nurse pile eased off and looked at him, then at me, then back at him. They stood him up, and Hemingway looked at me, surprised I think to find me at the other end of the hand he still clung to. Then he let go of it. He didn’t say anything, just dropped it and looked down at the floor. Shuffled down the hallway and into the cleaners almost on his own. A little like a bear now, a resigned bear. No more lion. Outgunned.

I hurried after and helped them put him up on the gurney.

Dr. Solti stood behind me in the cleaners, inspecting my work. That man makes me nervous. But I knew my job from years of routine and I got through the prep despite him. At one point Mr. Hemingway looked up at me and drew a quick breath as if to say something, but when he saw Dr. Solti he said nothing.

One thousand one, one thousand two, one thousand three.

He convulsed something terrible, but the straps held fine. Once he calmed down I noticed that he was crying. Patients seldom do. They seldom cry. They’re too busy dancing. But I swear he was crying. His eyes were shut tight. Large drops squeezed out and stayed on his eyelids, forming little pools. Glistening. They didn’t belong there, the tears didn’t. Legends, just like statues, don’t cry.

One thousand one, one thousand two, one thousand three again.

This time he danced so hard that the right ankle strap broke and Mr. Hemingway’s foot shot up and hit Dr. Solti, who had movedaway from the machine and was on his way out, I think, on the elbow. This made him drop his clipboard, which clattered to the floor. I don’t think the kick had hurt him or anything. You would have thought he had nearly been killed though.

“What the hell is wrong with you people?” he said. Yelled. At me.

I ran over and grabbed the foot. Held it. My touch seemed to calm him down a little. I glanced quickly at the strap. It was the clasp this time that had given out. It had also torn some skin, and some flesh, I think, off his ankle because I was getting blood all over me. Dr. Solti picked up his clipboard and turned to me. “You make damn sure this doesn’t happen again, or you won’t have a job,” he said. Yelled.

Mr. Hemingway was post-dance now and rock-still again. And no more tears. His eyes were shut, though. His face was drawn tight into a grimace that would not relax. He looked carved out of something gray and sad. I unhooked him and rolled him over into revival.

The following Thursday there was only him and me in the cleaners. He hadn’t struggled at all coming in, had let them lead him. No resistance. All resigned to his fate. He had laid down on his own and the two nurses left, one for revival and the other for wherever he had come from. I knew neither of them. Didn’t even recognize them. I did my prep and he answered all my questions fine. Then I rolled him into the juicer.

“What is your name?” he said.

He was talking to someone else, that was my first notion. I looked up to see who else had arrived without me noticing. I saw nobody. When I looked down at him I saw that he was looking straight up at me.

“What is your name?” he asked again.

I told him. “John.”

“John,” he said, “Please don’t do this to me.”

Now, here’s the thing: We’re supposed to ignore anything they say. That’s our policy. But he meant it so hard it stopped me cold. I didn’t know what to answer.

“Please don’t,” he said again.

“It’s for your own good,” I said. Finally. Out of the manual.

“That’s what they keep telling me,” he said. “That it will help. But it doesn’t, John. It is not helping. It’s not erasing my problems. It’s erasing me.”

I was about to answer I don’t know what, when Dr. Solti came in.

“Ready?” he said.

“No,” I answered.

“Well, get with it,” he said.

I did.

One thousand one, one thousand two, one thousand three.

One thousand one, one thousand two, one thousand three.

:

He returned one week later, Dr. Jacobsen presiding this time. Dr. Solti, from what I had heard, was away somewhere on vacation. Fine by me. I preferred Jacobsen by a mile.

In a wheelchair this time. When he stood up I could see that he had lost weight. This was strange, for if we did anything right at Saint Mary’s it was the food, so he must not be eating or something. I also noticed wrinkles of skin sagging on his face and into his beard. He looked very tired.

I wasn’t sure he even recognized me at first, but when he spoke I knew he did.

I was working my prep list and he found my eyes from where he was lying. And held on to them. “Please,” he said. “Please don’t do this.” Same as last time. But then he said, “You’re killing me.”

I wasn’t sure I heard that right, and I must have looked it, for he said it again, “You’re killing me.” This time I heard him fine.

We’re trained to handle these things, these comments, whatever they say. Two rules, well three. The very first one is to ignore what they say, if at all possible. Best policy. Just don’t listen.

But if you can’t do that, if they keep going and like Mr. Hemingway insist on saying things to you, then you must realize that they’re confused, that they don’t really know what they’re talking about. That they are sick, which is why they’re here, after all. It’s kind of elementary when you stop to think about it. We know what’s best for them, they don’t. That they’re usually just babbling, not really saying what they’re saying, they don’t really mean it. So, bottom line, rule number two, never believe anything they say.

That done, rule number three, reassure them.

Only Mr. Hemingway seemed very much to mean exactly what he said. He was not babbling. He was stating a fact.

This is what I should have said: Oh, don’t be silly. No one’s killing you. Trust me, this is for your own good. You know, something like that. Something out of the manual. Something reassuring. But instead I said the only thing that came to mind, “What do you mean?”

“I can’t write,” he said.

And I still didn’t understand, so I repeated, “What do you mean?”

“I’m losing my memory,” he said. “I can’t write anymore.”

Memory loss is of course a common side effect, but it is only temporary, only lasts for a few days, or for a week or two at the most, after the shocks. That’s what we’re taught. “You’ll get it back,” I said. I did my best to sound reassuring.

“That’s what they tell me,” he said. “That’s what Solti tells me, and Jacobsen as well. But I don’t believe them. I can’t remember even the simplest things anymore. I can’t remember Paris, I can’t picture the streets. I can’t smell the earth or hear the wind. I can’t write anymore, John.”

I was surprised, and not a little flattered, that he remembered my name.

“Doctor Solti and doctor Jacobsen know what they’re doing,” I said. “You really shouldn’t worry.”

He didn’t answer me. Didn’t look back up at me. Instead he closed his eyes and sort of fell back even though he was really lying down, if you know what I mean.

I ran through the list with him and he answered my questions fine, if quietly.

Rolled him into the juicer.

One thousand one, one thousand two. At 440.

:

He spoke to me again the following week. We were in the cleaners.

“I can’t write anymore, “ he said. “I can’t write anymore. Do you understand? Can you understand that? I can’t remember.”

“Honestly,” I said. “It’s normal. There is nothing to worry about.” Then I added our stock phrase for good measure, “The doctors know what they’re doing.”

“The doctors have no idea what they’re doing,” he said.

“We see this all the time,” I lied. “Patients feel they’ve lost their memory, only it always comes back. Sooner or later it always comes back.”

“I don’t believe you,” he said. “It’s getting worse and worse.”

“You look better,” I said. That too was a lie, but I was trying to reassure him.

“No,” he answered. “I don’t look better. I look like shit. And you have no idea what I’m talking about, do you?”

“I do understand, Mr. Hemingway,” I said, although I really didn’t.

“How could you? How could you have any idea what it feels like?” He said, almost cried. “I’m all dark inside. Can you imagine that? Can you, John? All dark, all silent. Nothing. It is like a morgue in here. You’ve welded me shut with your electric machine, and my head won’t let me out anymore. I can’t remember things. I can’t imagine things.”

“Mr. Hemingway,” I began. But he didn’t hear me. He was still talking.

“That’s gone too now. I can’t imagine things.”

He grabbed the sleeve of my coat to make sure I was listening, pulled me closer to him. And from real close he looked right up at me, imploring me with his face. “Please, John. That’s all I have. My memory and my imagination are all I have. My imagination is the light I see by when I write. Don’t you see? And it too is gone. There’s no light now. I have no light. Nothing to see by. This damn electricity has gouged my eyes.”

“I promise you, Mr. Hemingway,” I lied again, and more convincingly this time. “I don’t know of a single patient that has lost his memory for good. It always comes back. Always.”

Well, was that really a lie? I don’t know. I’ve never heard of it happening, of permanent memory loss, I mean. Perhaps it could vanish forever, what do I know? But I figured I could tell him just about anything at this time, so long as it calmed him down. I had to reassure him. My job. He let go of my sleeve.

The odd thing was that I think he believed me. This, when he would not believe the doctors. Strange. He looked up at me again. “Is that really true?” he asked. “Really true? It always comes back?”

“Yes,” I said. “It’s true. It always comes back. Always.”

He didn’t answer me. He didn’t say a thing. He just lay still and let me get him ready. His usual one-word replies to my questions. Check. Check. Check.

:

And that was the last time he spoke with me. During his stay. Ever. They brought him down for three more treatments, but it was as if he had already left. Left as a person, I mean. He no longer looked at me. It was like he didn’t recognize me anymore, or didn’t want to. Though he did answer my checklist questions with soft yeses and nos, they came from far away, and seemed lifeless, as if spoken by some machine.

One day nurse Wilheit told me something I hate her for telling me. She told me she had overheard Jacobsen telling another doctor that in April, when they went to get him for this visit, they had found him on his knees, crying, begging his wife not to send him, begging the orderlies not to take him for any more treatments. On the floor, bawling.

The great Mr. Hemingway.

I can still see him, on the floor, begging for his life. Much as he begged me.

He went home two weeks later. That was June 28th, nine days ago.

On July the 3rd I bought the paper as usual at the tobacco store. It was overcast and not too hot. Looked like rain by evening. I sat down on my porch to read it. Mr. Hemingway was the headline. Dead. He had shot himself in the head. I read the article over and over.

And I heard him again, over and over: “Please, John. That’s all I have. My memory and my imagination are all I have. My imagination is the light I see by when I write. Don’t you see? And it too is gone. There’s no light now. I have no light. Nothing to see by. This damn electricity has gouged my eyes.”

Of course, there is nothing I could have done about it. I did what I was told. He wasn’t my patient, after all. He was Dr. Solti’s, or Jacobsen’s.

But I didn’t go to work that day. Couldn’t make myself do it. I called in sick. Instead I went to the library to borrow something he had written. Only to discover I wasn’t the only one who wanted to find out what he was all about. All of his books were checked out, with others asking for them as well.

So I went to a bookstore. Then another. Then a third before I finally found a paperback copy of his stories. Selling like hotcakes, said one of the clerks. Seemed please about it. Pleased that he was dead to give business a little shot in the arm.

I’m not much of a reader, but this book I read, all day and into the night. Then again. Then I slept. When I awoke it was almost noon on the 4th of July and I was supposed to visit my uncle. But I never left my house. Instead I read the book again. And as I read it I met the man I had helped kill. He talked to me, clearly and from many places. Alive.

And I could finally see what he was talking about, that light he wrote by, because I could see so clearly, so vividly what he told me in his stories. That was the light he was talking about.

I could touch the world he showed me. I could see by his imagination, for as I read my own imagination cast a light that I could see by. And now I think he had told me the truth. I think we were in fact killing him. Welding his memories and stories shut in darkness, like he said, for would he have killed himself had his memories and his imagination survived? I don’t think so.

I had lied to him.

Of course there was nothing I could have done. I keep telling myself this. But it does no good. That’s just another lie.

I could have done things. A lot of things. I could have complained to my boss, or to the hospital management, about Dr. Solti, about his longer than normal double doses. I could have gone to the papers about it. Sure, that would have cost me my job, but what is my job now? Now that I’ve killed him, now that I have come to know that man that I have helped kill. My job would have been a small price to pay. No price at all, really. Just knowing I had saved him would make my life worth living again.

But I did nothing. Instead I lied to him. I reassured him. I killed him.

I have a double barreled shotgun. Just like he did. It’s the one I inherited from Pa. The one Pa cleaned every time he had used it, and at least once a week on principle. It leans against this table where I sit as I write this. It is loaded and I wonder if I, like that gray lion, have the courage to use it.

 ::