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I lived for the details, and the writer I once was made vivid use of them. The cartoonish image of my head being fried, tiny shocks and whiffs of smoke coming off it as the electric current went through, haunted me even though I knew that ECT no longer was administered with convulsive force, jolting patients in their straps. But in the end, no matter how much I wanted to stay put, I ran out of resistance. Suicide could wait, my sister said. She relayed messages from each of my doctors that they would look out for me on the unit.

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No one would force me to do anything, including ECT. I felt too tired to argue. In return for agreeing to undergo one of several available protocols — either switching my medication or availing myself of ECT — I would get to stay at 4 Center as long as I needed at no cost.


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My sister picked me up in a cab, and as I recall, I cried the whole ride up there, watching the passing view with an elegaic sense of leave-taking. Everything seemed empty and silent under the fluorescent lighting except for one ish man pacing up and down the hallway in a T-shirt and sweat pants, seemingly oblivious to what was going on around him. Underneath the kind of baldfaced clock you see in train stations were two run-down pay phones; there was something sad about the glaring outdatedness of them, especially since I associated them almost exclusively with hospitals and certain barren corners of Third Avenue.

And then, in what seemed like an instant, my sister was saying goodbye, promising that all would turn out for the better, and I was left to fend for myself. View all New York Times newsletters. Cellphones were also forbidden for reasons that seemed unclear even to the staff but had something to do with their photo-taking ability. In my intake interview, I alternated between breaking down in tears and repeating that I wanted to go home, like a woeful 7-year-old left behind at sleep-away camp.

The admitting nurse, who was pleasant enough in a down-to-earth way, was hardly swept away by gusts of empathy with my bereft state. And yet I wanted to stay in the room and keep talking to her forever, if only to avoid going back out on to the unit, with its pathetically slim collection of out-of-date magazines, ugly groupings of wooden furniture cushioned with teal and plum vinyl and airless TV rooms — one overrun, the other desolate.

Anything to avoid being me, feeling numb and desperate, thrust into a place that felt like the worst combination of exposure and anonymity. I emerged in time for dinner, which was served at the premature hour of , as if the night ahead were so chockablock with activities that we had to get this necessary ritual out of the way.

But as it turned out, the other patients were finished eating within 10 or 15 minutes, and I found myself alone at the table, not yet having realized that the point was to get in and out as quickly as possible. Or that, despite its being summer, there was barely any fresh fruit in sight except for autumnal apples and the occasional banana.

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From the very first night, when sounds of conversation and laughter floated over from their group to the gloomy, near-silent table of depressives I had joined, I yearned to be one of them. Unlike our group, they were required to remain at lunch and dinner for a full half-hour, which of necessity created a more congenial atmosphere.

No matter that one or two had been brought on to the floor on stretchers, as I was later informed, or that they were victims of a cruel, hard-to-treat disease with sometimes fatal implications; they still struck me as enviable. No one could blame them for their condition or view it as a moral failure, which was what I suspected even the nurses of doing about us depressed patients. In the eyes of the world, they were suffering from a disease, and we were suffering from being intractably and disconsolately — and some might say self-indulgently — ourselves.

There were two beds, two night tables and two chests of drawers. The shower water came out of a flat fixture on the wall — the presence of a conventional shower head, I soon learned, was seen as a potential inducement to hanging yourself — and the weak flow was tepid at best.


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  • I got into bed that first night, under the ratty white blanket, and tried to calm myself. The lack of a reading lamp added to my panic; even if my depression prevented me from losing myself in a book, the absence of a light source by which to read after dark represented the end of civilization as I had known it. My mind went round and round the same barrage of questions, like a persistent police inspector. How did I get here? How did I allow myself to get here? But the truly intolerable part was that I had acquiesced in this godforsaken plan; there was ultimately no one to blame for my banishment to this remote-seeming outpost but myself.

    I plumped the barracks-thin pillow, pulled up the sheet and blanket around me — the entire hospital was air-conditioned to a fine chill — and curled up, inviting sleep. There was nothing to feel so desperate about , I tried soothing myself. You can ask to leave tomorrow. All over the city, less depressed or entirely undepressed people were leading their ordinary lives, watching TV or blogging or having a late dinner.

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    Outside the room the light was blinding. Two of the aides were at the desk, playing some sort of word game on the computer screen. They looked up at me impassively and waited for me to state my case. My hands were clammy and my mouth was dry. One of them got up and went into the back to check whether the resident in psychiatry who was assigned to me had approved the request.

    She handed me a pill in a little cup, and I mumbled something about how nervous I was feeling. I was no one to her, no one to myself. My frantic sense of dislocation and abandonment persisted for the entire three weeks I spent on 4 Center, yielding only at rare moments to a slightly less anxious state of hibernation. By the end of the second week, when I was no longer chained to the unit, one of the male nurses would invite me for coffee breaks to the little eatery on the sixth floor where the hospital staff repaired for their meals.

    These outings were always kept short — we never lingered for more than 15 minutes — and they always brought home to me how artificial the dividing line between 4 Center and the outside world really was.

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    One minute you were in the shuttered-down universe of the verifiably unwell, of people who talked about their precarious inner states as if that were all that mattered, and the next you were admitted back into ordinary reality, where people were free to roam as they pleased and seemed filled with a sense of larger purpose. As I cradled my coffee, I looked on at the medical students who flitted in and out, holding their clipboards and notebooks, with a feeling verging on awe. How had they figured out a way to live without getting bogged down in the shadows?

    From what source did they draw all their energy? A weekly schedule was posted that gave the impression that we patients were quite the busy bees, what with therapy sessions, yoga, walks and creative-writing groups. The real draw was the promise of baked goods and freshly brewed coffee. But in truth there was more uncharted time than not, especially for the depressives — great swaths of white space that wrapped themselves around the day, creating an undertow of lassitude.

    Forging friendships on the unit, which would have passed the time, was touch-and-go because patients came and went and the only real link was one of duress. The other restriction came with the territory: people were either comfortably settled into being on the unit, which was off-putting in one kind of way, or raring to get out, which was off-putting in another.

    I had become attached to my roommate, who was funny and somehow seemed above the fray, and I felt inordinately sad when she left, in possession of a new diagnosis and new medication, halfway into my stay. Still, the consuming issue as far as I was concerned — the question that colored my entire stay — was whether I would undergo ECT.

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    It was on my mind from the very beginning, if only because the first patient I encountered when I entered the unit, pacing up and down the halls, was in the midst of getting a series of ECT treatments and insisted loudly to anyone who would listen that they were destroying his brain. And indeed, the patients I saw returning from ECT acted dazed, as if an essential piece of themselves had been misplaced.

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    During the first week or so the subject lay mostly in abeyance as I was weaned off the medications I came in on and tried to acclimatize to life on 4 Center. I met daily with Dr. She sported a diamond engagement ring and a diamond wedding band that my eye always went to first thing; I took them as painful reminders that not everyone was as full of holes as I was, that she had made sparkling choices and might indeed turn out to be one of those put-together young women who had it all — the career, the husband, the children.

    During our half-hour sessions I tried to borrow from Dr. But the reprieve was always short-lived, and within an hour of her departure I was back to staving off despair, doing battle with the usual furies. One day early into my second week, I was called out of a therapy session to meet with a psychiatrist from the ECT unit. I still wonder whether this brief encounter was the defining one, scaring me off forever. She pointed out that I spoke slurringly and that my mind seemed to be crawling along as well, adding grimly that I would never be able to write again if I remained in this state.

    Her scrutiny seemed merciless: I felt attacked, as if there were nothing left of me but my illness. Obviously ECT was in order, she briskly concluded. I nodded, afraid to say much lest I sound imbecilic, but in my head the alarms were going off. Not yet. It was the first stirring of positive will on my own behalf, a delicate green bud that could easily be crushed, but I felt its force. The strongest and most benign advocate for ECT was a psychiatrist at the institute who saw me three decades earlier and was instrumental in convincing me to come into 4 Center.

    In his formal but well-meaning way he pointed out that I lived with a level of depression that was unnecessary to live with and that my best shot for real relief was ECT. He came in to make his case once again as I was sitting at dinner on a Friday evening, pretending to nibble at a rubbery piece of chicken. The other patients had gone and my sister was visiting. I turned to her as he waxed almost passionate on my account, going on about the horror of my kind of treatment-resistant depression and the glorious benefits of ECT that would surely outweigh any downside.

    Help me, I implored my sister without saying a word. Tears trickled down my cheeks as if I were a mute, wordless but still able to feel anguish. My sister spoke for me as if she were an interpreter of silence. Instead of growing stronger on the unit, I felt a kind of further weakening of my psychological muscle.

    The new medication I was on left me exhausted, and I took to going back to sleep after breakfast. I was tired even of being visited, of sitting in the hideous little lounge and making conversation, of expressing gratitude for the chocolates, smoked salmon and change for the pay phones that people brought.

    I felt as if I were being wished bon voyage over and over again, perennially about to leave on a trip that never happened. I went out on several day passes in the week leading to my departure, as a kind of preparation for re-entry, but none of them were particularly successful. On one, I went out on a broiling Saturday afternoon with my daughter for a walk to the nearby Starbucks on th and Broadway.

    I felt thick-headed with the new sedating medication I was on and far away from her. When she left me for a minute to make a phone call on her cell, I started crying, as if something tragic had happened.