The patient lies on a table in socks and a hospital gown. There are electrodes on his head, chest, arms, and legs. They are glued to his body with a green gel that conducts electricity. There is an oxygen mask over his mouth and a needle in his arm. Blood pressure cuffs around his ankles are inflated to block the flow of the paralytic drug succinylcholine to his feet. During the procedure the patient will be under general anesthesia and paralyzed, and his twitching toes will be the only sign of the convulsions he’s experiencing. The convulsions from electroshock will last thirty seconds and will rearrange his brain with the goal of healing. Afterward he will wake up on a gurney with no memory of the procedure and a nurse will ask him where he is. He will answer that he is at the General Clinical Research Unit on the fifth floor of the New York State Psychiatric Institute at 1051 Riverside Drive in Manhattan. In Allen Ginsberg’s poem “Howl,” this place is called “Rockland.” The patient will walk back to the ward with the nurse steadying him, eat a breakfast of oatmeal and coffee, and peel the dried green glue off his forehead.
“These days, I think of ECT as clean power, good electricity added to a wet, saline medium in which electrical signaling has become chaotic and mistimed,” Donald Antrim writes in One Friday in April: A Story of Suicide and Survival. The book is a memoir of the author’s first brush with suicide. It’s a condition he distinguishes from depression, which Antrim calls “a concavity, a sloping downward and a return”:
Suicide, in my experience, is not that. I believe that suicide is a natural history, a disease process, not an act or a choice, a decision or a wish. I do not understand suicide as a response to pain, or as a message to the living. I do not think of suicide as the act, the death, the fall from a height or the trigger pulled. I see it as a long illness, an illness with origins in trauma and isolation, in deprivation of touch, in violence and neglect, in the loss of home and belonging. It is a disease of the body and the brain, if you make that distinction, but its etiology, its beginning, whether early or later in life, in the family or beyond, is social in nature. I see suicide as a social disease. Antrim refers to his book variously as a “report” or a “letter,” and if we think of it as a memoir, it has a peculiar problem: its narrator is recounting a phase of a few months when he existed outside of time. The “one Friday in April” is where the book begins, when Antrim is on the roof of his apartment building in Park Slope, Brooklyn, hanging from a fire escape and almost letting go. We are up there with him for a long time, eighteen pages but a matter of hours, with a helicopter hovering overhead and people on neighboring roof decks enjoying after-work cocktails. Antrim tells us about his condition and tells us about his past, in stories from memory that spring forth in their own paragraphs without transitions, their naked presentation lending them extra force. Do these stories—of his birth when he was pulled from his mother’s arms; of his mother’s subjection to Munchausen syndrome by proxy, a form of abuse that in her case involved multiple unnecessary childhood heart surgeries; her and his father’s alcoholism—constitute a case study, an explanation of the “social disease” he suffers? Yes and no. This book is not a complete autobiography; it does not tell the whole life or attempt to explain everything. It is a description of psychosis, a break from reality, and the memories it contains represent paths back to that reality, to the “historical time” the patient has departed.
The tone of the book is, by necessity, intimate. Antrim clearly has in mind the task of reaching those who have experienced similar mental states and their loved ones, an audience so broad it might include all of us. (In my own case, my uncle and godfather Chris committed suicide, in the garage attached to his house in Oregon with the door closed and the engine turned on, in August 2008, two years after the events of his own life that Antrim describes.) The sentences often switch between the declarative and interrogative moods, with frequent use of the second person. “What were my crimes?” he asks.
What are yours? What do you look forward to? I looked forward to poverty, abandonment by my remaining family members, the inability to write or work, the dissolution of friendships, professional and artistic oblivion, loneliness and deterioration, institutionalization and the removal from society—abjection and the end of belonging with or among others. I would be alone. One Friday in April is an attempt not to be alone and to throw others a lifeline.
In the spring of 2006, by many metrics, Donald Antrim was far from abjection. He was in fact on the verge of a significant literary success. That July, while he was in the mental ward and undergoing ECT, The Afterlife, his memoir of his late mother, was published to wide acclaim and would be a finalist for the National Book Critics Circle Award in 2007. He was the author of three dark, wild, brilliant, and very funny novels that had been published between 1993 and 2000, and he had been named to the New Yorker’s “Future of American Fiction” list, the so-called “20 under 40” (Antrim was born in September 1958), in the summer of 1999. He had a romantic partner, Regan, who took him to the hospital and called and visited him during his stay along with several close friends. He had troubles and a troubled past but many things to live for. This is one reason why he sees suicide outside the framework of rational decision-making and messages sent to the living.