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

I want to begin by telling about the equipment and how I fit in.

The machine itself looks a little like a modern radio. White metal front and sides. The back is black. It's got small rubber feet and a polished wood top. One of my jobs is to keep the top polished and the rest of it clean too. I clean it every day. Every morning before we administer. Polish it twice a week. Tuesdays and Fridays.

There's a dial you turn but not for stations, as with a radio, but for voltage. It starts at 100 at the lower left and goes all the way to 500 at the lower right, almost full circle. We gave him 440.

There's a little meter that shows the output voltage, kind of a double check to make sure you get what you set on the dial. Then there's the on-off switch of course, which starts the humming. Then there is the "current" button which you press to send juice to the electrodes. The electrodes attach to the back of the machine and that's where the power cord comes out too. It weighs perhaps 10 pounds. It looks harmless enough.

The patient end of the electrodes are small metal disks about the size of a quarter, but thinner. They are built in to a leather band which we wrap around the patient's head to keep them in place. It looks like a headband when it's on. We call it "the helmet."

Then there's the jelly jar. We put the jelly on the temples before we fit the electrodes. The jelly shines when it goes on and smells fresh. I normally rub the first lot 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, kinda lets the electricity in easier. I used to pretend I was opening a door, allowing the juice in. The jelly also helps to prevent the skin from burning. It works most of the time.

We have four rubber bits, different sizes. They're for biting. They go in the mouth so the patient can bite down on it and save his teeth. It also keeps the tongue out of the way so they don't bite into it when they convulse. I've seen the bit come out and what happens when they bite their tongue. It's a real mess.

There are padded leather straps to tie the patient down. Arms and legs and thighs and 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, kids, or smaller men we don't use the straps. Although they are padded they can still cut the skin and they can make a real mess if they dance a lot. If we don't use the straps we just hold them down with pillows instead. We prefer the pillows. With him we had to use straps.

I am the only nurse assigned specially to Electro. That stands for the Electroconvulsive Therapy Unit, which is the official name. The doctors refer to it as the ECTU, we refer to it as Electro. The others who come here are regular nurses that just come in to help.

I keep the rooms clean. We have three rooms at Electro. One is for prep, which we call "the cleaners," and one if for administering, which we call "the juicer," and the last one is for recovery, which we call "comeback." First we take them to the cleaners, then into the juicer. Once done, it's over into comeback. That's our special lingo.

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

And I keep the checklists. This is the most important part. There's a checklist for each patient that I have to run through every time. Goes something like this: No food for eight hours. Check. Recently voided. That means gone to the bathroom, both number one and two. Check. That's an important one, it makes a real mess if they don't, it comes out all ends otherwise when they dance. No water for four hours. Check. That's important too. Once an old lady snuck out of the cleaners and had a glass of water, she was so thirsty she said after. Well, she almost choked to death while dancing when the water all came up and into her lungs. Kinda bubbled up and all over her face and into her nose and she looked like something come out of the lake. Then she stopped breathing. It was a mess. They got her back though. 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 it then of course I've selected it. I've brought that up to Dr. Sol 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 the mouth, I place it by the pillow, ready to go. Straps required. That's a yes or no one. If yes, straps applied. Check. If no, pillows ready. Check. Patient ready. Check.

Then there's the machine check list. I do that once each morning before the show. Goes like this: Machine cleaned, which has its own checklist. Check. Electrodes attached. Check. Electrodes tested. Check. I do the testing. We have a meter that attaches to each electrode with an alligator clip. I set the voltage at various levels and press the juice button. Hold it down for two seconds, one thousand one, one thousand two, the same length of time we use in the juicer. The meter registers the voltage which checks both that the juice is coming through and at the right strength. 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. Electrode strap oiled and cleaned. Check. Electrodes firmly in place. Check. I think of that as "helmet ready," almost like we were taking off for somewhere in a plane.

Machine ready. Check.

Then there are the cleaning check lists. Won't bore you with those.

I run the cleaners. I make sure that all patients are good and prepped. When I started out here at Saint Mary's that's all I did. The cleaners. I'd prep one patient while the one just done was in the juicer and so on, keeping a good flow going. Then it got kinda slow and we didn't have so many, so I did both cleaning and helped in the juicer. Now, if it gets busy, one of the other nurses run the cleaners. I do the check lists and work the juicer. If it's slow, I still do both. Ward nurses handle the comeback, although I'm officially in charge there too.

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

They checked him in under a different name. To keep it quiet. This was towards the end of November last year. Not exactly sure of the date, it was really hush. Even so, word soon got out. Everyone here said they knew who he was. They all said they had read his books too. I did too, said I had read him, although I never did. I think a lot of them were lying.

He was a large man but worn out it looked like. Gray. Big beard. But worn out, can't think of a better word. Even though it was common knowledge he was here no one knew that he was gonna get juiced.

And that morning's list didn't give it away either. G. Saviers, it said.

Third and last one for the day. A slow day. I would be doing the cleaning myself.

But this was not G. Saviers. It was E. Hemingway. That's who it was. He didn't say anything. He didn't look at me. His eyes were closed mostly. He answered my questions, but just barely. He sounded tired, kinda pissed off. His voice was thinner though than I would have expected from such a large man.

"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 answer for a check.

He didn't take long. Needed the number three bit, second biggest. He was too big for pillows, I applied the straps. Got him all good and secured to the gurney. Then I wheeled him into the juicer and took up my position at the head of the bed.

Dr. Jacobsen, our balding German or Dane, not sure which, Europe somewhere, asked if everything checked and I said yes. Good, he said. Let's get ready. I remember being surprised Dr. Sol--he's in charge of ECTU--wasn't there, this being such an important patient. Dr. Sol was not the one to stay away from anything important.

I picked up the helmet from the machine cart and fit it around the gray head. He looked up at me then. Didn't say anything, just looked. I know that look. Doesn't matter if you're Mr. Joe or Mr. Hemingway, I know that look. They're afraid, that's what the look is. Eyes look real calm but they plead like, beg you to not do this. They don't understand, of course, that this is the best thing for them. They're sickos, even Mr. Hemingway here is a sicko, and this is the best thing for them. It's how cows look at you when you come to get them for the butcher and his gun. Done it many times back home. As if they knew. They don't know, of course, cows, but they look like they do. And perhaps they do. I don't know.

I adjusted the helmet and tightened the strap. It's important that the quarters fit tightly against the temples, smack in the middle of the jelly. He closed his eyes, but only for a second or two, then he looked up at me again. Wouldn't stop looking. I doubt he saw me though. I doubt the cows saw me. But they wouldn't stop looking either.

Dr. Jacobsen was running through his own checklist, and asked me if the electrodes were in place. Yes. Check. Rubber bit in his mouth. Yes. Check. Straps firm. Yes. Check.

He then looked over the machine and filled out his list. All set to go.

There were four people in the room this first time. There was myself, at the head of the bed as usual. There was Dr. Jacobsen, the administering doctor. Nurse Lewis, a rather large woman from Wisconsin with freckles and a fleshy bottom lip who was assisting Dr. Jacobsen. And then, just before we were ready to go, there came Dr. Sol. He didn't say anything. Just walked in and stood a few yards away, inspecting things. I don't think he was meant to be there, for Dr. Jacobsen frowned when he noticed him.

Mr. Hemingway had closed his eyes. Just waiting.

Some of the doctors will ask first, kinda get everybody in sync. Not Jacobsen. He simply presses the button. Just like that. 440 volt. One thousand and one, one thousand and two, one. A little over two seconds.

Initially nothing happens. Just the sizzle and smell. I'm not even sure the others notice them, but I stand the closest and I notice. I listen for it and smell for it and when you do you hear it and you smell it. I don't like the smell but I can't escape it.

Then all hell breaks loose. When the juice hits the brain it goes berserk and begins sending out all kinds of signals in all kinds of directions with all kinds of commands and the result is what we call dancing. Mr. Hemingway almost bit through the rubber bit, the convulsion was so hard. His chest rose like a bridge and almost broke the chest strap in the process. At least it didn't come loose or I would have been in trouble to say the least.

He arched for a good ten, fifteen seconds and then went pretty spastic, arms, legs, feet, shaking, then another arch. Then he was still.

"Again," said Dr. Sol.

Jacobsen turned around and looked at him. He didn't say anything though.

"Do it again," said Dr. Sol.

"Not so soon," said Dr. Jacobsen.

"Do it again," said Dr. Sol for a third time.

"We can't do it again so soon."

Dr. Sol walked up to the machine and without as much as a look at anyone pressed the button. One thousand and one, one thousand and two, one thousand and 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 could tell. Empty eyes, just open into nothing.

The dance broke the chest strap. Lucky it didn't work loose, it broke. Not my fault it broke. Bad strap. Besides, Dr. Sol went longer than normal too. Shouldn't have done that. He left the room without looking at anyone or saying anything. Dr. Jacobsen said nothing either but watched him leaving. Then he wrote something on his clip board.

I undid the helmet and rolled Mr. Hemingway into comeback. Nurse Wilheit was there. She's from long term, assigned there that day. She's somewhere between thirty and fifty, really hard to tell. Thin as a broom stick and about as attractive. The comeback duty nurse cleans the patient up, the jelly and such. Then she checks vital signs and makes sure they come around okay. Gives them water, helps them up and into the wheel chair for going back to their rooms.

Comeback is normally a pretty easy job, but if there's been a mess it can be hell.

Hemingway was somewhere in-between. I noticed blood on his wrists from straining, and he was also bleeding from his mouth. The bit was still in place though, so the tongue should be okay I figured.

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

Jacobsen and Lewis had left. There was just the machine and me. I gathered the things and put them on the cart. Then I looked out through the window behind it. It was what they call mullioned and set deeply in the wall. Eight small panes, two wide, four high. Very clean. I should know. Behind it was a beautiful day. I couldn't see a single cloud from where I stood. I leaned closer and looked up. 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 cleaning and I was off for the day.

He was back six days later. Again he was the last patient of three. And again he was listed as this Mr. G. Saviers. I did the cleaners. And again it was a beautiful day outside.

They let him walk on his own, but barely. I recognized one of the two nurses who led him in. They held him each by an elbow. Mr. Hemingway was trying to work his arms free, but only halfheartedly. The cow struggling. Irritated at being led.

They helped him up and onto the gurney. They laid him down.

"All yours," said the one I didn't recognize.

"Okay," I said.

Again, Mr. Hemingway only answered with yeses and nos and very softly. Twice I had to ask him again. He did not resist the straps or jelly.

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

There was no other nurse, just Dr. Sol and myself.

"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.

He didn't answer. Didn't even look at me, just at his checklist. Then he said, "Electrodes and bit."

At first I thought he wondered if I had replaced them too, and I hesitated. He looked up at my silence and I understood. He was continuing down his list.

"Yes, doctor," I answered, and applied them. Mr. Hemingway did not open his eyes even once.

Dr. Sol pressed the button. One thousand and one, one thousand and two, one thousand and three.

The straps held fine.

And again: One thousand and one, one thousand and two, one thousand and three.

And still held fine.

Dr. Sol left. His white coat was unbuttoned and flapped as he stepped through the door and disappeared.

Mr. Hemingway settled down and lay rock still. I unhooked him and wheeled him over to comeback. No blood this time.

Officially we still pretended that he was not here, at the hospital. Even when the Post-Bulletin, that's our local paper, reported that Mr. Hemingway had been seen talking walks just outside town, we said he wasn't here. It took until January before they admitted that he was a patient. We all saw the notice posted around the hospital. The official position, they called it, and we had to know it by heart in case we were asked about it. I remember it well. It went like this: "Mr. Ernest Hemingway is a patient at the Mayo Clinic. He is receiving treatment for hypertension, and his condition is regarded at satisfactory. He has received no surgical treatment and none is contemplated. It is necessary, however, that his right to privacy be respected and that he have the benefit of rest and quite."

The statement was a bit of a lie, we all knew that. No surgical treatment, they said. Sure, electro wasn't cutting, by definition, but it was cutting nevertheless. Not that it mattered. No one I knew was ever asked about it, and then he had gone home anyway.

Mr. Hemingway's first visit lasted nearly two months. We administered to him four more times during this stay for a total of six. But, it was really more than six for Dr. Sol gave him longer than usual double doses. I can't figure why. But you don't ask Dr. Sol questions. He's the expert.

He left us on January 22nd. Then we didn't see him for three months. It was a Tuesday, April 25th, when I heard he was back. He had arrived that morning. The day was gray but quite warm.

It was the Thursday following I saw his name on the list. His own name this time. Last, as usual, last one of four this time. At ten thirty he came, two nurses and him. Firmer grips, this time. He was tense, quite alert it seemed to me. They led him into the cleaners and he looked up straight at me. Then all hell broke loose. He threw the two nurses off of him and spun around. They both recovered quickly enough and set out after him. I stayed where I was. Kinda stunned. Kinda awed that he had seen me and panicked. Someone hit the bell and that means all hands on deck. Means someone needs manhandling. Means they were in trouble.

I don't like all hands. It's basically an everyone against one, each one grabs what they can of the patient, a leg, an arm, hair, chest, feet, anything that won't come off, and you hang on. When enough people have enough grips on enough body parts, the patient is normally still, and usually down on the floor. Normally still screaming though.

Mr. Hemingway was screaming. Very loudly. Like some sort of gray lion. I walked out into the corridor to watch the spectacle. I counted three and two more arriving. I stayed where I was.

"What the hell do you think we pay you for? Get in there and help them." Dr. Sol came up behind me.

Scared me almost to death. I hadn't heard him come. But I got the point. I ran over to the fracas and looked for something to grab. Nothing at first. Then his hand. His left hand. I simply took it. Took it and held it. I was going to do my bit and subdue the hand but it got to me first. It was like it felt another hand in it, one of its kind, and it clung to it for life. Mr. Hemingway's hand was large, mine was smaller. But still, his was like a child that had found a parent and now would not let go, not for anything. I squeezed back, sort of reassuring him I was there, papa hand to baby hand, and the damnedest thing, he calmed down. Calmed right down. The nurse crowd eased up and looked at him, then at me, and back at him. They stood him up. Hemingway looked at me, kinda surprised to find me at the end of the hand he still clung to. Then he let go. He didn't say anything, just dropped it and looked down at the floor. Shuffled into the cleaners almost on his own. I hurried after and helped them put him up onto the gurney.

Dr. Sol stood behind me, inspecting my work. He made 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 then did not.

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. Cry. They're too busy dancing. But I swear he was crying. Eyes were shut, tight. Large drops squeezed out and stayed on his eyelids, forming little pools. Glistering.

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

The left ankle strap broke and Mr. Hemingway's foot shot up and hit Dr. Sol. On the elbow. He dropped his clipboard but I don't think he was hurt or anything. But you would have thought it nearly killed him.

"What the hell is going on with you people?" he said. Yelled.

I ran over and grabbed the foot. He was calming down. It was the clasp that had given out. It had also torn some skin, and some flesh, off his ankle. I was getting blood all over me. Dr. Sol stepped back. "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. No more tears though. His eyes were shut, his face was drawn tight into a grimace that would not relax. He looked carved. I unhooked him and rolled him into comeback.

Next Thursday it was only him and me in the cleaners. He didn't struggle at all. They just led him in. He lay back on his own and the two nurses left. I began my list. Dr. Sol was not around yet.

"What's your name?" he said.

He was talking to someone else, that was my first notion. When I looked over at him, he was looking straight at me though.

"What's your name?" he asked again.

I told him. "John."

"John," he said. "Please don't do this to me."

We're supposed to ignore what they say. 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 then. Out of the manual.

"That's what they tell me," he said. "For my own good. It will help. But it's not helping, John. It's not killing my problem. It's killing me."

I was about to answer I don't know what, when Dr. Sol came in.

"What's the holdup," he said.

"Two minutes," I answered and got on with the list. Dr. Sol stood there waiting.

He was back again a week later. This time it was Dr. Jacobsen presiding. Dr. Sol, from what I heard, was away somewhere on vacation. I preferred Jacobsen by a mile. He let me do my job without standing over me like a mountain.

Looked to me like Hemingway was losing weight. If we did anything right at Saint Mary's it was the food, so he must have stopped eating or something. I noticed wrinkles of skin sagging on his face into his beard. He looked very tired. No struggle at all. Only one nurse to guide him.

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

He looked me in the eyes from where he was lying down. "Please don't do this," he said. Same as last time. "You're killing me," he said. I wasn't sure I heard that right, what he said exactly. And I must have looked it, for he said it again, "You're killing me." I heard him fine this time.

We're trained to handle these things. These comments. Step one is that we must never believe anything the sickos say, they are confused, which is why they're here. It's kinda elementary when you stop to think about it. We know what's best for them, they don't. They're usually just babbling, not really saying what they're saying. Step two is reassure them.

Only Mr. Hemingway seemed very much to mean what he said. He wasn't babbling. It was a statement of fact.

I should have said: No, don't be silly. This is for your own good. Or something like that. Out of the manual. Reassuring. Instead I said, "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 for a few days, or a week or two at the most after the shocks. "You'll get it back," I said. I tried to be reassuring.

"That's what they tell me," he said. "That's what Jacobsen told me. But I don't believe him. I can't find even the simplest things anymore. Can't remember Paris, can't picture the streets. Can't smell the wind. I can't write anymore, John."

I was surprised he remembered my name.

"The doctors know what they're doing," I said. "Don't worry."

He didn't answer me. Didn't look 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 rolled him into the juicer.

He spoke to me again next week.

"I can't write, " he said. "I can't remember."

"Don't worry," I said. "The doctors know what they're doing."

"They have no idea what they're doing," he said.

He sounded certain.

"I've seen it so many times," I lied. "Our patients come here and feel they've lost their memory, only it comes back. Sooner or later it comes back."

"I don't think so," he said. "It's getting worse with each treatment."

"You look better," I said. Reassure him.

"No," he answered. "I'm not looking better. I look like hell. And you don't understand. No one here understands. I'm all dark inside. All silent. It is like you have welded me shut with your electric machine. I can't remember. I can't imagine."

"Mr. Hemingway," I began. But he didn't hear me. He was still talking.

"I've lost it too. I can't imagine things either."

He grabbed my coat-sleeve to make sure I was listening. "You must understand, John. My imagination is the light I see by when I write. It's gone. I have no light. I can no longer see. You've blinded me."

"I promise you, I don't know of a single patient," I lied again, "that has lost his memory for good. It always comes back."

Well it wasn't really a lie, was it? I've never heard of it happen. And I figured I could say anything as long as it calmed him down. Reassured him, as it said in our training. Reassure him. He let go of my sleeve.

It was as if he believed me, when he would not believe the doctors. "Is that really true?" he asked. "Really true?"

"Yes," I said. "It always comes back. Always."

He didn't answer. He didn't say a thing then. Just lay still and let me get him ready. One word replies to the list. Check. Check. Check.

He didn't speak to me again during his stay. He came for three more treatments, but it was almost as if he had left. As a person, I mean. He no longer looked at me. Like he didn't recognize me any more.

Nurse Wilheit told me she heard something strange about this time. She told me that 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 hated her for telling me. I still see him, on the floor, begging for his life.

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

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

And I heard him again: "You must understand, John. My imagination is the light I see by when I write. It's gone. I have no light. I can no longer see. You've blinded me."

Of course, there is nothing I could have done about it. I'm just a worker bee. I did what I was told. He was Dr. Sol's patient, or Jacobsen's. Dr. Sol was responsible.

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

I went to a bookstore where I found the last paperback copy of a book of his stories. I'm not much of a reader, but this book I read, all day and through the night. Then again. Then I slept. When I awoke it was the 4th of July and I was supposed to visit my uncle. But I never left my apartment. Instead I read the book again. And as I read I began to realize what I had done. With each story I realized it more, deeper. I heard the voice I had helped kill, had killed. Heard it clearly and from so many places. He spoke from my own memories, with my own memories. He spoke with my dreams, with my fears. And he spoke from the bed in the cleaners, as he lay there and I looked down at him from the head of the bed. Begging me to stop. Begging me. The same voice begging me. On the floor begging his wife not to send him away. He spoke, I thought, with my soul, with my deepest self, and I began to see, very clearly, what it was I had done.

He had told me the truth. We were killing him. Silencing him. All doors, all windows, all memories, all stories welded shut in darkness, like he said. Like air for his lungs, he needed these memories, those things we hid from him. Like air we took away. I saw him gasping for it and not an iota of air, not a glimpse of memory.

Of course there was nothing I could have done. I keep telling myself this. But that is a lie. There were things I could have done. I could have told someone that he was getting more than the normal amount of juice. Told someone. If not at the hospital, someone at the papers. I could have told them what he told me. That we were killing him. That I was killing him.

I could have complained to the hospital management. It would have cost me my job, sure. But what is my job now with this death on my conscience. A small price. No price at all. Just knowing I had saved him would make life worth living.

But I did nothing. Instead I lied to him. Reassured him. Killed him.

I have a double barreled shotgun. Just like he did. It's the one I inherited from pa. The one he cleaned every time he had used it and at least once a week on principle. It leans against this table. It is loaded and I wonder if I have the courage to use it.