Because the Hospital was so expensive, all the patients had either good jobs or strong support networks that they could rely on. It wasn’t the same way at the psych ward, where I’d spent a week the previous summer. There were some people  I met there and thought: yeah, you should probably kill yourself. 

Maybe that sounds cruel. But there were people who really weren’t going to get any better, just older. There were people who really were burdens on their families, who were contributing nothing. Most importantly, they were fucking miserable. When they left the psych ward they were going to be in serious debt, maybe even homeless. That was the real cruelty, in my opinion: people were being kept alive against their will, in a world that refused to care for them, just because suicide offended people’s delicate sensibilities. 

There was one woman, Marianne, who was in her seventies or eighties. Her daughter visited every couple of days. During the day, Marianne was mostly quiet, always confused, often halfheartedly working on a watercolor or gazing at the TV. 

One night she woke us all up by screaming: “Get me out of here! I’m not crazy! Help me!” The nurses calmed her down, but half an hour later she was at it again. “Help me! Get me out of here: They sedated her, but even that didn’t work, because it went on for hours. Or maybe it only felt like hours – like guests at a casino, we had no clocks. 

My roommate and I pulled pillows over our heads and groaned. The sleeping pills we had been given were not strong enough to withstand Marianne’s screaming. And she really was screaming, howling with terror. It made me realize I had become a different sot of person, a person who could hear someone scream help me and think: shut the fuck up. 

By the time I got out of the hospital I just wanted someone –someone with a white coat and diploma, ideally – to admit it: some people just don’t get better. Not because they didn’t deserve to, or because they didn’t try hard enough, but because some of us were broken beyond repair, and no amount of positive affirmations or SSRIs or adult coloring books or therapy dogs or ketamine infusions or chamomile tea was ever going to fix that. I thought maybe if someone would just admit that, then I would feel at least a little bit more free, or at least like less of a failure.