Is "Next to Normal" Normal?

Julie Hersh, a former ECT patient, evaluates a play about ECT.

Posted Jun 19, 2010

A few months ago I headed to New York for my friend Jenny Fisher’s 50th b-day celebration along with a few high school friends. I sprung for tickets to “Next to Normal,” a play described to me as a musical about familial dysfunction. When we waffled about our other activities, I suggested that we see Ground Zero. I wanted to physically experience for the first time the spot that remains seared in the memory of every living American. My friends appreciated the free tix, but thought I was nuts. “What’s next on the Depression Tour?” They razzed. “Graveyards? Prisons? Hospitals for the terminally ill?”

 “Next to Normal” is fabulous; make time to see the show. The script zings, both funny and painful. The music pulses, keeping a tough subject palatable—even entertaining. If you’ve seen the show and read my book you might understand why I was sobbing by the end of the first act. Middle-aged Diana, the play’s lead, is adored by her husband Dan, but drops into a deep depression. Despite medication and psychotherapy, she catapults further. Diana attempts suicide followed by ECT. The details are different, but this story is my story on stage. 

The second act takes the audience into ECT – flashing lights, loud music and memory loss in large form. The lead character can’t remember her husband’s name, her children’s names, or where she lives. My jaw locked and tears evaporated. Here we go again, ECT demonized for theatrical effect. Don’t get me wrong, I understand theater. Someone under anesthesia with a positive outcome is pretty boring on stage. But people are already terrified of ECT. For a procedure that is 80% effective, far better than most anti-depressants, ECT has had a bad rap.  Sure I incurred some memory loss, but nothing like what is depicted in “Next to Normal.” I was outraged.

I returned home to tell my family about my trip, still frothing about the play and how ECT was misrepresented. My family asked about the rest of the trip. I told them about the Depression Tour and how I forced my friends to go to Ground Zero for my first-time experience. My 13 year-old daughter looked at me with more than her usual irritation at my stupidity. “Mom,” she said, fist on hip, elbow bent, “you’ve been to Ground Zero. We went. As a family.”

What is the quote in Next to Normal? How do you remember what you’ve forgotten? I stand corrected.

In the spring of 2007, I had done three treatments of ECT and marched out of the hospital before I had obtained the recommended minimum six. My doctor begged me to continue, but I refused. Instead, we took a family trip to New York.  

I remember parts of that trip, running in Central Park with sunlight dripping through trees, and watching "Spamalot." I can almost feel the panic that rose in my chest followed by a numb realization that my depression had returned. I don’t remember Ground Zero. When we returned to Dallas, I did three more ECT treatments.

Recently, on book tour in Darien, CT, I visited a book club that had read my book and had seen “Next to Normal.” I complained about the demonization of ECT. One woman objected to my assessment. She felt the play depicted ECT as frightening, but not evil. Diana, the lead character, forgets but regains her memory. Diana survives. The play ends on not a perfect, but hopeful note.

So does “Next to Normal” portray a normal ECT result? My guess is no, but there is a challenge in securing accurate feedback about ECT’s full impact on patients. I have one friend who after going through ECT, did forget names and was incredibly disoriented for a 48-hour period. Unfortunately this happened on a holiday weekend. His wife could not reach a doctor for support while her husband’s mind wandered on a scale she never imagined. I was stunned. After listening to this story, I asked the wife an important question. “If you could go back in time, would you choose ECT again?” Yes. She didn’t hesitate.  Her answer was “Yes.”

When thinking about ECT, we often get trapped in the horror of possible outcomes instead of weighing the risk of the procedure. Depending on the person, there may be short-term memory loss or even permanent memory loss immediately surrounding ECT.  The depth of memory loss is impossible to predict in advance, although I believe the normal experience is closer to mine than what’s been portrayed on stage. The depth of memory loss, however, is not the critical question to debate. When I did ECT, I was highly suicidal. Memory loss versus death seems a reasonable trade to me. I suspect my friend would answer the same way.

All serious medical procedure involves risk. Not many people refuse a triple bypass because a scar will remain on their chests. They live with the scar—in order to live. My ECT scar is the memories I can’t remember.  But this I do remember. That scar is the penalty, a small penalty in retrospect, for a procedure that allowed me to live.

In retrospect, I’d still go see “Next to Normal” even if the show caused a substantial rise in my blood pressure. Great theater forces us to examine a topic and pick apart our comfortable assumptions. “Next to Normal” is great theater. Don’t miss it. Click here to get those tix: http://www.nexttonormal.com/app/webroot/land/info/?gclid=CLX6-KuOraICFRc....

My book Struck by Living is now on IPAD and Kindle. For more information go to www.struckbyliving.com