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BOOK REVIEW

In ‘One Friday in April: A Story of Suicide and Survival,’ Donald Antrim looks back at his own worst time

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We are suffering an epidemic of epidemics. Some of them are real, most not. In two years, COVID-19 has killed four and a half million. Over four decades, HIV has claimed about nine times that. Diabetes: a million and a half, every year.

Racism, on the other hand, while “a serious public health threat” according to the CDC, is not an epidemic. Hate is not an illness. Nor is there an “epidemic” of misinformation, since it’s clearer to say that wealthy individuals are profiting off an insidious strategy with precise intent. There is no epidemiology of right-wing politics.

But what about suicide — the tenth leading cause of death in the United States? Is there “an epidemic” of people killing themselves? This is, indirectly, the central concern of Donald Antrim’s latest book, “One Friday in April: A Story of Suicide and Survival.” This memoir — or “this letter, this report, this book” — opens with Antrim hanging off the fire escape, testing his resolve to not let go: “I was afraid for my life. I didn’t know why I had to fall from the roof, why that was mine to do.” With help from friends, he checks into a hospital, takes medication, checks out, grows afraid for his life, checks back in, undergoes several rounds of ECT, checks out, and is able to live again. Structurally, it’s not that different from surviving cancer — sickness, treatment, remission — and this is the book’s crucial point.

Like other romanticized illnesses, suicide has been pathologically individualized. As a parallel, Antrim briefly mentions the “type” of the consumptive patient prior to the discovery of the mycobacterium tuberculosis. After the rise of antibiotics, one was no longer “prone to tragic, early death,” but simply sick. In “The Myth of Sisyphus,” Camus wrote that what concerned him was “the relationship between individual thought and suicide,” and isolated the individual by describing suicide as a confession: “that life is too much for you or that you do not understand it.” In philosophy and fiction, suicide has been heroic, mysterious.

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In reality, Antrim insists, suicide is “a social disease,” a psychosis in which the patient is not in control of their thoughts or actions. “Why that was mine to do”: Antrim frequently interrogates one’s method of choice, what some psychologists refer to as “coupling.” Patients focus on a specific way of killing themselves. But, Antrim asks, “Are our plans for dying forestallments of dying? I have a friend who saved prescription pills for two years. She lived in Greenwich Village, on a high floor of a large apartment building…. She never thought of the window, and never swallowed the pills.” Sometimes, coupling can be a way of staying alive, of deferring one’s hardest choice. “I did not want to die,” Antrim writes of his moment on the fire escape, “only felt that I would, or should, or must.” For the suicidal, this kind of futurelessness is common. Antrim is right to call it an “eternal state,” an extreme version of depression where past and future collapse: there is only now, was only now, will be only now. And then, if we get help, it ends.

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As a memoir, the book is superb, rich with all the details and vocabularies that comprise any de-mystification of illness. “Sharp objects were known as sharps.” Certain patients require “constant observation. We called it CO.” The hospital’s infrastructure is one of manifested mistakes. Just as no one thought to check under a patient’s tongue until they hoarded or sold the medication they didn’t swallow, there’s a specter of failure in certain details: “Doorknobs were narrow and thin, rather than bulbous; there was no way to hang a knotted sheet. No nails showed in the furniture.” As he begins to heal, he notes that, “The decline in psychotic certainty can be heard as the opening of new frequencies in the voice.”

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Antrim’s friends, who visit him in the hospital, are not “distant” but “disconnected”: “How were they to understand my feeling that I was dying, that I was leaving them?” After his slow return to health, he jokes about his ECT so as “to make comedy of my difficulty finding words or remembering names, as if it were my responsibility to make others comfortable with my new disability.” As anyone who’s struggled with serious mental health issues can attest, to write that word — disability — requires a permission difficult to give oneself. We are, we insist, not really sick, not really crazy; we’ve simply seen the future. Could this really be psychosis?

At its close, Antrim describes “One Friday in April” as “seek[ing] a paradigm shift in our understanding of suicide in society.” If it is a disease — “If we accept that the suicide is trying to survive” — then it is a treatable condition, an epidemic demanding a serious public response. As a parallel, Antrim conjures the disappearance of “asylum,” by which he means not only the hospitals “designed as working communities, institutional homes for people who need them,” but the concept itself of “a refuge, a place away from harm.” A social illness requires social treatment — in this case, agreeing that society itself exists, and legislating accordingly. “We are burdens to our caretakers,” Antrim writes, “we know this, no matter what you say to soothe us, no matter that you love us.” But in society, we are all burdens to each other, no matter how often and how brashly we pretend otherwise. And we can, if we choose, carry each other.

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ONE FRIDAY IN APRIL: A Story of Suicide and Survival

By Donald Antrim

Norton, 144 pages, $23

Patrick Nathan is the author of “Image Control: Art, Fascism, and the Right to Resist.”