The American Academy of Emergency Medicine confirms it: Each year, between one and two dozen adult US males are admitted to ERs after having castrate… - David Foster Wallace

Fiction is one of the few experiences where loneliness can be both confronted and relieved. Drugs, movies where stuff blows up, loud parties — all these chase away loneliness by making me forget my name's Dave and I live in a one-by-one box of bone no other party can penetrate or know. Fiction, poetry, music, really deep serious sex, and, in various ways, religion — these are the places (for me) where loneliness is countenanced, stared down, transfigured, treated.

I was always either so unreasonably and pointlessly happy that no one place could seem to contain me, or so melancholy, so sick and silly with sadness that there was no place I could stomach the thought of entering. I hated it here. And I have never been as happy as when I was here. And these two things together confront me with the beak and claws of the True.

That dead-eyed anhedonia is but a remora on the ventral flank of the true predator, the Great White Shark of pain. Authorities term this condition clinical depression or involutional depression or unipolar dysphoria. Instead of just an incapacity for feeling, a deadening of soul, the predator-grade depression Kate Gompert always feels as she Withdraws from secret marijuana is itself a feeling. It goes by many names — anguish, despair, torment, or q.v. Burton's melancholia or Yevtuschenko's more authoritative psychotic depression — but Kate Gompert, down in the trenches with the thing itself, knows it simply as It.

It is a level of psychic pain wholly incompatible with human life as we know it. It is a sense of radical and thoroughgoing evil not just as a feature but as the essence of conscious existence. It is a sense of poisoning that pervades the self at the self's most elementary levels. It is a nausea of the cells and soul. It is an unnumb intuition in which the world is fully rich and animate and un-map-like and also thoroughly painful and malignant and antagonistic to the self, which depressed self It billows on and coagulates around and wraps in Its black folds and absorbs into Itself, so that an almost mystical unity is achieved with a world every constituent of which means painful harm to the self. Its emotional character, the feeling Gompert describes It as, is probably mostly indescribable except as a sort of double bind in which any/all of the alternatives we associate with human agency — sitting or standing, doing or resting, speaking or keeping silent, living or dying — are not just unpleasant but literally horrible.

It is also lonely on a level that cannot be conveyed. There is no way Kate Gompert could ever even begin to make someone else understand what clinical depression feels like, not even another person who is herself clinically depressed, because a person in such a state is incapable of empathy with any other living thing. This anhedonic Ina