powerful description of ECT as "a gift wrapped in thorns" will stay with me for the rest of my life. It is so apt, with so many associations tied to "gifts" and "thorns"! She still has great power to evoke a strong reaction with her images.

I know her aim in writing this article was to educate. I have had an obsession with that going back to the '70s. My obsession took the form of describing depression, as well as medications and their effects, from the lay viewpoint, to anyone who would sit down with me and talk. This practice was not without its hazards back in the '70s, especially in a small, upstate-New York, somewhat conservative, rural community. It has been a happy discovery to learn in our four years in the Upper Valley that such subjects can be and are discussed here openly and without shame or embarrassment. Mental illness will probably never be regarded with the same aura of objectivity by the public as cholesterol levels, say, but we have come a long way since the '70s.

I find the conclusion of the article—that serious depression and its treatments to some degree diminish us—both realistic and at the same time heartrending, the more so in the case of a person of Graff's gifts. However, I want her to know that her influence may be more powerful than she realized when she wrote the article. I can't count how many kind people have recommended the article to me since the issue came out, nor how many people I have recommended it to. I sent it to my children in the hope that it would help validate their experience growing up in the care of a seriously depressed parent. And I've sent it to my extended family and my friends in the knowledge that the information would clear away a lot of the mystery and some of the fear of ECT.

I am resigned at this point to the idea that my future in all probability holds more ECT. But if knowledge is power, this article has empowered more of us than Graff knows, and I personally am deeply grateful. Her influence may be dispersed, but the reality she describes gives the rest of us the information we need to keep on plugging, even if one of the gifts that struggle requires for relief is "wrapped in thorns."

Sally Stone
West Lebanon, N.H.

We're always glad to hear from readers about matters pertaining to medicine at Dartmouth or to the contents of past issues of Dartmouth Medicine. Letters to the editor may be sent to DartMed@Dartmouth.edu. Letters may be edited for clarity, length, or the appropriateness of the subject matter.

Toll taken
The feature article in your Fall 2005 issue by writer Nancy Graff, on the ravages of severe depression, reveals the toll taken by this mental illness.

I, too, through the years have experienced long periods of deep depression and sadness. I, too, have known all too well the ups and downs of depression that run not only through my family but through my own life as well.

I would like to add, however, a measure of hope to our situation, in reference to the last line of Nancy's article: "I am simply what's left." The devastating illness, so aptly described, does not, I feel, alter who we are inside. Our hopes, our dreams, our desires, and even our sadness and struggles make up our uniqueness—a picture of our true selves.

"What's left," therefore, is not the absence of things we've done before, but a changed look at who we are now underneath and have always been. It is our being, spirit, and soul that are sustained, with an inner knowing we must share. This is "what's left"—not erased, just subdued at times from the illnesses in our realm. This is called life.

Linda Steele
Claremont, N.H.

Steele is on the staff of DHMC's inpatient psychiatry unit.

Riveted reader
Thank you very, very much for sharing Nancy Price Graff's experiences with depression with the readers of Dartmouth Medicine. Her article held my attention riveted all the way through.

I hope she will stay with us!

Roger E. Condit, DC '59
Farmington, Maine

Symphony of sharing
Recently, as I was sitting in the Norwich Car Store, waiting like a parent waits in a hospital lounge, worrying that the surgeon will come out with bad news about a procedure gone awry on one's precious child (well, okay, so I'm being melodramatic), I picked up the Fall 2005 issue of Dartmouth Medicine. I had read the cover story about Hilary Ryder but not the rest of the issue, which, due to the length of the automotive "surgery," I had the good fortune to finish in its entirety.

Though tears have been shed before in
the Car Store, I am sure, it was never for such deep reasons. Starting with the editor's note, through the personal accounts by Nancy Speck and Nancy Graff, I was profoundly moved. And not only by those stories, but by the heartfelt piece by the dean, by the persistent pushing against the edges of knowledge evident on so many pages, by the citations of accomplishments and accolades, even by the letters section—all these elements of the magazine reflect the way DM has touched and continues to touch so many.

I want to say how much I appreciate what the magazine's staff does again and again to reflect the best of medicine at Dartmouth—this whole crazy quilt of human beings working, living, suffering, sharing, growing, and giving. Like an orchestra, you create a moving symphony.

And when the news came, I felt no pain despite the size of the bill. After all, it was only a car.

Jonathan M. Ross, M.D.
Norwich, Vt.

Ross is an associate professor of medicine at Dartmouth and, as it happens, a contributor to one of the features as well as to the "Letters"