Anhedonia and It (p. 697)
They’d tried Tricyclics, M.A.O.I.s, insulin-comas, Selective-Serotonin-Reuptake Inhibitors, the new and side-effect-laden Quadracyclics. They’d scanned his lobes and affective matrices for lesions and scars. Nothing worked. Not even high-amperage E.C.T. relieved It. This happens sometimes. Some cases of depression are beyond human aid. […] But in her toxified soul Kate Gompert felt only a paralyzing horror at the idea of the squat dead-eyed man laying toy track slowly and carefully in the silence of his wood-panelled rec room, the silence total except for the sounds of the track being oiled and snapped together and laid into place, the man’s head full of poison and worms and every cell in his body screaming for relief from flames no one else could help with or even feel.
Context
Ernest Feaster of Wellesley Hills: model trains, a devout wife, seventeen straight years of It, every treatment in the armamentarium tried and failed. "Some cases of depression are beyond human aid" — and the toy-track tableau fuses the essay's flame imagery to the most domestic possible silence.