St. Elizabeth’s Medical Center—called St. Elizabeth’s Hospital in Infinite Jest as it once was officially and apparently still is colloquially—is a vast agglomeration of architecturally disparate buildings, a complex of complexes bounded by Washington, Cambridge and Warren Streets. The entire sprawl takes up the northwest end of the Brighton hill of would-be Enfield that is central to the novel’s action. St. Elizabeth’s is essentially impossible to photograph or describe in any kind of satisfactory way. It’s not a metaphor for the novel, but one could be forgiven for momentarily thinking so.

As the hospital-next-door in a book full of medical facilities, overnight admittance always looms as a possibility for the novel’s tennis-playing and addiction-recovering characters.

The Enfield Tennis Academy’s top-ranked John “No Relation” Wayne is held here for observation, with a curiously doting Avril by his side, following what is euphemized as “a violent allergic reaction to a decongestant.” For others, visits are more routine, as St. Elizabeth’s—actually called St. E.’s more often than its full name is used—plays host to twelve-step recovery meetings, including the “Sharing and Caring” (NA) and “Better Late Than Never” (AA) groups frequented by Ennet House residents. Of greater importance to the plot, St. E.’s is where E.T.A.’s Otis P. Lord, the unlucky number-cruncher of Interdependence Day’s Eschaton game, is hospitalized with a “Hitachi monitor over his head”—in a room shared by Don Gately, who arrives “in a truly bad way” following a less comically violent encounter.

Although St. Elizabeth’s is a background setting through most of the story, much of its last third takes place within its walls. Significant passages here focus on one character’s painful personal flashbacks, making this fact more a cerebral one. However, St. E’s is nonetheless the corporeal stage for what may be the novel’s central struggle, from which emerges its “catatonic hero”—as predicted by E.T.A.’s Hal Incandenza in a paper for his seventh grade Entertainment Studies class, i.e. a notion Wallace advances first as a throwaway joke, only to make it profound and real much later.

Unlike the Enfield Tennis Academy, which is entirely fictional, and the Enfield Marine / Ennet House complex, which is fictionalized, St. Elizabeth’s Hospital is as real as Boston locations from Infinite Jest get… at least from the outside. While I didn’t go wandering its hallways, I did look up certain proper nouns associated with it. Unless names have changed over the years, there is no “Grand Rounds Auditorium” on site, and its psychiatric ward is not called “5-East.” Although its emergency room appears quite capable, it has no “Trauma Wing” that I can confirm. It also probably goes without saying that no “Better Late Than Never Group” calls it home. 

Even outside, at least one thing is different: no “robed lit lady’s downcast-looking statue” sits atop St. Elizabeth’s, although the courtyard statue pictured above, in the roundabout of the women’s health center at what seems to be the complex’s highest elevation, seems plausible enough as its real-life inspiration.