by Mark Lukach
Giulia continued to spiral into crippling anxiety. She began to call in sick to work. She even agreed to see a psychiatrist but was offended by the initial diagnosis of depression. Depression didn’t happen to someone like her. This was just a minor setback. She’d will herself through it. The psychiatrist prescribed sleeping pills and antidepressants. Giulia had no intention of taking them. Regardless, she had the scripts filled at the local pharmacy and brought them home. When she set them on the table, she joked that I should make sure to hide the pills in the morning, because since she was so depressed, what if she took them all? We laughed, a bit uneasily. The idea of my principessa committing suicide seemed absurd.
That night we sleepwalked through the same failed ritual, more hours of trying to calm Giulia to sleep, to no avail. In the morning, I woke up late and rushed out the door to get to school on time. I completely forgot about the medicine, which remained on the dining room table where we had left them the night before.
I came home from work and Giulia was Skyping with her mom, who seemed to be glaring at me through the computer. I had no idea what was going on until Giulia said to me, “You left the pills out.”
“I did?” I asked innocently.
“Yeah, you did,” she said. “I asked you to put them away.”
“Oh yeah, that’s right, you did ask, I’m sorry I forgot,” I said. “I was so rushed this morning, I forgot.”
“Well, don’t forget anymore,” Giulia’s mom said to me. “And hide them like she asked you to.”
“Okay, I won’t, I’m sorry, I just, you know, forgot. I’m always so tired, I was so rushed.” I didn’t think it was a big deal.
And we hung up Skype, and it wasn’t until later, after dinner, as we were getting ready for bed, that I learned it was a very big deal that I had left the pills out. Giulia told me that when she woke up that morning, she saw the pills, and sat down at the dining room table, and stared at them, and then called in sick for the third day in a row. She sat with the orange jars and studied them. She shook them out into her palm to test their weight. She arranged them in patterns.
And she thought about taking all of them.
“But I wanted to call my mom, first,” she told me as I listened in horrified silence. “I’m not sure why, I just wanted to talk to her. So I Skyped her, and told her that I was thinking of taking all the pills, and my mom begged me not to. So we kept talking. We talked until you got home.”
“What time did you call her?”
“I don’t know, maybe ten or so.”
Which meant that Giulia’s mom had stayed on Skype for six hours, stuck on the other side of a computer screen on the other side of the world, refusing to let Giulia hang up until I came home.
This changed everything. I asked Giulia to stay in our bedroom with the door closed, and I took the pills and went around the house for a few minutes, opening and closing drawers in each room to make as much sound as I could to make it hard for her to know where I hid them, the worst game of hide-and-seek I had ever played.
The diagnosis of depression and the prospect of suicide suddenly became very real. The pills no longer felt optional, and I insisted that Giulia take them as prescribed, and while supervised. In the morning, I’d take a dosage out of the bottles before returning them to their hiding place and bring the few pills back to her with a glass of water. I watched her take the medication. It was the same routine at night.
After the Skype call, Giulia’s dad, Romeo, dropped everything and flew out to California. At six feet seven, with a mustache that he has had since he was sixteen, Romeo was a two-time Olympic water polo player and easily could have been the most intimidating person you’ve ever met. Instead, he was the complete opposite: gentle and mild. When I first met him, he was more nervous than I was.
When Romeo arrived, I breathed a sigh of relief. It had been almost a month of Giulia’s faltering stability, and now I could go off to work and know that she was safe with family. She had unofficially put herself on sick leave and went to bed with little to no expectation of going to work the next day, so father and daughter spent their days together walking the beach; riding bikes; talking about work, and life, and balance, and happiness.
And nothing helped.
Even away from work, Giulia’s anxiety grew. She went from restless sleep to no sleep at all. She stopped eating. The color drained from her skin. It was like watching her vanish right before my eyes.
One morning, when I woke up, Giulia sat calmly at the foot of our bed.
“I talked to God last night, Mark,” she told me.
Giulia and I both grew up Catholic, but she wasn’t what I would call religious. She almost never talked about God and rarely prayed. I couldn’t hide the skepticism in my voice.
“Really?” I said.
“I did, and he talked back,” she said. “He’s never talked back before, but last night he did. His voice was so loud and clear. I thought it was going to wake you up.”
“What did he say?” I asked.
“He said that everything is going to be all right. We are going to figure this out.”
“Well, that’s good to hear,” I said for her benefit, but nothing about this felt good. Giulia had never talked like this before. I wanted to tell her how crazy this sounded, hearing voices in the night, but she seemed comforted by a reassuring message. I just listened.
“The little girl inside me is so full of life and wants to be free and feel love, and God is going to help that little girl find her way out.”
“Good,” I said again, no less nervously.
The next morning, when I woke up, Giulia wasn’t sitting at the foot of the bed. She was pacing around the bedroom, mouthing thoughts to herself.
“Good morning, honey. How did you sleep?” I asked.
“I talked to the Devil last night, Mark,” she said, speaking very loudly and quickly. “He said everything is not going to be okay. He said that there is no way out of this. I can’t be saved. I’m not worth saving. We might as well just give up.” She was very matter-of-fact about this, as if reading the weather forecast, but with a rushed intensity.
I jumped out of bed and pulled her close to my chest.
“Oh, honey. I’m so sorry.”
“It’s okay, Mark. I’m not sorry. Just stop wasting your time with me. It’s not worth it.”
“Giulia, you’re totally worth it,” I whispered back to her. “There is no Devil talking to you. It’s just you and me.”
“You don’t know. You weren’t there. The Devil is real and he’s here and he’s going to make me pay.”
“I don’t believe that for a second, Giulia,” I said. Which was true. I tried to calm her with the same reassurances that hadn’t been working for six weeks. I simply didn’t know what else to say to my wife, so I stumbled through more meaningless affirmations.
“You are an amazing woman. You are doing such a great job. You don’t have to pay for anything. You are going to be great and you’re doing all the right things.”
“But you were asleep! You didn’t hear what I heard!”
Giulia was growing desperate for me to believe her, but I couldn’t pretend anymore that hearing God and the Devil was no big deal.
“I didn’t hear what you heard because the Devil isn’t real, Giulia. He’s not real. He’s not tormenting you. This is all in your mind.”
With that, Giulia exploded. “You don’t believe me? That the Devil is here to get me? Fine, whatever, get out of my face. This is all going to be over soon anyway.”
She pushed me away and stormed out of the bedroom. I heard her stomping around in the living room, mumbling to herself the whole way.
I left our room as well and crossed the hallway to the guest room, where Romeo slept. I woke him up and quickly explained what was going on. “I think we need to take her to the hospital,” I told him. He agreed.
We went into the living room. Giulia glared at me and began to beg her dad. “Papa, the Devil was here last
night. You have to believe me. Mark doesn’t believe me, but you do, right, Dad?”
“Giulia, mi dispiace, povera Giulia,” Romeo responded. Giulia, I’m so sorry, poor Giulia.
“Giulia, we need to get you some help,” I said. “We are worried and don’t know what to do. We want to take you to the hospital.”
“No! Don’t waste your time. The Devil said I’m not worth it. They won’t do anything there anyway.”
“Please, Giulia,” Romeo said. “We want to get you help to feel better.”
Giulia backed away from us. “Leave me alone!” she shouted as we slowly approached her, cornering her in the front entranceway. “It’s not worth it! Stop wasting your time!”
Finally Romeo and I grimaced at each other, knowing what we had to do. He grabbed her around the legs, and I scooped her under her armpits, and we carried her down the hallway. She shrieked and reached out wildly for anything to hold her back and latched on to the hallway bathroom doorknob. I pried her fingers individually while she tried to squirm her body free. Romeo and I worked in silence, overpowered by the fierce sound of Giulia’s resistance. I caught a glimpse of Romeo’s face and saw that he was sobbing, and only when I saw his face did I realize how much I was crying, too.
We got her down the narrow stairs into our garage and into the passenger seat of our Honda Civic. Once in the car, she settled down, and we sped off to the emergency room, Romeo crammed into the seat behind Giulia. We didn’t say anything, but we both wanted her to be within arm’s reach. As we wound along Park Presidio Boulevard through Golden Gate Park, Giulia quickly popped off her seat belt and shoved open the car door. I swerved as I slammed on the brakes. Romeo and I simultaneously reached over to close the door and grab her before she could throw herself out.
I left Giulia and Romeo in the driveway of the Kaiser Permanente ER with the car idling and ran inside.
“My wife’s having some kind of a breakdown!” I couldn’t believe what I was saying. “She keeps saying that she talked to the Devil, and she tried to throw herself out of the car on the way over here.”
“Okay, where is she?” the admitting nurse asked.
“Out in the car. Can someone come and get her? She won’t get out of the car.”
“I’m sorry, we can’t do that. If she doesn’t walk in here voluntarily, we can’t drag her in.” He was disinterested, as though he had said this to people a million times before.
“Then what do I do?” I asked, exasperated.
I had been in this waiting room before—for stitches to my head after my surfboard hit me, for an infected foot—and I knew it to be wide and spacious, but now it felt tiny and choking. I needed to get out of the room, out of the hospital, but I had to get Giulia out of the car first.
The nurse paused for a minute, to muster up some compassion for what he had to tell me. “You have to call the police. Sit in the car with her, explain her behavior to the police. They will show up and arrest her, and they will walk her in the door. It’s probably going to take a while. And she’s going to be in handcuffs.”
I rushed back out to the car and told Giulia that if she didn’t come into the hospital, the police would come and arrest her and make her go. She resisted for almost fifteen minutes. I had 911 punched into my phone and my finger hovering above the “Call” button before she finally agreed and got out of the car, Romeo holding her arm as she pushed herself out of the seat, me grabbing her other arm once she was out of the car, so that she couldn’t break our grip and slip away from us.
The admitting nurse interviewed Giulia in a triage room that was no bigger than a closet. I sat with Giulia and let her answer.
“Have you been feeling stressed lately?” the nurse asked.
“The Devil tells me to quit,” Giulia said.
“Okay, does that feel stressful?” the nurse asked.
“It doesn’t matter, the Devil says this is all pointless so it doesn’t matter if I’m stressed or not.”
“But it matters to me,” the nurse said, “because I want to help you feel better.”
“There is no feeling better,” Giulia said.
Eventually I stepped in and told the nurse everything. The new job. The escalating anxiety. The loss of sleep, appetite, and weight. The dozens of ways we tried to get her to sleep. Her dad flying out from Europe. The sick days. The obsessive fixation on God and the Devil. The absence of mental illness in her personal and family history. The startling intensity. The fear, the fear, the fear.
The nurse stepped out and left us in the closet. They had wheeled in a portable computer for the nurse to take notes, and the quiet hum of the screen was the only noise between us. We had no idea what was coming next.
Just as I realized that they had shoved us out of sight into a tiny triage room because it was the best way of hiding Giulia from the rest of the waiting room, a different nurse ushered us into a full room. This new nurse took Giulia’s vitals and asked her many of the same questions, and I launched into my explanation a second time. Then a third time, when the ER doc came and ordered Giulia to be injected with Ativan to calm her down. The first hour was a blurred shuffle of people, and I told as much as I could to each one, in the hope that they could make sense of what I couldn’t understand. Then we waited—and waited and waited—for the mental health worker who was on duty that day.
We sat quietly, Romeo and I, disoriented and unsure of what to say. Giulia became increasingly groggy as the Ativan did its job. The hospital posted a security guard outside our door, an older man who slowly eased into his chair. The precaution felt ridiculous.
The social worker finally arrived, after five hours. Giulia was now fully under the influence of the Ativan and groggily rolled her head in the direction of the social worker when she walked in. The social worker asked Giulia the same questions the nurse and the ER doctor had asked her.
“Have you ever felt suicidal?” the social worker asked Giulia.
“No,” she answered, barely whispering the words.
“But she did try to throw herself out of the car on the drive over,” I said urgently. I needed the social worker to see the full picture, and Giulia clearly wasn’t painting it. “And earlier this week, she spent all day contemplating an overdose on sleep medication. A psychiatrist prescribed them, and Giulia asked me to hide them. I forgot to hide them, and Giulia spent all day looking at the pills, tempting herself to take them.”
“If you wanted to take them, what stopped you from taking the pills, Giulia?” the social worker inquired.
“I called my mom. She talked to me. I didn’t take them.”
“So you didn’t take the pills because you talked to your mom,” the social worker reiterated.
“Yes,” Giulia said.
“Okay then, well, that’s a good sign. Giulia, you’re not doing so great, but you’re going to be fine,” the social worker said. “You stopped yourself before because you talked to someone. That’s a good thing, and a good sign that you’re going to be fine.”
The social worker was trying to calm down Giulia, but it was having the opposite effect on me. I was completely unconvinced by this optimistic spin. “Are you serious?” I asked, shocked. “She might not have taken pills, but she’s talking about the Devil.”
The social worker ignored me and focused back on Giulia. “I’m going to write a prescription for a different sleeping pill and a better antidepressant, and you all can go home,” she concluded.
“Really?” I asked. “A sleeping pill and an antidepressant? She’s already been prescribed those and they didn’t do anything. What about the voices?” I was incredulous that the social worker wanted more of the same approach. There had to be something else, some wunderpill that would quiet the voices and chase away the fear. Surely there had to be.
“Yes, everything’s going to be fine, these medications should help,” the social worker said, reassuring us. “She just needs sleep.” She turned her attention back to Giulia, who had been silent through the wh
ole exchange. It might have been the Ativan, but I think Giulia had been resigned to the fate she thought the Devil had sealed for her.
“I want you to make a contract for safety with your husband,” the social worker said. “That means you two make an agreement that you will be safe. If you’re ever feeling like you might hurt yourself or hurt someone, you have to tell Mark about it. It’s clear that he wants you to feel better and keep you safe. Don’t act on any suicidal feelings, tell Mark first, and he can get you help.”
We all nodded, waited in line at the pharmacy to fill Giulia’s new prescriptions, and drove home.
After six hours at the ER, we felt that we were being shooed away with nothing but a different prescription and a contract for safety. I was hoping for more guidance from professionals whose help we needed. Or at least a different type of medication, one that would deal with these new obsessions with God and the Devil. Maybe this was the only help they could provide. But I felt abandoned all the same.
I needed something to latch on to, so I treated the contract for safety like a reaffirmation of our marriage vows. When we got home from the hospital, I got a pen and a journal and went off to the beach with Giulia and Goose. Romeo stayed back to call Mariarita.
It was a beautiful day, with a clear blue sky, light winds, and casual waves that broke hundreds of yards out in the low tide. We sat in the sand and repeated promises we had made to each other throughout our relationship and wrote them down in the journal: to be open and honest with each other; that we loved each other, and our love was so strong we could get through anything; that we would keep each other safe if we felt scared or alone.
Then we rolled up our pant legs and waded out into the shallows of the water. I pulled out my phone and snapped a picture of Giulia—“This is what you looked like the day you beat this thing,” I said to her as I took the picture and she tried to smile—and then we dipped our hands in the water to rinse them. The waves lapped in against our legs, leaving trails of foam. I scooped up a helping of the ocean and poured it into Giulia’s hands, and she did the same to me. I then washed her face, and she washed mine. We didn’t say a word but flowed on intuition as we rinsed away the horrors of the day. I focused on her smile, bello come il sole, and tried to erase the jarring memory of forcing her into the car as she resisted.