by Mark Lukach
“I’m sorry I scared you today, Mark.”
She sounded like herself. Not slurred by the Ativan, not agitated by the voices she was hearing. Just Giulia.
“It’s okay, Giulia. I’m sorry I haven’t been patient with you.”
“Through sickness and in health, Mark. That’s right now.”
The water calmed us down. Giulia stopped talking about God and the Devil, stopped talking about giving up, stopped talking about being scared. We instead somehow found optimism that the worst was over, we had survived the ER, and things were going to work out, like they always did. I needed to believe these things to be true, so I let them be. Giulia unexpectedly jumped onto my back and let me carry her, piggyback style, out of the water. With her on my back, I felt the lightness of relief. We turned our backs to the sea and splashed through the waves to the dry sand, where Goose was digging for rocks.
Even though you’re not supposed to turn your back on the sea.
Mariarita arrived the next night. She pretended to be happy with us all together, but her worry was palpable. I alone couldn’t help Giulia. Romeo hadn’t stopped things from escalating either. It was now a full-court press, all three of us in the house to love Giulia back to health.
Mariarita saw motherhood as her life’s work. She bragged that her children never ate a single frozen meal in their lives and every dinner was home cooked with fresh ingredients. She printed up e-mails that Giulia wrote to her and made them into a scrapbook. Her world was Giulia and her younger Pietro.
When Mariarita met me when I was eighteen, she absorbed me into her care as well. One summer I visited the family in Italy and fell asleep on the beach for a few hours, and Mariarita spent the afternoon readjusting the umbrella over my head so that I didn’t get sunburned.
When Giulia and I married, I nicknamed Mariarita “Suoc,” short for suocera, Italian for mother-in-law. She loved the name and wore it proudly in front of her friends.
Suoc was now here, in full mama-bear mode, and wanted to sleep with Giulia, so mother and daughter settled in the guest room. Romeo slept in our bed. I took the couch.
I collapsed in the living room but took a little while to drift off. With Giulia’s parents there to help, I should have felt relief, but instead I felt like I had been exiled to the couch. “Let the adults handle this.” I tried to see the situation as Giulia’s parents might have: their little girl was in crisis and needed support and protection. Her young, surfer-dude husband meant well but wasn’t equipped to do the job. Look what had happened with leaving the pills out, after all. I had to admit that I didn’t have a clue about what to do, but that didn’t stop me from feeling defensive and petulant.
Eventually, I drifted into the first solid night’s sleep I’d had in six weeks.
Then, at seven a.m. the next morning, Romeo jolted me awake.
“We need to go back to the hospital,” he said.
I jumped up, pulled on pants, and found Giulia pacing around the guest room, her mom upright on the bed, eyes wide-open and full of tears, shaking her head in disbelief. Her terror was obvious.
“Mark, the Devil was here last night. But don’t worry. I protected my mom. I protected you. I protected all of you guys. I stayed awake and the Devil is still here but can’t get you because I am here.” Giulia was babbling. “I need to get out of here. It’s over, and worthless to fix things.”
This time Giulia didn’t fight getting into the car or resist going into the ER. We drove back to the same Kaiser Permanente ER and went through the same admission process with many of the same people from two days before. A nurse hooked Giulia right back up on an IV drip of Ativan. After thirty minutes, she began to settle down in the hospital bed. Suoc sat at the foot of the mattress, Romeo took the chair, and I sat on the floor, my back against the wall. We were all lost, silent, sunk in our own worlds. None of us could do anything. Over the past six weeks, we had steadily ramped up our attention and focus on Giulia, Skyping and praying and meditating and holding her in our arms, but we hadn’t helped her. It was almost as if her slide into psychosis was inevitable and that no matter what we did, she still had no appetite, couldn’t sleep, heard voices in the night, and remained fixated on heaven and hell.
The steady beep of Giulia’s heart-rate monitor lulled me into an uncertain sleep while slouched on the floor. When I woke up, I told Giulia about the dream I’d just had, one I’d been having for weeks.
In the dream, Giulia and I walked together, hand in hand, and the surroundings changed rapidly—my childhood in Tokyo, Ocean Beach, our freshman dorm. Everywhere I had ever been, we now walked together, as if the entire span of our separate lives had been predestined to bring us to where we stood together.
We didn’t know where we were going, but we were looking for something. It was urgent that we find it, but I didn’t know what it was. All of this uncertainty had derailed our plans, and in going from place to place, and year to year, it was as if we were sifting through the past to find where we had gone wrong, so we could get back on the path we had always been on. Each time I had this dream, like I just had sitting on the hospital floor, I woke up before we found what we were looking for and where we had gotten so lost.
I explained the dream to Giulia, with her parents in the room. It was the first of dozens of intimate conversations between husband and wife that would occur in full view of family and medical professionals. “I know what we are looking for in my dream. We are looking for peace, and we are looking together. You must feel very alone right now. I do too, Giulia. I’m scared, too. But we are actually standing side by side, always holding on to each other. Can’t you see how beautiful that is? We will find this peace, Giulia. We might feel awake in a daze, but soon we will find our peace.”
Giulia paused for a long time to process what I’d said.
“Mark, I am the Devil,” she whispered through the fog of Ativan.
The on-call psychiatrist was tall and serious and spoke with efficient purpose. But he brought no good news.
“Giulia needs to be admitted to the psych ward for treatment,” he said.
I knew that this was coming, that this was the inevitable next step in the process, but it still felt surreal.
“There’s a complication,” he added. “Here at Kaiser, we don’t have a psych ward. We have psychiatrists who treat people in the ER, and who do outpatient care, but we don’t have an inpatient facility.”
“So where is she going?” I asked.
“We don’t know yet,” he confessed. “When we admit a patient through our ER, we call the other hospitals in the area to see who has an open bed.”
“What if no one has an open bed?” I asked.
“Then we wait,” he said.
More waiting. Was this how every mental health crisis was handled?
“It could be a long wait,” he added.
He turned to leave, and I stopped him.
“How long do you think she will have to be in the psych ward?” I asked, my voice cracking with desperation.
“It’s tough to say,” he said. “At least overnight, possibly several nights.”
“Will they be able to get her better?”
“I wouldn’t be sending her there if I didn’t believe that,” he said.
I lost track of how many hours we waited. Suoc and I left the ER to get some food for lunch, hamburgers and milkshakes from a place across the street that I had always wanted to try. But not like this.
Romeo called the airline to try to change his flight back to Europe, since he was supposed to leave the next day. He hung up in frustration when they kept asking him for his confirmation number and he kept saying that he didn’t have it because we were in the emergency room. We all napped.
After hours of waiting, four people appeared in the hospital room, and my world erupted. Everything seemed to happen at the same time. It all felt out of reach, and the best I could do was hurry to keep up. The four people loaded Giulia onto a stretcher to wheel her into the
ambulance for transport to a hospital on the other side of the city, where they had an open bed. Suoc went in the ambulance with Giulia, and I sprinted three blocks to the parking garage to get the car, Romeo chasing behind me. The ambulance was already out of sight by the time we pulled away from the ER, so we sped across the city to the hospital on our own. I screamed about not being able to find a parking spot, and I slammed the door shut in fury once we found one. I left the keys in the car and raced back to get them, then dashed off to the hospital lobby. The receptionist saw us panting and somehow understood and told us what to do. “You need to go to the third floor. There are four elevators, and only the one on the far left stops at the third floor. Get on that one.”
There were other people waiting for the elevators. I walked to the fourth one and pushed the button and waited uncomfortably. Another elevator opened and the people around me asked if I was going up and I didn’t know how to tell them that I had to ride the special elevator because my wife was being admitted to the psych ward, so I said nothing.
The elevator eventually arrived and slowly creaked up to the third floor. The doors opened, and I stepped off into a new world.
The entirety of the walls were glass windows, and almost all the blinds were pulled. The waiting room was about eight feet by ten feet, the floor a bland, greenish tile, with a few beaten-up vinyl chairs sagging along the perimeter. Mariarita was collapsed in one of the chairs, hair disheveled, hands clasping each other for something to hold on to. She had just landed the night before. She had cried so much already that now her body shook but no sounds or tears came out.
The waiting room was an enclosed fortress in the middle of the ward. Chaos swirled around it. The only bridge between the fortress and the chaos was a single glass door.
No one greeted us in the waiting room. No warm, comforting smile, no pat on the hand. Instead just those glass windows with blinds pulled, a few signs printed on white paper, hastily taped up.
Visitors are advised that they are not permitted to bring ANY of the following objects when they visit a patient:
weapons
sharp objects
drugs
alcohol
cigarettes
cameras
anything with drawstrings (sweatshirts, shoes)
Packages must be checked at the nurses’ station and objects in violation will be confiscated.
Visiting hours are from 7–8:30 pm. Saturday and Sunday there are also visiting hours from 12–1 pm.
No former patients are allowed to enter as visitors.
There were a few open gaps in the blinds, which offered a glimpse into life on the third floor. I could see flashes of people walking past, but not Giulia. The only unimpeded view was from the glass door, in the far corner of the room, so I went over to look through and see more of what I could.
Directly across from the doorway was the nurses’ station, a stout counter at least twenty feet long. Several people sat at the station, all looking down at paperwork. I knocked at the door. A few nurses looked up, then returned to their paperwork. No one moved.
I craned my neck to the left to the end of the nurses’ station, and I saw Giulia. She was sitting in a chair across from a nurse with a clipboard. Giulia was in the hospital robe that they had given her in the ER, her glasses on, her shoulders held upright in a perfect balance, as if she were balancing a textbook on her head. I tapped on the glass again, louder. I wanted to reassure Giulia that she was okay, that the people were there to help her. She looked up, saw me, and looked away, returning her focus to the nurse at her side.
I sat back down.
“What’s going on, Suoc? What happened?” I asked my mother-in-law.
“Nothing,” she replied with her thick accent. “They brought her up here while you parked the car and now we’re here. What can I say.”
“What did the nurses say?”
“They didn’t say anything to me. They took Giulia inside and closed the door and that is it. Nothing.” Suoc lowered her head.
I felt so much of everything and had so much to say, but I didn’t know where to start, and no one was listening to me anyway. She doesn’t belong here. You take care of her or I’m going to sue you for everything this hospital is worth. Give her the best room. She doesn’t like heavy carbs with her meals. If any of the patients even tries to touch her, I will fucking kill them.
My heart raced, my fingers twitched, my stomach hurt. My saliva tasted bitter, as if I were going to vomit.
I walked back to the glass door to look at Giulia’s new world.
A pale, gaunt man with thinning gray hair and a jean jacket hovered near Giulia. He looked to be in his late forties, and his movements were painfully slow. We made eye contact for a flash of a second, and I was terrified of what he might do to my wife, the two of them locked away from me on the other side of a glass door.
An older Chinese woman raced by, pacing furiously, swinging her arms in exaggerated circles. She talked as she walked to no one in particular, and no one listened to her. I was scared of her, too.
There was a big guy in his twenties, well over six feet tall and probably more than 250 pounds, with frumpy brown hair matted as though he had been lying in bed for days. He shuffled in and out of view, his pants sagging underneath his hospital gown, revealing the top of his bare ass. He saw Giulia, and saw me at the door, and flashed me a confident smirk. He scared me most of all.
What the fuck had we done? Where had we taken Giulia? This place was full of crazy people who would rip apart someone like my sweet, beautiful wife, who let me remind you wasn’t crazy at all. She just hadn’t slept. She was stressed out. She just needed to sleep.
Finally, one of the nurses stood up from her seat behind the station and walked over to the glass door. She surveyed all the patients to make sure they were at least six feet away, a rule that wasn’t posted in the waiting room but I eventually learned. She inserted one key into the doorknob and then a second key into a lock on the wall. With two keys in place, the door buzzed, and she pulled it open and stepped briskly into the waiting room and slammed the door behind her.
I jumped up to meet her. Suoc and Romeo stayed on the chairs behind me, overwhelmed by the expansive gulf between their refined Italian language and this American nightmare.
“What do you want?” the nurse asked coldly.
“Uh, what do you mean,” I said. “We just dropped off my wife, Giulia, she’s there talking to a nurse, and uh, we, uh, have some—”
“I know you dropped her off. So what do you want?” she repeated.
“Well,” I said, taking a deep breath. “What is going to happen? This has never happened to us before.”
The nurse rolled her eyes, irritated. “Your wife is clearly psychotic and delusional. She has been brought here on a 5150 and so—”
“A 5150, what does that mean?” I said. “And what’s psychotic?” I thought of psychopath, and psycho killer. Did they think she was going to hurt somebody?
“A 5150 means she’s been involuntarily checked in here, and so she needs to stay at least seventy-two hours, as required by law.” She brushed off my question about psychosis and stared at me, signaling that I wasn’t going to get any more out of her.
“When can we come and visit her?”
“The visiting hours are posted,” she said, not even bothering to answer my question.
“I know, but it’s so short, only seven to eight thirty p.m. Can’t I visit her during the rest of the day?”
“No.”
“But that’s too short,” I said. “You don’t understand.”
“Your wife is here on a 5150, that’s what I understand,” she lectured me. “She has certain rights, and you have certain rights. You’ve obviously had a long day. I suggest you go home and come back tomorrow to visit her.”
“But can we go and see her room?”
“No, we need to process her and get set up, and that is best done alone, away from the family.”
I didn’t like being called “the family.”
“But I want to see the facilities. Is she going to get meals? Will you take good care of her? What will she do all day? Can I call her? What’s wrong with her?”
The nurse had no time for this. “I have to get back to work. Come back during visiting hours.”
I started panicking. “Wait, please. Please. You don’t understand . . .” I was croaking. “Please. Can I at least say good-bye to her?” I wanted to take it all back, go back to the emergency room, to the social worker who said that Giulia could come home, to the waves and the ocean that were supposed to wash this all away. But now Giulia was locked in and I was locked out and I couldn’t even say good-bye. “Please. Just let me say good-bye to her.”
If she had to stay there, I at least wanted to go to Giulia and hold her hands and look her in the eyes and kiss her forehead and tell her to be strong and that there is so much love in the world that will lift her up out of this darkness.
“Please,” I begged. “Please. I didn’t say good-bye to her.”
“It’s up to her,” the nurse said, finally cracking. “I’ll go ask if she wants to talk to you. But she has rights. Otherwise, we’ll see you tomorrow.”
The nurse crossed back into the other world and I stood at the door, my hands and face pressed against the glass. Giulia watched me. She sat so still and upright, trying to hide her fragility. The nurse approached her and asked her something as she gestured back to the door where I was peering in. Giulia shook her head no.