by Mark Lukach
“What if we make some sort of deal?” she tried to bargain. “Like how about a month from now? You let me kill myself in a month. Sound good?”
I shook my head. “I don’t think so.”
“Six months?”
“Nah.”
“Okay, fine, one year. You let me kill myself in one year.”
At a loss for what else to do, I agreed. “One year. Okay. I can do that. If in one year from now, you still don’t feel any better, then fine.” I didn’t really agree, of course. I instead lied to her and pretended that she only had to make it through the year, and then it would be over. She believed my lie and was gleeful about it. Now she was the one skipping across the top of the dunes as I plodded back to our car.
Our families asked constantly what they could do to help. But what was there to do? They called and e-mailed, but they were spread all over the country and the world. It’s not like they could drop off dinner or swing by to keep Giulia company for a few hours so I could step away.
Cat and her husband, Alex, came back and spent the weekend with us. My brother Matt and his wife, Grace Ann, did the same thing a few weeks later, and then it was Giulia’s brother Pietro’s turn. There was more laughter in our house when we had guests, but as soon as they left, the pall of depression blanketed our home once again.
So they continued e-mailing me and calling me. “What can we do?”
Managing family became an additional challenge. They looked to me for direction, but I didn’t have any. I didn’t know what I was supposed to be doing, let alone what our parents in Japan and Italy could do. Giulia and I both came from families of problem solvers, so I knew they were talking among themselves and constantly brainstorming how they could be more hands-on to help us. But the prodding efforts of well-intentioned support felt suffocating. Of course, it would have felt even worse if they’d treated us as though everything were normal, but we were all in a lose-lose of helplessness.
I went to the Internet for advice and found a post on a forum with a few suggestions for what families can do from afar. It encouraged small, steady reminders of care and concern, with no expectations of a response. I forwarded it along to my mom, who put a plan in action. The e-mails slowed down—enough for me to know that they were there, but they otherwise accepted that they had to wait for me to call them rather than the other way around.
The frequent calls and e-mails were replaced by the slower art of letter writing. We began to get letters in the mail. Roughly once a week, a letter from a different family member showed up, a beautiful, thoughtful reflection on why they valued their relationship with Giulia. The letters were accompanied with photos—my dad sent a photo of Giulia and him at the marathon I ran in Washington, Matt sent a picture from the wedding. We hung the letters up on the fridge and put the pictures throughout the house, and I often found Giulia reading them or staring at the photos, the slightest hint of a smile sometimes on her face.
These gestures helped. This was our families doing it right.
The first time I left Giulia alone at home, awake, was mid-November, almost two months after her discharge from the hospital. Two months of always keeping her in sight. But at some point we needed to let the space return into our relationship, to detach each other from our intense codependency.
That morning we had a lovely, leisurely bike ride across the Golden Gate Bridge into Sausalito to each lunch. The ride back out of Sausalito is mostly uphill, and Giulia was drained when we got home. She definitely needed a nap, so when my friend Austin texted me about going surfing, I figured I’d give it a shot. Giulia had been in good spirits all day, it had been a pretty good week. I’d have to leave her alone at some point, so today was the day.
I loaded up my car with my board and wetsuit and left, hesitant but optimistic. We’d spent the day together outside and active, with no talk of suicide, no medicated stares. She’d be fine, right?
I suited up with Austin near his house, and then we hoofed it over the dunes and paddled out together. The wildlife was a frenzy of joyful activity—dolphins burst out of the faces of waves, sea lions popped their heads up to see who was in their ocean. Austin and I swapped off one fun wave after another.
As I hosed down afterward with fresh water outside of Austin’s garage, I felt genuinely happy. It had been a good day. If we could string together a few more days like this, I’d be okay, and Giulia might start to come out of her haze.
When I got home, Giulia was sitting still at the dining room table. She didn’t say hi. She instead said, “Don’t worry about my medicines tonight. I already took them.”
At first, I was more confused than panicked. “What do you mean? You don’t even know where the pills are.” I didn’t remember where they were currently hidden—either behind Infinite Jest on my bookshelf or in my toolbox. I was still changing the hiding spot every few days.
“I found them,” she said quietly. “I actually took more than I needed. When you left, I found the Zyprexa and put a big fistful of the pills in my mouth.”
“Oh shit, oh shit, oh shit,” I gasped, now fully panicking. “Did you swallow them?”
“No, I spat them out.” She was calm and matter-of-fact about all of this. “I spat them out in the garbage disposal.”
I raced into the kitchen and there they were, as promised, about twenty cream-colored pills of Zyprexa, dissolving in the bottom of our garbage disposal.
“Giulia . . .” I was becoming frantic, hyperventilating. I didn’t know what to do or say.
“Don’t worry, Mark, I didn’t swallow any. Not the first time, or the second time.”
“The second time?!?!?” I felt like I couldn’t breathe.
“The second time I didn’t swallow any either. I spit those out into the garbage.”
I ripped the trash can out from under our kitchen counter and tore through the messy contents.
“Not that garbage can,” she yelled to me over the commotion I was making. “The one in the bathroom.”
Once again, she was telling the truth. A few dozen pills were in the bathroom trash can.
I went to the bedroom and started to pack a bag for her, not thinking, just acting.
“What are you doing, Mark?” Giulia stood in the doorway, glaring and accusatory.
“I’m packing your bag. I have to take you back to the hospital.”
“No, Mark, please don’t do that. I can’t go back there. Please. I didn’t take any pills, I promise. I spat them all out.”
“But you tried to overdose, Giulia! Twice! I wasn’t here to stop you, I left you and you found the pills and almost took them!”
“I tried, but I didn’t do it. I have chances to do it all the time, but I never do. I spat all the pills out.”
I was still racing, grabbing clothes from the closet and throwing them on the bed, unable to look at her, my hands shaking as I tried to fold up the clothes I had picked out.
“Mark, please calm down and listen to me,” Giulia insisted.
I stopped and looked right at her. “I wasn’t here to make sure that you were safe. And I can’t always be here, always by your side. I need to make sure that you’re safe.”
“I am safe,” Giulia said firmly with emphasis. “I didn’t swallow any. I had the chance, but I didn’t do it. I spat them all out.”
She had a point. Between the garbage disposal and the trash can, I’d recovered what looked like four dozen pills. A bottle held only fifty, so maybe she hadn’t actually ingested any.
I put down her clothes and went to the computer to research “Zyprexa overdose.” Symptoms were rapid heart rate, slurred speech, possible coma, and death. I put my hands on Giulia’s chest to feel her heartbeat, just as I had done in the hospital to prove to her that she was alive. It thumped along at a normal rate. Her speech was not slurred. She was alert. And the pills added up.
My head spun as I tried to make a choice between two impossible options. The first was to reopen the trauma of the hospital by taking her
to the ER. Her parents would probably fly back out, she’d be on lockdown for another seventy-two hours—back to square one, after two months at home. The second option was that we stay at home, I monitor her heart rate, and trust her, and try to stay calm as the possibility of a drug overdose hung in the air.
I asked her over and over again to please tell me the truth, promise me that she hadn’t swallowed any of the pills, and she never wavered in her response. I finally relented and put away her clothes, and we went into our normal routine. I nervously checked her heart rate every twenty minutes or so, each of us hating the other for having to do this. When she fell asleep, I continued to check her pulse, laying my hands against the softness of her neck to feel the steady beating.
The next morning she woke up, and we went to IOP together to tell her therapist and psychiatrist what had happened, and they both agreed that we had done the right thing. I left IOP and went to see my friend Paul, who lived only a few blocks away. Paul is one of the friends who gets it and doesn’t try to talk you out of problems when they can’t be talked away, so we filled the time by picking up guitars and strumming away the hours of IOP as I tried to forget my wife’s suicide attempts.
I still don’t know if those classify as genuine suicide attempts. She had stopped herself. Twice. She had the time, the space, and the means to end her life. She had tried to write a note but didn’t know what to say, so she skipped that step. I had to give her credit for stopping. She still had enough fight in her to spit out the pills.
Eventually I had to return to work. When I first filed the paperwork for Family and Medical Leave, three months felt like an eternity, and no way would Giulia need that much time to get back on her feet.
But Giulia was not showing signs of improving. She plateaued in a lethargic depression. She constantly complained about the Zyprexa, so her psychiatrist switched her to Risperdal, another antipsychotic medication. These medications are not fast acting but instead take weeks to reach full effect. At times I felt like Giulia was a subject in a medieval science experiment—this drug didn’t work? Let’s increase it, or decrease it, or replace it, or add something else to supplement it. Sorry you’re suffering through depression, psychosis, and miserable side effects while waiting to see if it works.
But I refused to lose hope. The Risperdal was a welcome break from the Zyprexa. Giulia was less sluggish, and her rapid weight gain slowed down. She was more spontaneous in conversation; she said more than just “yes” and “no” and rarely paused before answering. It had been more than two months since she had exhibited any sign of psychosis. Progress. Finally.
We flew to New York City for Christmas, where Giulia’s whole family was waiting to see in person what I was describing over e-mail every night. It had been almost three months since Romeo and Mariarita had seen Giulia, and they were eager to see the signs of improvement I had been reporting over the past few weeks. My parents had seen Giulia only through Skype and were desperate to see her and help out.
In New York, Giulia cried for a full hour upon seeing her parents. When they returned to their hotel, she cried for another hour. In the morning, she woke up crying. I had never seen her cry so much.
“Talk to me, Giulia, tell me what’s going on,” I begged her as we dressed to meet her parents for lunch. She didn’t respond.
“It’s been going so well, what happened? What changed all of a sudden?” I prodded more. She still didn’t respond.
We left my brother’s apartment, where we were staying, and began the walk up Park Avenue to the restaurant. I continued to pester her with questions. Finally, with the restaurant in sight, she turned and told me.
“I stopped the Risperdal because I hate it so much. I’ve been doing better and hate the pills and didn’t want to be so drugged around my parents, so I stopped it.”
She spun back around and continued to walk to the restaurant and was visibly crying. I rushed up to her and asked, “You stopped all of the Risperdal? All six milligrams?” It was a maximum dosage, one that she should have slowly tapered off of over the course of a month. I was still giving her the medication each night and watching her take it, but clearly she had found a way to dispose of the medicine. With such an abrupt stop, she was in a free fall of withdrawal.
“Yes,” she said through weepy tears, and was walking back again toward the restaurant as I stood still in shock and concern. And before I had time to respond we were in the lobby, Giulia’s parents embracing her through her convulsing tears, and we pretended not to mind the looks from strangers.
Giulia got back on the Risperdal, and I went back to work. My parents came out for their first visit since Giulia had been hospitalized. I was still Skyping with my mom on an almost nightly basis, but she hadn’t been able to get away from her job in Japan until I was on the eve of returning to my own job. I eased into the comfort of having my parents around the house. My dad had to return for work, but my mom stayed on for another few weeks. I didn’t realize until my mom was around how much I had needed her physical presence and not just our nightly calls. She gave me the space to pull back from my devotion to Giulia’s recovery. I dreaded the day my mom would have to leave.
Around this time, Giulia’s suicidal obsession shifted. A common misconception of suicide is that someone will try any available method, but studies show that the suicidal tend to fixate on one method at a time. It’s not like if you take a gun away from a suicidal person but give him a rope, he will immediately hang himself. It’s the exact opposite. It’s all about one method, and if that method isn’t available, the person’s suicidal focus can falter.
For a long time, Giulia had focused on a drug overdose, since it felt the most accessible. A friend in IOP told Giulia that very few drug overdoses successfully lead to death, so she abandoned the idea of an overdose. She instead fell into the allure of the Golden Gate Bridge, one of the most iconic suicide spots in the world. With its four-foot-high railings and lack of any type of safety net, it’s shockingly easy to hop the fence and fling yourself into the churning bay below. More people have killed themselves at the Golden Gate Bridge than at any other place on earth. Straddling the edge of the Western world, with stunning views of San Francisco, the bridge stands as a destination spot for suicide.
For Giulia, the Golden Gate Bridge was easy. We lived close. I was back at work. And my mom was gone.
One day while teaching, I looked down at the floor and didn’t see the carpet of my classroom below me. Instead I saw my feet balanced on the rusted orange bridge, the bay a swirling two hundred feet below. I could even feel the wind. I had already dreamed about Giulia’s suicide. Now I was hallucinating about it, in a classroom full of high school kids.
One day I came home from work and found Giulia sitting on the carpeted floor in our guest room, Goose sprawled next to her. I could instantly sense that something was wrong.
“Hey, honey, is everything okay?” I asked.
She didn’t say anything in response.
“Giulia? You okay?” I asked again.
“I guess.” She sighed. “It’s just—I can’t figure out what I’m going to do with the Vespa key.”
“What do you mean? What would you have to do with the Vespa key?”
“I mean, when I drive to the Golden Gate Bridge, I’ll probably take the Vespa. When I park it, what should I do with the key? If I leave it in the scooter for you, someone will probably steal the scooter. But if I bring it with me, and they don’t find my body after I jump, you’ll lose the only key we have to the scooter.”
She looked at me pleadingly. “What am I supposed to do with the Vespa key?”
Giulia’s psychiatrist added lithium to her chemical cocktail, not because he suspected she had bipolar disorder—they still didn’t quite know what she had, maybe schizophrenia, but maybe not—but because a recent study showed that lithium augmented the benefits of antidepressants. The combination of lithium, Risperdal, and Lexapro didn’t have any noticeable impacts on her mood and inste
ad left her in the most stilted and zombified state yet, her arms frozen stiff at her sides, her fingers spread apart, her lips pursed, drool sometimes lingering at the corners of her mouth. It was awful.
Giulia’s least favorite side effect was the weight gain. She stood in front of the mirror, slow and wavering, and poked at her expanded waistline and grimaced. She didn’t fit any of her clothes anymore. She had to buy a whole new wardrobe, and she hated how her new clothes fit. I stood behind her and told her that the weight didn’t matter, she was still so beautiful, but she didn’t believe me.
Fortunately, weight gain felt like something tangible where I could help. I coached soccer, swimming, and water polo. I was clueless about suicide, but I had plenty of ideas for how to get active and lose weight.
I searched for “gym” in Google Maps to find the one closest to us. Living way out on the western fringe of San Francisco, in an unpopular middle-class neighborhood, we didn’t have many options. All the fancy gyms were across town, like the one Giulia had previously belonged to when she scootered across the city to her job. I was surprised to find any gym at all, let alone one only a mile away and that had group classes like “cardio-kickboxing” and “Body Sculpting.” Giulia loved classes at the gym. Best of all, it was only $10 a month. I signed us up over the phone without even visiting.
Fitness USA turned out to be lovably horrendous. It was in the basement of a strip mall, next to Hollywood Eyebrows, and it was covered in wall-to-wall bright red carpet. The walls were mostly mirrors, with the occasional flash of blue paint intermixed. There seemed to be no organization to the arrangement of the rusted machines. It felt like an abandoned set of American Gladiators.
The gym members were almost exclusively old Asian people, which made sense since our neighborhood was mostly filled with old Asian people.
We tried the “cardio-kickboxing” class. We were the only white people, the only people under the age of sixty. I was the only male. Even our teacher was an old Chinese woman. After the first fifteen minutes she ran out of moves, and we spent the next sixty minutes recycling and reshuffling the same moves over and over. She played a pulsing, tacky playlist of jock jams on full volume, and for seventy-five minutes Giulia and I danced, writhed, air-punched, and flailed, surrounded by Chinese and Filipino grandmothers. We loved it.