My Lovely Wife in the Psych Ward

by Mark Lukach

  Giulia cheered. She hated all of her medication, but she especially hated the antipsychotics, which she felt were the biggest culprits for her weight gain and lethargy.

  “Giulia has been on some form of an antipsychotic for a long time, and I’d like to see how she does without them. Her psychosis has been gone for months. She will stay on the lithium and the Prozac. If she does well without the antipsychotics, we might be looking at a different diagnosis as well. Let’s give it a few weeks, and see how this new medicine combination works. We can regroup after that, and see if we want to further explore ECT.”

  We all stood up, shook hands, and I stuffed the ECT pamphlet in my back pocket. I wanted to be open-minded, but really. I hoped I would forget that the pamphlet was in my pocket and destroy the damn thing in the laundry.

  Back in our aerobics class, the music pulsed and pounded. We punched our arms and stomped our feet into the offensively red carpet.

  “Come on, keep punching, left, arm, left arm, left arm!” our loopy ancient Chinese teacher shouted out over the music. She was wearing our favorite shirt, “Don’t worry, I won’t hurt you.”

  Aerobics class continued to be as delightful as it had been the first day. We never spoke to any of our classmates, but almost all the old Chinese women smiled at us when we came into class, the tall surfer husband and the silent wife.

  As usual, I tried to keep my focus on myself and away from Giulia, because the sight of her trying to keep up with sixty- and seventy-year-old women broke my heart.

  But all the room’s walls were mirrored. I tried to let aerobics class be something for me, a break from caring for Giulia, but inevitably my gaze drifted over toward Giulia’s reflection, and I’d feel sad for her, and me, and us.

  Today was different. I could see that immediately. All of the physical manifestations of her illness—the locked fingers, the pursed lips, the hunched shoulders, the slowness, the slowness, the slowness—were gone. She reached farther, stretched more, punched harder, kicked more vibrantly. She had stopped Risperdal, and now, at aerobics class, she was escaping the molasses.

  The music kept pounding, the teacher kept shouting, the old women kept dancing, and I stopped moving. All I had at that moment was Giulia. I turned to watch her directly, not trusting what the mirror had shown me, worried that it was too good to be true. But the mirror hadn’t lied. Looking at her, I could see that she was just as alive as her reflection. Her brow shone with sweat, a brilliant smile on her face.

  She caught me watching her and yelled over her shoulder, “You’d better keep going, or you-know-who might actually hurt you, no matter what her shirt says!” And then she lifted her head and laughed at her joke, a natural, liberated laugh that was the sweetest noise I had ever heard.

  Giulia was back. I turned back to our teacher, who stood with her hands on her hips and impatiently pointed at me to get back into punching, and I happily agreed and air-punched so hard that I thought I might throw my arm out of its socket.

  Giulia’s slide into psychosis had been unexpected and abrupt, but it was nothing compared with her escape out of depression. It evaporated before my eyes in an aerobics class, with wall-to-wall red carpeting, bad music, and elderly Chinese women.

  “I’m done!!!” Giulia texted me a week later, after her final session of IOP. It was just over nine months since she had been hospitalized, which meant eleven months since she had first shown anxiety about her new job.

  We went out to our favorite pho restaurant to celebrate, one we had discovered in the months after Giulia’s hospitalization. It was our escape when I didn’t feel like cooking, which was all of the time, and we sometimes ate there three times a week. Our favorite waiter gave us free appetizers like he always did. Giulia and I spent most of the night telling stories of the past nine months, and each one left us laughing at all of the absurdity.

  “Remember when I thought that I was going to die when you visited me in the hospital?” she said.

  “Which time?” I said, and she squealed in laughter, slapping her hands on the table and then clutching at her sides, which hurt with so much laughing. I was melting in my seat to see her laugh like this again, after such a prolonged absence.

  “You know, when you got there and I thought I only had an hour to live, and spent the whole time counting down the time, and then, when it got close . . .” She couldn’t even finish her thought, she was so hysterical in laughter at how she had gotten up and sprinted away from me as the hour finished ticking down and slammed the door to her room shut.

  It certainly wasn’t funny at the time. It was terrifying. We had spent an hour together as Giulia counted down what felt like certain death.

  But for some reason over pho, we thought it was hilarious.

  I took out my phone and showed her the picture I had taken the day before she was admitted to the hospital, frail and terrified on the beach, “the day you beat this thing,” as I’d told her that day. And then I took a picture of her here, smiling over a steaming bowl of pho, her face full of confidence, her smile bello come il sole once again.

  It was only at the end of dinner that we acknowledged all of the uncertainty and unanswered questions. Giulia was discharged from IOP without a firm diagnosis. They had more or less ruled out schizophrenia but didn’t have a great diagnosis in its place. We had no clear explanation for what had gone wrong. It was probably related to a combination of lack of sleep, stress, hormones, and chemicals in her brain, but not even her clinicians knew what it was.

  Which also meant that we didn’t know if it would come back. Ninety percent of the time psychosis recurs. Ninety percent. The odds were troubling, but we buried the odds and focused on the memory of our charmed lives and convinced ourselves that Giulia would be in the other 10 percent. The working diagnosis, which felt jerry-rigged to fit the occasion, was “major depression with psychotic features,” but in my mind, I just called it a nervous breakdown.

  We also couldn’t say what made it better. Medicine had helped the psychosis fade, but it also seemed to prolong the depression. All of the time Giulia spent in therapy must have helped, as did the friendships she forged through her recovery and the family who stood by her side. Right?

  It all remained mysterious. The discomfort gnawed at us, but we willingly returned to laughing. We needed to celebrate for the night. Whatever it was, it was over. Done. Good riddance. Don’t let the door hit you on the way out.

  Our waiter came over with the bill. He laid it on the table and then said in his halting English to Giulia, “You look so happy tonight, and that makes me so happy.”

  “I know,” Giulia said. “I am so happy.”

  I lounged on the couch in my gray lifeguard sweatpants, sand still caked to my feet from the dog walk earlier in the day, my hair oily and tangled. I had been ocean showering with a surf for the past few days, and I smelled like salt water and neoprene. The sweatpants were part of my lifeguarding uniform, back when I worked as a beach lifeguard at a crowded beach town in Delaware the summer before Giulia and I had married. I kept the sweatpants as a reminder of how strong and fit I had once been, when I used to swim and paddle miles in the ocean each day and do hundreds of push-ups and sit-ups a week. I multiscreened with the Giants game on TV and Twitter on my phone.

  “Can you finish washing the dishes?” I yelled to Giulia, who was in our bedroom, also playing with her phone.

  “Can you do them?” she called back.

  “I cooked dinner. You know our rule, ‘If you cook, you don’t clean.’”

  “Yeah, but seriously, that was a pretty simple dinner,” she said. “Fried rice is easy to make, but it makes a huge mess.”

  “I did the grocery shopping for the food, too,” I insisted.

  “Well, I did the laundry today. Folded it and everything,” she said.

  “But you didn’t put it away. I was the one who put the laundry away.”

  We went back and forth, tabulating our labors. This was a staple of our relationship,
a competition over who had contributed more. Most of the time it was playful.

  But I wasn’t feeling playful tonight. I had cooked the dinner. I had done the grocery shopping. I had done all of that, for months. I had run our household by myself, for months. I ran her life, too. I had to. If it was up to Giulia, she would have stayed in bed all day or, worse, tried to hurt herself. So I planned her days for her: yoga, painting classes, volunteering at the children’s day care at UCSF. I ran my life, too. I clung to my job. I drove her wherever she wanted to go. I sacrificed my entire life to her recovery. I wish I could say I wasn’t resentful, but at that moment, with dirty dishes in the sink and Giulia justifying why she didn’t have to do them, I hit my limit. I didn’t want to get off the couch to finish the dishes. I wanted my no-longer-sick wife to do it.

  “You know, Giulia, I did all the dishes, and all the cooking, and all the cleaning, and all of everything, for nine months.” My voice grew louder with each word. “I know you were sick, but you’re not anymore, and if it’s okay with you, I’d love to get some goddamn help around the house!”

  My outburst at Giulia hung in the air. It carried with it my own depression from the events of the past year. Now that Giulia was better, I’d hoped that it would be replaced with joy, but instead, resentment took up residence in my heart. Every evening I got home from work and changed into my gray lifeguard sweatpants. But I wasn’t wearing them to do push-ups anymore. It was to sag into the couch and channel surf. On the weekends, if the waves were good, I’d paddle out to surf, but otherwise it was the same gray sweatpants, the same indent on the couch, the same pointless television.

  I heard Giulia get up from the bed and go to the kitchen. I heard the water flow, the clank of dishes. She finished just as quietly and went back to our room, closed the door, and went to bed.

  Every other week, I went to my therapist. She worked in a basement office decorated with small wooden statues from around the world, and her gentle voice sounded even quieter under the hum of a white noise machine that ensured our privacy from those in the waiting room. I loved her. She gave me the patience and reassurance I desperately needed.

  We talked almost exclusively about Giulia for the month of her psychosis and continued to talk about her during the eight months of her depression. But as the illness subsided, the talk turned to me. My therapist wanted to know why I so badly wanted to be Giulia’s hero. “The good news and the bad news is that you’re not that powerful,” she often told me. “But you sure do try and be powerful.”

  I wasn’t too interested in understanding why I devoted so much of my caregiving to Giulia. To me, the answer was simple and clichéd: love.

  But I did want to know why I felt like such shit.

  I had never felt so disinterested and lethargic before. I’m typically all energy, all the time. In college, when I sang for a ska punk band, I wrote a song called “Happy Here, Happy Now.” Some of my bandmates joked that it should have been “Happy Here, Happy Dumb,” because happiness is an easy target for adolescents to mock. I didn’t understand at the time that happiness is a beautiful form of courage.

  “Of course you feel like shit,” my therapist said. “You’ve been through hell for the last nine months. It’s about time you feel this way. You haven’t had the chance yet.”

  I stared at her, puzzled.

  “You keep saying that you took care of Giulia because you love her, but I’m not sure you really know what love looks like.”

  I recoiled at this suggestion. “What do you mean? I just sacrificed everything. How is that not love?”

  “Sacrifice is a part of love, Mark. But might there not be more to love than just how much you sacrifice?”

  I squirmed uncomfortably in my seat. I didn’t know where this was going.

  “Let me put it another way,” she said. “It’s like you’ve survived a tsunami, Mark. I’m sure you saw the footage from the tsunami that hit Indonesia. Entire buildings wiped out. People swept away. Horrifying stuff. It’s not hard to imagine you and Giulia on one of those beaches. You were in bliss together, and then the wave hit. You grabbed on to a tree and each other and held on as the water pushed and pulled and tried its damnedest to rip you apart, but you kept holding on. For nine months, you held on.”

  I nodded. I hadn’t dared watch the footage. I had enough nightmares.

  “And then, just as unexpectedly as the wave hit, it receded. It’s gone. You’ve made it, the two of you. You can stop holding on to that tree so tightly. You can let go of each other. You survived the tsunami.”

  “Exactly!” I said. “Which should feel good, right? So many people don’t survive. Families are torn apart by mental illness. Ours wasn’t. People kill themselves every day. Giulia didn’t. So why don’t I feel happy?”

  “Look around you, Mark,” my therapist said. “Look at the carnage: the demolished hotels, the uprooted trees, the crumpled cars. The realization that not everyone made it. The worst is over. But everything you once knew is gone. The love you had with Giulia, the way you once knew it, is gone.”

  She was right. Nothing was the same. Nothing could ever be the same. Our bliss, our puppy love from college, our charmed lives, it was all gone. Giulia’s psychosis and depression would color the rest of our relationship. Maybe even my own happiness wouldn’t come as easily as it always had. I would have to work for it and have the courage to do the work.

  “If it’s all destroyed, I guess we rebuild,” I said.

  “Exactly,” my therapist answered.

  “What does that look like?” I asked.

  She didn’t answer.

  It was a blustery spring day. The wind howled and swirled the sand throughout our neighborhood. Sand drifts built up along the Great Highway. Even though we lived ten blocks from the beach, you could still feel the grit of sand in the air in our house.

  We took Goose out to Fort Funston, a dog park that sat atop beach dunes a few miles south of our house. Fort Funston was one of our favorite walking spots, although we knew it would be miserable out there today. But Goose needed his walk, so we bundled up to brace the wind and the cold.

  Giulia’s phone sounded: a friend texted with a last-minute extra ticket to go to a concert in Oakland that night. Opening act went on at eight, headliners would probably be on at ten. Did Giulia want to go?

  “You can’t go, Giulia,” I said, barely letting her finish all the details.

  “What do you mean I can’t go?” she said. “I want to go, so I’m gonna go.”

  “Be serious, Giulia,” I said, shrugging her off.

  “Be serious about what?” She put her hands on her hips.

  “Giulia, you haven’t stayed up past nine p.m. in almost a year. We don’t live anywhere near a BART station, so you’d have to drive, and you hate driving the car. You don’t know how to get there. And let’s not forget that we’re talking about you driving at midnight, or even later. This is a terrible idea. You’re not going.”

  Giulia was furious. “But I want to go.”

  “Yeah, well, guess what, it’s back to reality. I’m tired of sugarcoating life to you. You’re better, so you can handle the truth. And the truth is, we don’t always get what we want, and you don’t get to go to the concert.” I refused to budge.

  I maintained a cold hostility, but Giulia was raging.

  “You don’t get to tell me what to do,” she hissed.

  “Yes, I do,” I said. “I took care of you when you couldn’t take care of yourself, and going to a concert tonight is not taking care of yourself.” I was screaming now too, enraged that she couldn’t see how bad an idea this was. “I’m sorry, Giulia, but I do get to tell you what to do.”

  “Thanks a lot, jerk.” She stormed off into the wind and sand. I sat with Goose for a minute, burning from the wind and even hotter inside. She was better but was priming herself to make terrible choices, and if things went wrong, I would have to clean up after them. I finally tugged on Goose’s leash to continue the walk, foll
owing Giulia’s trail, but she was quickly out of sight.

  Thirty minutes later, we were back at the car, where Giulia waited for us. I unlocked the door, and we all drove home in silence and spent the rest of the day not speaking. The concert came and passed. Neither of us mentioned it again.

  I limped through the end of the school year, and as I promised, I quit. I had teary good-byes with the colleagues I had grown to care for, but I felt no remorse as I took down the maps and inspirational quotes from my classroom walls.

  Giulia and I didn’t have any plans for the immediate future, except for my brother Matt’s wedding in Nashville. Beyond that, we didn’t know when we would return to work, or what type of work, or even where. The wedding was our only concrete plan, and we decided to drive to Nashville, just as we had driven to Delaware the year before. Anything to try to re-create the spark of the past.

  However, we had only four days to make it to Tennessee on a dry, dusty southern route. We beelined south to Barstow, California, stayed the night, and then turned east on the horizontal line that is I-40. What lay ahead was eighteen hundred miles of uninterrupted interstate.

  I tried to find fun places to stop along the way, but Giulia just wanted to get to the wedding. She napped for long stretches as we drove through the heat. I pretended not to mind. But the road was long and lonely. I was behind the wheel for ten hours the first day, bored by the soundtrack within the first few hours, not interested in podcasts. I was left alone to be tormented by my thoughts.

  I ran through all of the amazing things that my friends had done over the past year. One friend published a book. Another quit his job and started his own thriving business. A third launched a fresh-pressed juice company that was exploding in popularity. Our siblings all took big steps forward in their careers. It seemed that the past eleven months had been good to everyone but us. I couldn’t imagine having a job right now, let alone kicking ass at one. When I felt the envy creeping in, I always tried to convince myself that there was no greater accomplishment than to give of yourself entirely in the care of someone you love. But here in the desert, Giulia couldn’t even stay awake to keep me company. I was alone and miserable.