My Lovely Wife in the Psych Ward

by Mark Lukach

  “È bello,” she affirmed. Behind Suoc’s dark glasses I could tell that she was fighting tears.

  “È molto bello,” I agreed, putting my arm around her. Giulia bounced Jonas in her lap, and he smiled and giggled at her.

  Very beautiful.

  eight

  October 2012

  It took Giulia six weeks to go psychotic the first time. The second time, it took only four days.

  The Monday after Jonas’s baptism, a weekend that glowed with the promise of everything falling into its right place for us, Giulia went to a company-wide meeting run by the president. It lasted three hours. Giulia called me the minute it finished. Her workplace was going to do a massive restructuring, and she was panicking. She had been at the job for only three weeks. Last one hired, first one fired—that was her fear. Since I stayed home with Jonas, she was our sole source of income and, equally important, her employment provided our health insurance. We had managed to stay afloat financially through the time off, and to travel by the grace of our savings, but now we needed to get serious again about our finances, especially since we had Jonas. The pressure to keep her job was real, and she stressed under the burden.

  The night after the meeting, Giulia was a nervous wreck. She tried desperately to figure out what the restructure meant and what role she would play in it. She barely slept that night.

  The next night, in the relentless churn of her mind, she concluded that the restructure was built entirely around her team, and it was actually an elaborate test for her, to see if she could hack it at this new company. The only way to pass the test was to realize that it was a test—to look behind the curtain and see the restructure for what it was.

  The following morning, she e-mailed her therapist and her psychiatrist, who both wanted to schedule an appointment as soon as possible. But Giulia didn’t want to miss work or miss a moment at home with Jonas, so she didn’t make appointments with either.

  This all felt eerily similar. Giulia fixated on something unreasonable—a company-wide meeting that she misconstrued as being all about her. She worried frantically about the impression she was making at work, in person and through e-mails. She called me several times during the day—not to check in on Jonas, but to try to sort through the barrage of thoughts haunting her.

  But I figured we could handle this anxiety. We knew what to look for. Missing sleep was the primary trigger. The third night of the new crisis, in the blur of the middle of the night, I tried to convince Giulia that she needed to prioritize seeing her psychiatrist, and she might need to take more than just the Prozac she was on. Maybe she needed to go back on lithium or antipsychotics.

  She wouldn’t hear it. She insisted that this wasn’t going to be a repeat of the last time, that she was in the lucky 10 percent who never had relapses, and the more we talked about it, the faster and faster she spoke, and the more she acted as she had two years before, and the more I feared that maybe she was on the verge of a relapse.

  We couldn’t agree on what to do. We both knew that meeting with her doctor would put her on a path lined with orange vials of pills. I believed that was the way to get her some sleep and keep this crisis from escalating further. Giulia doubted the efficacy of the medicine and instead dreaded a return to a sluggishness that eroded her sense of self. We hadn’t talked about what to do if she couldn’t sleep again. And now, in her restlessness and agitation, we couldn’t agree on anything.

  I eventually fell asleep as I always did, and Giulia stayed awake, but by morning she agreed she had to see her doctor. She scheduled an appointment for Friday afternoon.

  I e-mailed Giulia’s parents. Giulia had already Skyped them, and they were worried by how she was talking. But through my fear, I remained optimistic. We were still early in the process. Giulia was getting anxious and losing sleep, but we had experience. We knew which medications worked and at what doses. She’d had only three sleepless nights, after all.

  That Friday morning, after a fourth night of no sleep, Giulia was standing in our room when I woke up to the sounds of Jonas sometime after dawn.

  “I figured it out, Mark!” she declared. “I know what’s going on. Heaven is a place on earth. That’s the test. That’s why they are restructuring. It’s because heaven is a place on earth. And I figured it out! I need to tell everyone that I figured it out, and what a great thing to figure out. Heaven is a place on earth! I need to tell them all this, and then they will let me stay.”

  I knew then that we couldn’t wait for her afternoon appointment. She had to see a doctor immediately. I changed Jonas into a new diaper and dressed him, and Giulia fed him and cheerfully talked him through her delusions as he nursed. I Skyped her parents and told them we had to go to the hospital. They were wide-eyed with fear. “Mom, Dad, it’s such an amazing world because heaven is a place on earth! We are so lucky!” Giulia shouted over my shoulder to them.

  I braced myself to get Giulia in the car. Romeo wasn’t here to help me carry her this time. I hated the thought of Jonas seeing his mom scream and lash out as she had before.

  To my surprise, when I told Giulia that we needed to go see the doctor right away, to get the right medicine, she agreed. She helped me pack up a bag of bottles and diapers. I buckled Jonas into his car seat, and Giulia took her seat next to him in the back, as she had done since he was born. She smiled and made baby faces at him.

  We looked like a family off to a picnic.

  Instead, we went to the emergency room.

  We drove the same route—19th Avenue, across the park on Park Presidio, and then a right on Geary, to the Kaiser emergency room—and I couldn’t shake the memories: Giulia and her parents in the car, Giulia trembling in fear of the Devil, trying to jump out of the car while we were in Golden Gate Park.

  This time around, Giulia was elated. As I drove, I played lullabies for Jonas, and Giulia sang along. In between songs, she told him over and over how good this world is and how lucky we were. I frequently glanced at them in the rearview mirror and saw Giulia cooing at him and tickling his cheeks. This was nothing like the psychosis from before.

  The wait to see a doctor was only five minutes. I think the triage nurse saw us—a frenzied, babbling mother and a five-month-old baby—and put us high on the priority list.

  The on-call psychiatrist began by asking Giulia what was going on.

  “Oh, nothing’s going on except that it’s great,” Giulia said. “I figured out that heaven is a place on earth, and I’m so glad I finally understand that. It makes everything so much better. What a great place for our son to live in. And for all of us. We’re blessed, and protected, because this is heaven. It’s all so amazing!”

  The doctor looked at me with raised eyebrows. “Anything you want to add?”

  “Yes, please,” I said. “She hasn’t slept well the last few days. I don’t think she slept at all last night. Three years ago something similar happened and she went psychotic and was in the psych ward for twenty-three days. She was obsessed with the Devil that whole time, and then spent almost nine months depressed.”

  “Yes, I know, I read her file,” the doctor said.

  “Okay, good, so you know her history. Then I’m sure you’ll agree that this looks so much better. Look at how positive she is being. It’s also only been four days. I think she’s probably starting to slide into psychosis, but we’re catching this so early, and it’s so positive, we just need to get her back on her antipsychotic medication, and I think it’ll all be fine. We know that she responds well to Risperdal and lithium. Let’s just get her back on those, and she should be fine in a few days, don’t you think so?”

  “I’m not sure, but thanks for the explanation to both of you,” the doctor said. “Giulia, do you mind if I go and talk to Mark in the hallway for a few minutes? It’ll be real quick.”

  “Of course,” Giulia agreed. “Take all the time you need. Jonas and I are fine in here.”

  I stepped into the hallway, anticipating that we were going to
talk about the logistics of having Giulia at home and the signs to watch out for.

  In the hallway, the doctor’s demeanor changed immediately, from patient and gentle to firm and matter-of-fact.

  “Giulia cannot go home,” she said. “She has to go to the psych ward.”

  “No, no, no, no way,” I said. “We’ve done this before. I know what I’m doing. It’s going to be fine. We just need Risperdal.”

  “No, you haven’t done this before,” she said. She wasn’t cold, but she wasn’t budging. “You have a five-month-old baby at home. Giulia can’t be home like this. It could be unsafe.”

  “It’s not unsafe, I promise you.” I began to panic. “Giulia has never once tried to hurt anyone while psychotic or depressed. She would never hurt Jonas.”

  “We can’t take any risks,” the doctor said. “Besides, look at her. She’s too unstable to be around your son.”

  “Don’t take Giulia way from us,” I begged. “We need her. Please don’t take her away from us.”

  I had so much to think about at once but couldn’t find a thought to land on, and they all rushed at me: the sadness, Jonas, the logistics, the fear, her parents, my parents, the wobbling of my knees, her job, our insurance. I thought I was going to throw up.

  I had genuinely, and naively, believed that they were going to let me bring Giulia home. I had worked so hard to support the mental health process. I figured that somewhere in her medical file it must have been written, Husband is an ally, you can trust him, he will follow whatever you say, but they were still going to rip her away from us. She wasn’t even that bad. I felt betrayed by the system I had worked so hard to support. It was as though the doctor were telling me that I couldn’t handle this, that’s why Giulia had to go to the psych ward. I felt like I was betraying Giulia.

  The doctor put her arm on my shoulder. I was crying by now, loudly, out of control.

  “I’m a mom, too, Mark,” she said to me in almost a whisper. “I would never want to take a mother from her child. But I can’t let Giulia go home in this condition. I can’t do it as a professional, but most of all I can’t let it happen as a mother. This isn’t good for your baby.”

  There was nothing I could say to convince her. I looked into her eyes in defeat. “How long is she going to be in there this time?” I knew that there was no way she could answer.

  “I don’t know,” she said. “But we have to go tell Giulia.”

  I nodded. We went back in the room.

  Giulia was still all smiles. She had Jonas in his arms, and the two were deadlocked in love with each other.

  “Are you okay, Mark?” she asked when she saw me. “Are you crying?”

  I forced a smile as I walked up to her and Jonas. “I’m okay,” I lied.

  “Giulia, you’re going to have to go to the hospital,” the doctor said. “Just like you did a few years ago. I don’t know what hospital, I have to call and find a bed for you. But that’s the plan.”

  Giulia looked at her, then back at me, and then at the doctor again. Remarkably, the news didn’t upset her.

  “Okay, if that’s part of God’s plan, then that’s okay,” Giulia said.

  “In the hospital, they are going to give you antipsychotics,” the doctor said. “Those medications are not good for Jonas, so you won’t be able to breast-feed him while you’re taking those medicines.” This was another sucker punch.

  The doctor was too upset herself to sound professional. “Do you want to feed Jonas one more time?” she asked, her voice quivering.

  “Yes, of course I want to,” Giulia answered. “I love Jonas.” She was so calm and unafraid. I began to cry again. “It’s okay, Mark,” she said to me. “Heaven is a place on earth.”

  The doctor quietly left our room and began the process of finding a place for Giulia. On the way out, she encouraged me to leave after Giulia finished feeding Jonas. He had already been in the hospital long enough, she said, and had seen enough with his impressionable eyes. Someone would call me once they knew where Giulia would be going.

  Giulia pulled Jonas to her breast and told him how wonderful everything was as he nursed. She told him she had to go away, but that it was going to be okay, and that she loved him, and that Daddy would take good care of him.

  By the time Giulia finished nursing, the doctor had returned. She took Jonas out of Giulia’s arms and handed him to me, and we drove away.

  I couldn’t bear to sit in the house, so I packed up Goose, Jonas, and our beach gear and went to the beach. I always went to the beach for answers.

  I set up the collapsible tent to shade Jonas and propped him up on a blanket surrounded by toys. Goose dug at rocks in the shallow water. I walked away from them. I didn’t want Jonas to hear me cry more than he already had. I sat down fifty feet away and dug at the sand around my toes and wailed, grieving for Giulia yet again.

  Ten minutes later, I collected myself and walked back to Jonas. As I approached him, I couldn’t make out the difference between what was a memory and what was happening now. There was the beach day three years ago when I took a picture of Giulia and told her that she had beaten this thing. And only a few days ago I was out on the beach just like this, as a normal stay-at-home-dad—Jonas under the tent, Goose digging at rocks, me waiting for Giulia’s FaceTime from work.

  And then there was now. Giulia wasn’t going to FaceTime, and she wasn’t coming home that night. I was terrified of the present, so I kept trying to think I was somewhere in the past. I had supported Giulia when it was just the two of us. I had managed to get the swing of parenting. But I didn’t know if I could care for both, Jonas and Giulia, simultaneously.

  I slid under the tent and sat beside Jonas. I didn’t say anything to him because I didn’t know what to say. He was five months old. What do five-month-old infants even understand? I wanted to assure him that it was going to be okay, but I didn’t honestly know. I wanted to explain to him that Mommy would be back, but I didn’t know how long she would be gone. I wanted to tell him that I loved him so much and promised to protect him. But could I really protect him?

  Jonas pawed at me and rattled and gnawed on his toys while I watched silently.

  Then my phone rang. It was Suoc.

  “What happened?” she asked.

  “It’s done,” I said. “They kept her. She is going back.”

  Suoc erupted, wailing. We didn’t stay on the phone long. She said she would come to California as soon as she could and then hung up.

  Jonas and I returned to our silence. I lost track of time: how long since he had eaten or napped or how long since I had eaten.

  My phone rang again. This time it was Jaimal, a surf buddy who lived just over the dunes from where Jonas and I now sat. “Do you want to catch some waves?” he asked. I hadn’t even noticed the surf conditions. I told him that I had just dropped Giulia off at the ER.

  Ten minutes later, Jaimal came running down the dunes toward us. He hugged me and sat under the tent with Jonas. I stood to pace outside.

  “I still don’t know what hospital she’s at,” I said in agitation. I checked the time: four p.m. We had left Giulia at the hospital three hours before.

  “They’ll call you when they know,” Jaimal said.

  “I hope it’s not the same one as last time,” I said. “And that she takes her medicine right away, and we don’t lose those seventy-two hours like we did last time.” Jaimal knew many of the details of Giulia’s first episode from our frequent talks in and out of the water.

  I rattled off questions: which hospital, how long would she be in there, who would be her case manager. I didn’t want to repeat all the hiccups of her previous hospitalization.

  When I paused, Jaimal asked, “What about Jonas, Mark? I know you’re worried about Giulia. Of course you are, we all are. But you’ve got this beautiful little boy here.”

  Jaimal shifted his attention to Jonas. “You’re such a sweet little boy, Jonas, you’re surrounded by love, aren’t you?” I hadn�
�t spoken directly to Jonas since we got to the beach. “Let’s talk about him for a few minutes.”

  Jaimal was right. Last time around I put all my focus on Giulia, abandoning every other part of my identity. I had stopped being a brother, son, friend, teacher—which was okay, sort of. But I couldn’t stop being a father.

  Jaimal and I sorted through the details. I had a few days’ worth of frozen breast milk. I would go half breast milk, half formula, until we ran out of milk, then entirely formula. Jaimal’s mother-in-law was in town to visit, and his son, Kai, was only a few months older than Jonas. I could drop Jonas at their house whenever I needed to. They would be unconditional babysitters as I adjusted. How lucky to have a friend like that.

  The hospital finally called. They had found a bed for Giulia at a hospital south of the city, on the Peninsula, a full hour away from our house. Jaimal helped me pack up all of our beach stuff. I took Jonas home, collected his bottles, diapers, and onesies, and then dropped him at Jaimal’s.

  Then I drove to the hospital.

  The drive took seventy-five minutes, not sixty. I was fuming by the time I arrived. How could they have sent her to a hospital so far away?

  I forgot about the long drive once I set foot on the grounds. This was a nicer hospital, much nicer. It felt almost like a country club. There was still a locked door, and you had to call and be buzzed in to enter. Once inside the ward, there was another check-in desk, to make sure you weren’t bringing in anything that wasn’t permitted. Those features were never going to change. But that’s where the similarities ended. You called from the main reception of the hospital, so there was no claustrophobic, glassed-in waiting room. Instead, when you got to the door, they let you in, and you were there.

  The main door opened into the non-acute section of the psych ward, where patients milled about freely, reading magazines, playing board games, watching TV. Large glass-panel sliding doors led to an expansive patio, which opened onto a big grass field. Diagonally from the entrance was a long hallway with all the bedrooms. The hospital had done an impressive job of making the place feel welcoming.