My Lovely Wife in the Psych Ward

by Mark Lukach

  Giulia rocked in the glider and watched me, as if studying to remember the habits of parenting. She stroked the chair’s soft arms and asked, while looking down, “How is Jonas doing with the formula? Does he miss my milk?”

  I looked up and she avoided my gaze, and my heart groaned. “He’s doing fine with the formula, honey,” I said, and handed the now clean Jonas to her. They sat and rocked together, slowly, the rain continuing to fall against the window.

  The challenges began at dinner, after we had put Jonas to sleep.

  I made lasagna, our favorite meal from that brief moment of normalcy when Giulia was at work and I was at home. Giulia nibbled at the food but put her fork down.

  “Why aren’t you eating?” I asked her.

  “I’m nervous,” Giulia said.

  “What are you nervous about, Giulia?” my mom asked.

  “Everything,” Giulia said.

  After dinner, it was time for Giulia’s medication.

  In the hospital, Giulia took big pills. To get her 900 mg of lithium, she took three tablets of 300 mg each. For whatever reason, the hospital discharged her with a three-day supply of small pills. Her daily quota of 900 mg of lithium was going to take nine pills of 100 mg each. Same with the Haldol. Giulia and I popped all of the pills out of their aluminum and plastic sheets and laid them out on the table in front of her. There were at least fifteen pills.

  “I don’t want to take all of those,” she said. “I didn’t take that many in the hospital.”

  “I know, but it’s the same total,” I said. “These are just smaller doses, so you have to take more pills.”

  She frowned and picked up the first few. She put them in her mouth and swallowed them down with water. After a few seconds, she grabbed a few more. With the third dose, she tried to swallow them, but one got stuck in her throat. She drank more water, and more, and then before I knew what was happening, she threw everything up, all over the lasagna that sat untouched on her plate.

  I could see the half-dissolved pills floating in the watery vomit. She heaved again, and more water and medicine came up. My mom and I watched in horror.

  Giulia was embarrassed and without thinking reached into the mess to clean it up with her bare hands. She got vomit all over herself. I stopped her and took her over to the bathroom to get her cleaned up, as my mom tackled the mess on the table.

  When I came back to the kitchen, my mom whispered to me, “Are you sure we are ready to have Giulia home?”

  “Of course we are,” I snapped, brushing off her concern.

  What did we do now? Did I need to give Giulia more medication? What if I tried, and she threw up that, too? I called the hospital, got a familiar nurse on the phone, and explained the situation. She advised no more medicine tonight and get back on the routine the following day.

  After my mom and I finished cleaning the kitchen, Giulia went into the master bathroom to brush her teeth. She flashed a brief smile as she set foot back in her bathroom, home in her space, where she could have privacy and not be told when and how to do everything.

  The plan for the night was for Giulia to sleep in Jonas’s room with me, while my mother took ours. I still wanted to be the first one on hand to respond to Jonas’s cries in the night.

  Giulia was asleep within minutes of lying down, but it took me much longer. I listened to her breathing next to me, and Jonas’s breathing on the other side of the room from his crib. Giulia’s breaths were slow, deep, and exhausted. Jonas’s were shallow, fresh, and light.

  I finally fell asleep but jolted awake a few hours later to the sensation of absence. Giulia was not in the bed. The bedroom door was wide-open. I jumped out of bed and found Giulia in the hallway, walking in the direction of the front door.

  “Where are you going?” I asked her in a whisper.

  “Nowhere,” Giulia said, brushing me off and continuing down the hallway to the front door.

  “Giulia, where are you going? Come back here, please,” I hissed between clenched teeth, trying to keep my voice low. The last thing I wanted was to wake my mom up and further fuel her worries about Giulia being home. “What’s going on?”

  “Nothing,” she said. “I just can’t sleep.”

  The door to the master bedroom popped open, and my mom stuck her head out. “What’s going on?” she asked. The hallway was dark, lit only by a night-light that we kept on for Jonas, but I could still see the alarm in my mom’s face.

  “Nothing,” Giulia said. “I just couldn’t sleep. I’ll go back to bed now.”

  She turned around and walked back into Jonas’s room, lay down in the bed, and was almost immediately asleep.

  My mom and I stood in the hallway, stunned. I slouched and avoided eye contact with her. As I turned to go back into Jonas’s room, she grabbed me by the wrist.

  “We’re not ready for this,” she said.

  I woke Giulia up at eight a.m. for breakfast and medicine, and then we drove to the Langley Porter Psychiatric Institute at the University of California, San Francisco. Langley Porter was affiliated with one of the most respected psychiatry departments in the nation, but you wouldn’t know it from the aesthetics. The building was all rough concrete and right angles. Inside was the same frumpy furniture from every other psychiatric facility.

  Giulia’s outpatient program met on the fourth floor, and the director of the program, a petite graying woman, was waiting for us. She had the calmness and openness that I had grown to recognize in many other San Franciscans of her generation—retired hippies who had celebrated the Summer of Love in Golden Gate Park, not far from this very hospital.

  “Welcome to Langley Porter, Giulia,” she said warmly, shaking Giulia’s hand and then mine.

  Giulia didn’t say anything in response, so I said, “Thanks.”

  “Giulia,” the director said again, focusing squarely on Giulia, “before we start anything I want to make sure you know that this is a voluntary program. You don’t have to be here. We think it can help you, but it’s up to you if you want to come or not.”

  “Really?” Giulia asked, incredulous. I was shocked to hear this, too. This wasn’t the plan.

  “Really,” the director said.

  “Well, if that’s the case, I’m out of here.” Giulia pushed herself out of her chair and walked toward the door.

  “Wait, wait, wait!” I called out. “Let’s talk about this for a minute.” Giulia stopped in the doorway to the office. “Remember what Dr. Franklin said. You have to do this program. It’s the reason they let you out.”

  “Actually, she doesn’t have to,” the director corrected. “Giulia, this is up to you.”

  “Well, I don’t want to do it,” Giulia said. “I want to go back to living my life.”

  I couldn’t believe this. The day before, a doctor had let Giulia out of the hospital AMA with a clear recovery plan, and now a director at Langley Porter was letting Giulia shatter that plan. I felt the same defensive anger that I felt reading Laing. Why was this director giving Giulia so much control? Did she not think Giulia needed to be treated? Did she realize she was dumping Giulia’s illness—the vomited pills, the walking around in the middle of the night, the skeptical questions from family members—on me? My mom was going to be outraged if I came back with Giulia and no plan for an outpatient program.

  “Giulia, we want you to go back to living your life, too,” the director assured her. “I read your file before you got here. I think we can help you go back to living your life. It’s going to take a little more time, but I think we can help.”

  Giulia looked at the director uneasily. “But what if I don’t want your help?” she asked.

  “Then you don’t come,” the director answered.

  We all sat in silence. I couldn’t stop shaking my head.

  “You have a son, right, Giulia?” the director asked.

  “I do,” she said, smiling. “I missed him in the hospital, and I want to spend time with him.”

  “We want that, t
oo,” the director said. “Do you feel ready to be his mom at home?”

  Giulia paused for a long time.

  “I’m not sure,” she admitted. “I’m still on all these pills that make me so groggy, and I just had another psychotic break, and I can’t believe that this is my life.” She started to cry. “I want to be back at work and be with my son and instead I just spent a month in the hospital and now I have this program and I have to take pills forever.”

  The director allowed Giulia to cry and waited until she had composed herself before she responded. “That’s where we can help,” the director assured her. “We want you to have all of those things, too.”

  There was another long pause before the director asked the pivotal question. “Do you want us to help?”

  Giulia thought for a minute and then quietly said, “Yes, I do.”

  Giulia and I tiptoed around each other as she went to Langley Porter. She feared the return of Mark the Medicine Nazi, the guy who quit her job and signed her up for dumb art classes. I worried about what Giulia might do if left to her own choices—overdose, jump off the Golden Gate Bridge, spend all day in bed, throw away her medicine.

  I grew to respect and trust Langley Porter. The director obviously was very skilled at empowering mental illness patients, while still getting good results. My sense of Laing softened. I felt less compelled to monitor Giulia’s medicine or incessantly call her doctors.

  The psychosis faded much the same way it had the first time—gradually, without fanfare, and leaving little cause for celebration, because it was immediately replaced with the deep chasm of depression. Giulia’s Langley Porter doctor swapped out the Haldol with Risperdal, and the one-word answers and delayed responses returned as well.

  I drew a firm line when it came to Jonas. I could give Giulia more autonomy, but I had to make sure that Jonas was okay, which set up the uncomfortable possibility that I might have to intervene between Giulia and Jonas.

  They had alone time together. I’d step into the kitchen for some imagined chore and leave them in the living room together. From there, I couldn’t help eavesdropping. It was excruciating. Jonas cooed at Giulia, who sat silently in response. There was no real togetherness. Jonas played alone and Giulia sat on the couch, impassive, as if the room were empty. Giulia’s thoughts were elsewhere, replaying the suffering she experienced in her madness, questioning why this nightmare had happened again. Jonas didn’t have answers, so Giulia mostly watched him in silence.

  I forced myself to give them five minutes, but usually after only a minute or two I couldn’t handle it anymore, and I crashed back into the room with the overwhelming positivity of Tigger.

  The Giulia-Jonas dynamic upset everyone who came to visit. Friends always called or texted afterward, saying how much it broke their hearts to see Giulia and Jonas in the same room, not connected. I was ashamed and defensive reading these texts, at the implied judgment of our situation. We stopped having friends over, even though I desperately needed to spend time with other people. I interviewed nanny candidates to help us with life around the house. Our first choice turned down the job. She said the sadness was too much for her to bear.

  One lunchtime, Giulia fed Jonas his mashed vegetables. She was mechanical, scooping and feeding as if paced by a metronome, and Jonas had a hard time keeping up with the pace.

  “Honey, slow down just a bit,” I said. “Wait until he has finished with the food in his mouth.”

  Giulia acted like she hadn’t heard me and continued to scoop up the green mush and lead it into his mouth.

  “Honey, please, just slow down a bit,” I said again. “Give him time to catch up.”

  She again acted like I hadn’t said anything and continued, as Jonas’s cheeks started to bulge with excess food.

  I laid a hand on her arm. “Giulia, just take a second to let him chew what he has.” The gentleness in my voice had disappeared.

  “I’m fine, leave me alone,” she said, shaking my hand off as she continued to scoop and feed, scoop and feed.

  “Goddamn it, Giulia, look at him!” I shouted. “Stop feeding him! He doesn’t have any room left!” I grabbed the spoon out of her hand. Jonas spit the food out of his mouth. Giulia sat with her head down, embarrassed and angry by the scolding.

  I eventually began to treat Giulia like a visiting guest when she was with Jonas—no expectations to change a diaper, cook, clean, grocery shop. I did my best to isolate her experience of parenting to only the fun parts and remove all the stressful, frustrating, and inane parts. I realized that the doctor’s concerns about Giulia’s ability to handle the unpredictable challenges of a baby were justified, so I shielded Giulia and Jonas from ever having to wade into that precarious territory. I kept telling myself that this was temporary, that this depression would go away as it had before, that Giulia wasn’t a bad mom, that she was just sick. I wasn’t always successful at convincing myself.

  One night after Giulia and Jonas had gone to sleep, I got hit with a stomach virus and spent the whole night on the toilet with diarrhea. I had full-body shivers and was in such pain that I had to crawl on the floor to get from room to room.

  Jonas began to cry at around three a.m., hungry for his nighttime bottle. Giulia didn’t budge. We had returned to sleeping in our room, Jonas in his, after my mom left, and from across the hall, Giulia didn’t hear Jonas’s cry for food through her medicated slumber. She never did. I was the one who responded, and I had grown to love it, because it meant I could leave our bedroom and go to his. His room felt so much warmer and more hopeful than ours, which had been consumed by Giulia’s depression. Middle-of-the-night feedings were pure, an unfiltered hour of tenderness. On a usual night, I rocked him during the feedings and gently sang songs, and after he finished eating, I lay with him in the guest bed as he drifted back to sleep. I tended to sleep there with him. I preferred it to going back to my wife in our bed.

  But this night there was no gentle rocking and sleeping. I could barely stand up, and I panicked when I heard him cry. I was horribly dehydrated and shaking with a fever. I crawled from the toilet to the kitchen, propped myself on the kitchen counters, scrubbed my hands with soap, and mixed a bottle of formula. I limped to Jonas’s room, lifted him out of the crib, and set him up on the floor to change him and feed him on blankets. I lay next to him and tried to quiet the shakes and the surging pain in my belly. I usually talked to Jonas through the feedings, but I had nothing to say because all I could think about was, How could I possibly hold up these two lives on my shoulders? What if something happened to me, then what would happen to them?

  Giulia left the program at UCSF after a month and transitioned to her original IOP program, from nine to twelve on Monday, Wednesday, and Friday. This meant more time together, which took some getting used to. Jonas and I had adapted well to dropping Giulia off each morning and picking her up in the afternoon. I explained to Jonas that we were taking Mommy to work, and for the rest of the day, I returned to the fantasy of being the stay-at-home dad while Giulia was off at her job.

  Now, we were home together all the time. Outbursts like the one over the feeding became more frequent, and I reached my breaking point. I had completely stopped surfing and running. I didn’t see any friends. I was doing a horrible job of taking care of myself, and it showed with my shortened patience. Granted, the demands of two working parents make for a lot of stressed nerves, but this was different. I spent all day focused on Giulia’s depression, Jonas’s well-being, and even Goose’s needs. The support I craved wasn’t there because Giulia needed as much care and attention as our child. It became harder and harder to stay patient with Giulia, and I lost my temper with her more regularly.

  I did finally manage to hire a nanny, and our savings continued to dwindle. We were definitely not going to be able to afford a house anymore and were probably going to be renting for life. Giulia had enrolled on disability, and her job kept us on their insurance, so there was some money to count on, but I worried more a
nd more about money.

  I eventually started to trust Giulia with more freedom. I had to. I first had to let go of driving her everywhere, even though it felt dangerous for her to drive. She couldn’t even focus on something like feeding Jonas. For weeks, Jonas and I had driven Giulia everywhere she wanted to go, whether it was IOP or a meeting with a friend. Giulia hated this. It was one of our biggest sources of tension. She agitated for the freedom to drive as much as she had lobbied to come home while in the hospital. Letting her drive felt so irresponsible that I couldn’t let it go. I needed to be convinced by a professional. I called her doctor, who said there was no medical reason that Giulia couldn’t drive, but it still didn’t feel safe to me. Finally, after a month at home, I relented.

  Without me babysitting her, Giulia gravitated toward her friends, especially the ones she had made in IOP, like Marie. Marie was a brilliant artist with bipolar who had been hospitalized ten times. Over the course of Giulia’s first, eight-month stint in IOP, Marie had been enrolled in IOP on three separate occasions. Marie was the type of bipolar patient who took herself off her medication regularly, because she hated how it sapped her creativity. While unmedicated, she often relapsed, hence the frequent in and out of the psych ward and IOP. She lived in the Outer Sunset, only a few blocks north of us. The two didn’t talk too much after Giulia had bounced out of her first episode, but now that she had relapsed, they were inseparable. They called and texted each other constantly. As soon as Giulia kissed Jonas good night for bed and handed him off to me to finish bedtime, she took her phone into the bathroom and called Marie. The two talked in hushed tones about how they were doing and how to get through the depression they were battling. They were a part of each other’s support systems. If Giulia had a bad day, Marie could help her make sense of it, and vice versa.

  It was a relief for Giulia to connect with a friend who understood her so intimately. I had depleted my capacity for talking about suicide three years earlier, but Marie was always there to listen to Giulia when she felt suicidal. Marie had experienced the psych ward, and suicidal depression, and could understand Giulia’s feelings and fears in a way that I couldn’t, no matter how empathetic I tried to be.