My Lovely Wife in the Psych Ward

by Mark Lukach

  Her blood work confirmed that her lithium levels were in fact low, and her doctor e-mailed that Giulia should increase her dose to 1500 mg, which Giulia did immediately and without complaint. “If Dr. Stefania thinks more lithium should help, I want to take more lithium,” she said.

  We called our parents and explained what was going on. Both sets offered to come out and help, but we told them not to. Beyond Giulia’s sleeplessness, everything else was as it should be. I was still working, Giulia was still working, and Jonas was still going to day care. We had daily contact with a doctor and access to all the right pills.

  On Thursday, October 16, the Giants were up three games to one against the Cardinals. Game five was in San Francisco at AT&T Park, an immaculate stadium perched on the San Francisco Bay. They needed only one more win to go to the World Series, and here was the chance to do it at home, in front of forty-two thousand rabid fans.

  Our routines were now set: Jonas and I watched the game, Giulia paced in the backyard. She walked in the cool green grass barefoot. A few early-season rains had already fallen, and our dead brown grass was growing back. The hard-packed dirt had been softened to a gentle mud. Giulia was often on the phone with friends, like Sachi and Leslie, but she paced in silence just as often. I always came out to check with her in between innings and offered to stay with her and talk, but we both knew that I should return inside to Jonas, who was waiting for me.

  Game five of the 2014 NLCS between the Giants and the Cardinals was a game of historic drama. The Cardinals took a 3–2 lead in the fourth inning and looked in control. In the eighth inning, the Giants sent in pinch hitter Michael Morse, a charming goofball with forearms the size of tree trunks. Morse hit a majestic, earth-shattering home run down the left field line to tie up the game. He rounded the bases with his arms held aloft, as if he were a child running through a park, pretending to be an airplane. Jonas and I jumped up and down in celebration and ran around the house like airplanes as well. Giulia came in at the sound of the commotion and stayed with us to watch the ensuing final inning.

  In the top of the ninth, our hearts were racing as the Cardinals loaded up the bases, but they failed to score. On to the bottom of the ninth, with the game tied and a trip to the World Series on the line. The Giants quickly got two men on, through a hit and then a four-pitch walk. The relief pitcher for the Cardinals was clearly struggling with his confidence. As he prepared to throw the next pitch, I said to Jonas, “Watch, Jonas. He’s going to throw a meatball right down the middle, to remind himself that he can throw strikes.”

  That’s exactly what the pitcher did. He lasered a strike right over the plate to the Giants hitter, Travis Ishikawa, who connected with the pitch and a hit a line drive that beelined toward right field. The second he made contact, everyone knew that the Giants had won. The ball rose up out of the infield, over the outfielder’s head, and kept soaring. It bounced on top of the right field wall, and the Giants won the pennant with a home run in the bottom of the ninth inning. It was a mythic baseball game.

  We erupted in our living room, and so did our whole neighborhood. Car horns were honking, people were running through the streets. Jonas was jumping up and down on the couch, screaming, “Meatball! Meatball! Right down the middle!”

  In the celebration, I fell for one of the biggest illusions in professional sports: I felt like this win somehow belonged to me. I found narratives from the baseball diamond and applied them to my life. I knew it was silly to do so, but I did it anyway. The guys in orange and white celebrating on the infield didn’t know that my wife wasn’t sleeping and was steadily taking more and more pharmaceuticals to stave off psychosis. Their walk-off home run had nothing to do with us. Yet I felt elated and interpreted it as a sign that everything was going to work out.

  And of course, Giulia didn’t sleep that night.

  Giulia canceled her trip to New York. Jonas and I didn’t go camping. We didn’t get refunds on the plane tickets or the campsite. Giulia took every pill she was directed to take. But she still couldn’t sleep.

  After a week of sleeplessness, we agreed to take a week off together, a medical leave of absence from our jobs, so we could be at home and not worry about the pressures of work. We hoped that a week would be all the time off that we needed. We turned off our morning alarm so we could wake when our bodies were ready for it, especially so Giulia could sleep in, if she slept at all. Although Giulia usually dropped off Jonas around eight, we now went together, something we never did but he loved, and we arrived after nine a.m. His teacher looked at us quizzically when we showed up together, and an hour later than normal, but she didn’t say anything.

  Then we had the whole day at home together, to try to do meaningful, calming activities—my newest iteration of art classes. We went on long walks in Briones with Goose. We grocery shopped and cooked together. We cleaned. We spent a lot of time in the garden. Giulia loved the sensation of the dirt in her hands, and while I weeded, she slowly rubbed the soil between the palms of her hands. We lived days as we had done five years before, but instead of creating a schedule in response to her time in the hospital, we were living this way to keep her out of the hospital in the first place.

  With the week away from the office, Giulia spent a lot of time on the phone calling friends. Ellie, a friend from our days of living at Ocean Beach, invited Giulia to spend the day out in the old neighborhood with her daughter, who had just celebrated her first birthday.

  “It’ll be great, Mark,” Giulia said, formulating a plan for the visit from the passenger seat as we drove together to drop off Jonas. “I can’t wait to see Ellie and the baby. You can surf while I’m there. You deserve to surf! Let’s not bring Goose, though. Just you and me, so you can surf and I’ll be at the house with Ellie and the baby, and it will be great. It will be so fun to see Ellie and the baby. I can’t wait. And you should totally surf. It’s a good idea. It will be great.” Fidgety and energetic, she repeated herself over and over on the way home from day care.

  “Maybe we should tell Ellie how you’re doing,” I said. “I know you’re not delusional, but you’re pretty clearly anxious and on edge. Ellie is home alone with a one-year-old. I think it’s only fair for her to know that this isn’t exactly a typical visit.”

  “Jeez, Mark, give me some credit, would you?” Giulia said. “Don’t you have any faith in me? I’m fine. We don’t have to tell her anything.”

  I packed the car with my board and wetsuit but had low expectations about actually getting in the water. None of our friends had seen Giulia in her escalating psychosis. Plenty had seen her suicidal, but this degree of anxiety and restless energy was something entirely different. I fully expected to be asked to stay around and not disappear into the ocean for a few hours. So I wanted to bring Goose, but Giulia was adamant that everything was going to be fine, leave Goose at home, otherwise he would be stuck in the car while I surfed.

  As we drove to the city, Giulia chattered the whole time and jumped erratically between topics: work, seeing Ellie, the friends she was calling, gardening, the ocean. None of it was delusional, but it was entirely out of character. On a normal day in the car, Giulia was quiet and content to listen to music. Not so today. She spoke with a desperate intensity, as though the rapid stream of words would prevent the silence from swallowing us up.

  At Ellie’s house, Giulia bounded up the stairs. I followed slowly, anticipating defeat. Within a few minutes, Giulia was shooing me away. “Go surf, Mark! That’s why I’m here! This is time for you to have fun. Let us girls have some mama time!”

  Ellie walked me to the door. As I stepped outside, she whispered to me, “I don’t know how to say this, so I’ll just say it: Please don’t get in the ocean. I need you to have your phone handy in case she becomes overwhelming.” She was obviously embarrassed to say this and had a hard time making eye contact with me.

  “I tried to get Giulia to tell you,” I said in response. “I wanted her to say how she was doing, but she didn’t wa
nt to.” I hung my head in shame. After all these years, I was still embarrassed when people saw Giulia in her time of sickness. It was so far from the Giulia that we all knew. Which was why I had wanted to call ahead, and sometimes did anyway, violating Giulia’s sense of privacy, so our friends could brace themselves to see her act so unlike herself. “She’s not delusional,” I continued. “She’s definitely not dangerous. She’s just . . . anxious. And wired from not sleeping.”

  Ellie nodded, accepting what I said, but she repeated her request. “Please keep your cell phone with you.”

  “Of course, of course,” I said. “Good luck.”

  I trudged down the stairs. I didn’t know what to do. Surfing was out. I had no dog, no book to read, and no interest in calling any of my old friends.

  I drove to the beach, plopped myself in the sand, and watched as guys in black wetsuits hooted and hollered their way through head-high waves. I stared at my phone, waiting for either Ellie or Giulia to call. Two hours later, Giulia called. I picked her up, we drove home, and Giulia rambled the whole time about how great it was to see Ellie and the baby, and asked why didn’t I surf, and said how we should have brought Goose, and I couldn’t say anything back because I was too embarrassed and defeated and angry to make a sound.

  One of the best strategies to help Giulia stay calm was to exercise. I couldn’t convince her to go to the gym on Monday or Tuesday, but she conceded on Wednesday. I hate gyms as much as I love trail running. I considered sending her off by herself, so that I could use the time for a much-needed run in the hills, but I changed my mind and went with her.

  Giulia slogged away on the elliptical as I cranked a few fast miles on the treadmill. It was bland and monotonous, but running was running, and it felt good to lose myself in exercise. Giulia was only a few machines away. She didn’t read anything, or listen to music, or even really look anywhere. She plodded along steadily, with no expression on her face.

  I went downstairs to lift a few weights, and we agreed to meet in the lobby at one forty-five p.m. Giulia has been impeccably prompt for as long as I have known her, so I made sure I was in the lobby by one forty-three. My shirt and shorts were soaked in sweat. Even my feet squished in my soggy socks and shoes.

  I stood in the lobby, self-conscious about the sweat puddle I was making on the floor. We were at one of those fancy new gyms: spotless tile, crystalline glass doors, perky smiles on the faces of the uniformed employees. A huge flat-screen TV played a tennis match on mute.

  No sign of Giulia. I shuffled my sweaty feet as the clock ticked along—1:46; 1:49; 1:52.

  Had she fallen asleep in the locker room? I knew that she had wanted to go sit in the sauna a bit. Maybe she had dozed off. I was just about to ask someone at the front desk to check on her in the locker room when an employee came sprinting down the hallway.

  “Someone call 911! There’s a woman in the locker room saying that we are all dead, she’s dead, her husband is dead, her son is dead. She needs help. We need to call 911!”

  I knew she was talking about Giulia.

  The employees who had been lounging behind the front desk sprang into action, the red uniform shirts a blur as they formed an impromptu huddle in the lobby. I jumped right in the middle of them.

  “It’s my wife,” I said. “I’m sure it’s her. Don’t call the ambulance.” They looked at me, their eyes wide with fear, and chose to trust me.

  Everyone spoke at once as we padded down the carpeted hall. The employee who had seen Giulia kept repeating the same thing: “She wouldn’t stop saying that we were all dead and something about us not being in this life anymore.” I kept trying to calm down any potential overreactions and avoid a 911 call. “It’s okay, it’s probably my wife, I can handle this, don’t call an ambulance.”

  We reached the door of the women’s locker room, and the female employee who alerted us all to the situation went in first. Immediately inside the door was Giulia, sobbing and huddled over. She looked frail and in pain.

  “Oh, Mark. We’re all dead now,” she said to me through her tears. “All of us. Even Jonas. We’re all dead.”

  I wrapped my sweaty arm around her. “It’s okay, Giulia, we’re fine, let’s go home.” I propped her up and ushered her out of the locker room. She felt lifeless under my arm. “It’s okay,” I said to the small army of stunned employees around us. “It’s okay. I know what’s going on. It’s okay, I’ve got her.”

  We walked down the hallway together, Giulia slumped against my body, and I was overwhelmed with a memory from many years before, long before Giulia had her first psychotic break. On a rare sunny weekend at Ocean Beach, the two of us sat in beach chairs and soaked up some rays. A carefree, naive life—pre-dog, pre-child, pre-psychosis.

  We watched a family crossing the dunes when the mother, a woman in her sixties, suddenly collapsed onto the sand, screaming that she was burning alive. I nervously walked over to offer some water—she refused. Her children, all adults, tried to calm her down, but it wasn’t working. I ran back and grabbed our beach umbrella and ended up standing over the woman to shade her. That helped a little, but she was still hysterical.

  It felt like an eternity before the husband arrived after parking his car. He broke into a sprint when he saw the scene—a small crowded gathering, his wife squirming in the sand, a stranger holding a beach umbrella over her. “It’s okay,” he said to us when he arrived, panting. “Thanks for the help, but I can handle this now.”

  I remember how scared I was by the woman, who shrieked that she was burning alive from the sun; how sad I felt for the husband, who looked worn down as he slumped over his wife and whispered to her that everything was okay; how unconvinced I was as he kept saying to strangers like me that it was okay and he knew what was going on.

  I was now that husband. The gym employees were the ones shaking their heads in fear and confusion.

  I practically carried Giulia out of the gym, all the while offering the empty reassurance that I had things in control.

  Giulia cried to herself most of the drive home. I wanted to ask if she was okay, but she was still spinning in the delusions, sorting them out in her head, and I knew the best thing to do was sit in silence. The psychosis would hopefully fade on its own.

  Alone with my thoughts, I panicked. Giulia was delusional. We were going on ten days of almost no sleep, she was taking all the medication, and she was delusional. Our plan, so carefully and thoughtfully constructed, suddenly felt absurd. I had considered sending Giulia to the gym on her own. How could I have left her alone? Why wasn’t she in the hospital? What if she had a delusion in front of Jonas?

  As Giulia wept and my mind raced, I gave up on our plan.

  Giulia called her psychiatrist when we got home. By then, the delusions had faded. I shamefully hoped that the psychiatrist would say enough is enough, time for the psych ward. That would be my out. Then I wouldn’t be the one quitting on the plan.

  But she didn’t. Giulia was calm and in control on the phone. Her doctor told her to keep staying the course. The medicine would kick in and Giulia would feel better. I shook my head in disbelief. Maybe her doctor wasn’t quite tuned in, fatigued by Giulia’s constant calls and e-mail. She had other patients, too. Maybe she was regretting her involvement in our doomed plan.

  We picked up Jonas at school and went back to our routine. That night, the Giants lost to the Royals in game two of the World Series. It was now tied at one game apiece. Jonas and I continued to chug along with our nightly routine. After the game, Jonas jumped on our bed, cheering, “Let’s go, Giants!” in his Buster Posey jersey as I videoed on my phone. Giulia lay on the bed, motionless, not listening or looking at anything.

  The reality settled in: Giulia was sick again. Laing saw it as a gift, but there were no gifts here. I had promised to let her have autonomy, and I gave it to her. Ten days into an autonomous approach to psychosis, I feared what that meant for me, and her, and most of all Jonas. Psychosis is terrifying when you see it f
or the first time. How much scarier it must be when it’s your mom and you’re not even three years old.

  Giulia didn’t sleep that night, either.

  “Where’s Mommy?” Jonas asked me the next evening. We were eating dinner. Giulia had not joined us to sit down and was instead walking around in the backyard.

  “She’s in the backyard, Jonas,” I said casually, trying to play off his question.

  “Why?” he asked.

  “Because she likes it,” I said, the best answer I could think of.

  He sat for a second and chewed on his food.

  “There are monsters in the house, Daddy,” Jonas said. I wasn’t sure if he was changing the subject or somehow continuing on his previous line of questioning. “I can see them. Monsters everywhere.”

  “Monsters?” I asked.

  “Yes. Big monsters. Scary monsters. But I’m not scared.” Jonas always tried to be bigger than he was. He was breaking my heart.

  “Well, good thing we have a special monster broom,” I improvised.

  “Monster broom?”

  “You know the broom we have? You didn’t know that it’s not only for cleaning up dirt? It’s also for sweeping out monsters.” Jonas was wide-eyed in disbelief. “I’ll go get the broom, you open the door, and we’ll sweep them out.”

  Jonas jumped out of his chair and ran over to the front door. I rushed off to get the broom from the hallway closet, and when I returned to the kitchen, Giulia was at the back patio doorway.

  “What’s going on, guys?” she asked quietly as she stepped inside.

  Giulia’s entrance put the two of us almost standing side by side, with Jonas at the end of the hallway at the front door. When she stepped inside, Jonas immediately walked toward me without saying anything.

  Giulia approached us, and Jonas held on to my leg. “Can you give Mommy a kiss, Jonas?” she asked.

  Jonas tucked closer into my legs as Giulia leaned in. He kissed her, but I could feel the tension in his body.