The first time I saw my wife walking around the Georgetown campus I shouted out “Buongiorno Principessa!” like a buffoon. She was Italian, radiant, way out of my league, but I was fearless and almost immediately in love. We lived in the same freshman dorm. She had a smile bello come il sole—I learned some Italian immediately to impress her—and within a month we were a couple.
She’d stop by my room to wake me up if I was oversleeping class; I taped roses to her door. Giulia had a perfect GPA; I had a mohawk and a Sector 9 longboard. We were both blown away by how amazing it feels to love someone and be loved back.
Two years after graduation we married, when we were both just 24 years old and many of our friends were still looking for first jobs. We packed our separate apartments into one moving truck and told the driver, “Go to San Francisco. We’ll give you an address when we find one.”
Giulia had a concrete life plan: to become a director of marketing at a fashion company and have three kids by the time she turned 35. My ambitions were looser: I wanted to bodysurf hollow waves at San Francisco’s Ocean Beach and enjoy my job teaching high-school history and coaching soccer and swimming.
Giulia was focused and practical. My head was often in the clouds, if not the water. After a few years of marriage, we started talking about having the first of those three babies. By our third anniversary our charmed adolescence was transforming into a charmed adulthood. Giulia landed a dream job.
This is where that lovely storyline ends.
After only a few weeks in her new position, Giulia’s anxiety level rose beyond anything I’d ever seen. She’d always been a bit high-strung, holding herself to impeccable standards. Now, at age 27, she was petrified, actually frozen—terrified of disappointing people and making the wrong impression. She’d spend all day at work trying to compose a single email, forward the text to me to edit, and still not send it. Her mind lost room for anything but worries.
At dinner she stared at her meal; at night she stared at the ceiling. I stayed up as late as I could, trying to comfort her—I’m sure you’re doing a great job at work, you always do—but by midnight I inevitably dozed off, racked by guilt. I knew that while I slept, my sweet wife was trapped awake with her horrible thoughts, uncomfortably awaiting morning.
She saw a therapist, then a psychiatrist who prescribed antidepressants and sleeping pills, which we both naively thought was a huge overreaction. She wasn’t that bad off, right? Giulia chose not to take the pills. Instead, she called in sick to work. Then one night, while we were brushing our teeth, Giulia asked me to hide her medications, saying, “I don’t like having them in the house and knowing where they are.”
I said sure, of course, but in the morning I woke up late and rushed off to school, forgetting her request. At the time I thought this was a minor oversight, like misplacing my wallet. But Giulia spent the day at home staring at her two orange bottles of pills and daring herself to eat them all. She didn’t call me at work to tell me this—she knew I would have come straight home. Instead she called her mother, in Italy, who stalled on the phone with Giulia for four hours until I returned.
The next morning I woke to find Giulia sitting on the bed, calmly but incoherently talking about the conversations she had overnight with God, and the panic set in. Giulia’s parents were already on a plane to California from Tuscany. I phoned the psychiatrist, who said, again, to take the medication. By now I thought that was a great idea—this crisis was clearly way beyond my depth. But still, Giulia refused the meds.
The next morning, when I woke, I found her pacing around our bedroom, relating her animated chats with the devil. That was enough. With Giulia’s parents, who by then were in town, I drove her to the Kaiser Permanente emergency room. Kaiser didn’t have an inpatient psychiatric unit, so they sent us to Saint Francis Memorial Hospital, in downtown San Francisco, where Giulia was admitted. We all thought her stay in the psych ward would be brief.
Giulia would get a little pharmaceutical help; her brain would clear up within days, maybe hours. She’d be back on track to her director-of-marketing goal and her three kids before age 35.
That fantasy shattered in the waiting room. Giulia was not going home today or tomorrow. Looking through the glass window into Giulia’s new, horrifying home, I asked myself, What the hell have I done? The place was full of potentially dangerous people who would rip apart my beautiful wife. Besides, she wasn’t really crazy. She just hadn’t slept. She was stressed. Probably anxious about work. Nervous about the prospect of becoming a parent. Not mentally ill.
Yet my wife was ill. Acutely psychotic, as the doctors put it. She existed in an almost constant state of delusion, consumed by paranoia that would not fade. For the next three weeks I visited Giulia every night during visiting hours, from 7:00 to 8:30 p.m. She ranted unintelligible babble about heaven, hell, angels, and the devil. Very little she said made sense.
One night, as I approached Giulia’s room, she saw me and collapsed on her bed, chanting, “Voglio morire, voglio morire, voglio morire.” I want to die, I want to die, I want to die. At first she hissed this through her teeth, then started shouting “VOGLIO MORIRE, VOGLIO MORIRE” in an aggressive roar. I’m not sure which scared me more: listening to my wife scream her death wish or whisper it.
I HATED THE HOSPITAL—it sapped me of all energy and optimism. I can’t imagine what it was like for Giulia. She was psychotic, yes, and tormented by her own thoughts, and she needed care and help. And for her to get that care she was locked up against her will and pinned down by orderlies who injected medicine into her hip.
“Mark, I think this is worse than if Giulia had died,” my mother-in-law said to me one night after leaving Saint Francis Memorial. “The person we visit is not my daughter, and we don’t know if she is coming back.” I was silent, but agreed. Every evening I ripped open a wound that I’d spent the whole preceding day trying to patch up.
Giulia stayed in the hospital 23 days, longer than anyone else on her ward. Sometimes Giulia’s delusions scared her; other times they assured her. Finally, after three weeks on heavy antipsychotic medications, the psychosis began to lift. The doctors still didn’t have a firm diagnosis.
Schizophrenia? Probably not. Bipolar disorder? Unlikely.
At our discharge meeting, the doctor explained to me how important it was for Giulia to take her medication at home, and how this might be difficult because I couldn’t forcibly inject it the way the orderlies did in the hospital. Meanwhile, Giulia still slipped in and out of delusions. During that meeting, she leaned over and whispered to me that she was the devil and needed to be locked up forever.
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