Giulia grew intolerably frustrated by our inability to understand her. She rolled onto her back, pulled her knees toward her chest, and chanted, “Voglio morire, voglio morire, voglio morire.” I want to die, I want to die, I want to die. At first she hissed through her teeth, then started shouting, “VOGLIO MORIRE, VOGLIO MORIRE, VOGLIO MORIRE!” in an aggressive roar. I'm not sure which scared me more: listening to my wife whisper her death wish or scream it.As author Mark Lukach concludes at the end of My Lovely Wife in the Psych Ward, he does sound like he has lived “a charmed life” – a childhood of love and adventure, mutual love at first sight with the woman he would eventually marry, professional fulfillment – so while he's describing the harrowing circumstances around his wife's recurring psychosis, I couldn't help but think, “This is awful, but it could be worse”. And despite having worked as a freelance writer and enjoying success with articles in major publications, I didn't find this to be an incredibly well-written memoir – the emotion is flat, the timeline rushed, no research is added for understanding – so I couldn't help but think, “This is okay, but it could be better.” Yet, as someone who has had no contact with the mental health system, I am grateful that Lukach decided to share his story: his might not be a typical life, but this memoir has the sheen of a truthful account; a worthwhile addition to the record of human experience.
The book opens with Lukach's fairytale romance with future wife Giulia – a beautiful, gregarious, and focussed Italian-born fellow-Freshman at college. They eventually marry, move to San Francisco, and begin their working careers: he as a teacher, she as a marketing manager. They have dinner parties and long walks on the beach, get a dog, and plot their happily-ever-after. And then Giulia becomes overwhelmed with work, can't sleep, and begins to have hallucinations about talking with God. When the sleepless nights continue, Giulia becomes terrified that she's now talking to the Devil, and as Lukach has no idea what else to do, he brings his wife to the ER against her will and consents to admitting her to the psych ward. Lukach is brutally honest about this experience: His uncertainty and fears, the cold bureaucracy he confronts with the health professionals, the toll this experience takes on him personally. When medication eventually allows Giulia to be released (after 23 days), she then sinks into an eight month long depression; wishing every day for death. Lukach pulls her out of that, too, and despite neither of them having worked for nearly a year, they have enough money saved to be able to go on a four month, round-the-world vacation; rediscovering their love and commitment.
Giulia feels so good at this point that they decide the breakdown was a one-time occurrence, and they have a baby. Not long after Jonas is born, Giulia begins to have delusions again; this time Lukach doesn't hesitate – he brings his wife to the ER and demands admittance to the psych ward. After an even longer stay this time, Giulia is again released and again suffers months of suicidal depression – all while her husband does his best to take care of the baby and the house and his sick wife. As he is not taking very good care of himself, friends intervene and one hands him The Divided Self: An Existential Study in Sanity and Madness: an “antipsychiatry” book that advocates for less medical intervention for the mentally ill. And while Lukach is eventually interested in what this book might offer him and his family, he really doesn't go into it far enough for my satisfaction. He and Giulia do make a “mad map” – Giulia is able to predetermine what care she is willing to endure in the event of further breakdowns (which totally makes sense: allowing someone to make decisions, while healthy and in concert with a psychiatrist, about her own future) – but when Giulia did have another episode, she was no longer willing to take the medications that, when healthy, she knew she would need; no longer understood why she couldn't have her two-and-a-half-year-old son visit her in a care facility.
I felt trapped by the impossibility of the situation. I didn't trust Giulia to make her own decisions. I wanted to make them for her, which led to her resenting me for not trusting her. I didn't want Giulia to resent me, but the only way to do that would be to allow her to make her own decisions, even if that included choices that could hurt or even kill her. It wasn't going to work if I remained in charge, and it would be too risky if she was in charge.What was most interesting was Kuhach's evolution as a caregiver: Everything was unknown during the first episode, he had a false confidence that he was an experienced decision-maker the second time, and by the third, he was willing to back off and let the professionals do their jobs. He never stopped advocating for Giulia, and he continued to visit her every day that he could, but he eventually understood that he would need to put Jonas and himself first. On the other hand, it was hard not to recognise that this is a family of inordinate privilege: They could go long stretches without working; her mother routinely flew in from Italy, and his from Japan, whenever needed; we're supposed to feel bad that Kukich has to give up frequent surfing for trail running. I was annoyed that their local coffee shop became hip for its selection of artisanal toasts, and I was shocked when Kukich concluded (after the suicide of one of Giulia's friends from the psych ward) that killing oneself is simply another kind of courage. He voices his frustration that prescribing medicines for the mentally ill is an imprecise science – Giulia seems to be forever over- or undermedicated while finding the right dosage – but it's obvious from their experience that they need to trust the process; Giulia needs medication, no matter its side-effects or the opinions of the antipsychiatry movement.
Ultimately, like I said in the beginning, this was an interesting experience for me to read about, even if I didn't think it was as well-written as it could have been. I wish the Kukichs all the best.
For further reading, this is the original article in The New York Times that opened up Kukich's writing career (talk about a charmed existence). And this interview in The Globe & Mail adds Giulia's voice to the story.
