All the Things We Never Knew (38 page)

The skateboarders I'd seen on so many nights during David's hospitalization were there again, along with the familiar clacketyclack of their skateboards against the cement. It immediately took me back to the lonely nights I'd entered and exited the hospital, awash in emotion and anxiety.

One of the young guys dressed in baggy pants and a T-shirt looked up at me and grinned. I smiled back. Had I seen this particular teenager before? I could not recall seeing any of the skateboarders' faces before today. Except for the vivid sound of the sport, I'd remembered the skaters only as dark sketches at the recesses of my memory. I wondered how much else I'd missed during David's illness.

In the lobby, clerks stared at their computer screens while families waited in the reception area for word of their loved ones. A young woman paced back and forth while talking on her cell phone. She wore a business suit, her face haggard from the day. People come to hospitals on their bad days, not their good ones. The panic, the anxiety, the smell of pharmacology and mental illness flooded my senses again. Dizzy, I leaned up against the reception desk. “I'm here to pick up my husband's medical records.”

A clerk arrived with a massive file, three hundred or so pages. On the top of the stack: a discharge summary dated October 24.

Final Diagnoses: Bipolar disorder, mixed state.

Suicidal ideation, resolved.

Partner relational problems.

Complicated bereavement.

Severe Secondary to financial problems, separation from spouse and daughter, death of father.

A note from his psychiatrist read, “David was discharged this morning. I wrote a thirty-day supply of medications for him. He was very pleased with how well he was doing and he acknowledged that while his brain wasn't all the way back it was most of the way back and he felt comfortable with leaving. His friend has written a letter regarding her concern that the firearm, which he had shot twice in the woods, was still lost. David has assured everyone that he does not know where it is.

“David does not feel that we need to call her and feels that the issue is resolved. He is not planning to go look for it and he thinks that it is just simply lost in the woods.”

The discharge note continued, “David's mother had set plans that either she, or his sister, Adele, would be with David constantly and felt comfortable that he would be okay. He was no longer expressing a plan to kill himself.”

My chest lifted with a breath of air that I couldn't let out. It was caught at the back of my throat, trapped with the anger and frustration I'd felt two years prior, when I tried so desperately to make sure the staff behind the glass windows realized the man they were treating needed their attention.

That David would lie about his planned suicide did not shock me. He'd lied to me plenty about everything from life insurance to his intimate relationships. But how could trained psychiatrists, the last line of defense, the people most expert at detecting the deceit and vagaries of bipolar, also be defrauded? And if it's as easy as David made it sound in those exit interviews, what hope is there of ever preventing suicide? What separates those who can be saved from those who, like David, simply can't believe in a future beyond their illness?

I sat in the hospital lobby reading through the documents for two hours. I called Ted Oster, the social worker who had been so helpful to me during David's hospitalization. “Sheila,” he said warmly, “how are you?”

“I know it must be odd to talk to me after all this time,” I said, “but I just can't
shake
this question, this question of why. I think I was shielded by shock and grief for the first year, Ted. But I really need to know. How could David have done this to Sophie?”

Ted grew quiet. “He could have used more time, undoubtedly. Unfortunately, there is no funding for transitioning patients. We do as much as we can.”

The weight of the hospital documents felt heavy on my lap. Ted drew in a breath and continued, “But David, David was unreachable, Sheila. The staff talked about it at length—his affect, his holding the staff at arm's length, his refusal to tell the truth about his gun. We were all very concerned. We, too, take this loss very personally.”

I thanked Ted for all he'd tried to do and hung up the phone. An unfamiliar noise escaped my mouth, the kind of guttural sound that comes from unresolved loss. Whether he knew it or not, Ted had given me an essential piece to the puzzle I'd tried to put together for two years, one I would never completely solve.

David had been unreachable
: to me, to his family, and in the end, to his doctors. A series of memories flashed vividly through my mind: him pulling away at the coffee shop when I'd first moved in to appreciate his smell, his distant and clouded affect the day of our wedding, his excuses as to why we shouldn't make love during my pregnancy. He was not mine from the beginning, and certainly not at the end, when he grew weary of the added isolation of mental illness. Everything I'd done to try to reach David was useless against his mistaken belief that we are alone in this world.

If mental illness caused David's isolation, I was powerless against it. But if it was the opposite, if isolation actually helps create mental illness, we might all avoid that fate—by allowing true intimacy in our lives, by telling the truth, by embracing our own authentic selves.

I would later read about a research project that highlighted the importance of intimacy and relationships in helping the mentally ill recover. Jay Neugeboren's brother, Robert, had been in the New York mental health system for nearly forty years and had been given nearly every antipsychotic medication known to humankind. Jay began interviewing hundreds of former mental patients who had been institutionalized, often for periods of ten or more years, and who had recovered into full lives: doctors, lawyers, teachers, custodians, social workers. He was fascinated with the question—what had made the difference?

Some pointed to new medications, some to old. Some said they had found God. No matter what else they named, they all said that a key element was a relationship with a human being. Most of the time, this human being was a professional, a social worker or nurse, who said, in effect, “I believe in your ability to recover, and I am going to stay with you until you do.” The author points out that his brother had recently recovered from his mental illness, without a recurrence for more than six years, the longest stretch in his adult life.

Of all the research I've read about breakthroughs in mental illness, this message resonates most loudly. We need one another to lead healthy lives, and when faced with the prospect of illness, be it mental or physical, we need to believe others can help us through to the other side. We need to believe that it is no different to ask for help with a mental illness than it would be for a cancer patient to ask for chemotherapy. We need to have faith in our own ability to endure, and when hope wanes, as it will with the illogical ups and downs of brain diseases, we should find our way back to our hearts.

I filed the papers back into the manila folder and walked to my car. My phone buzzed with a text message: “Hi Luv, Can't wait to see U and the girls tonight. Your man, C.”

Two weeks later, Colin and Sophie charged headstrong into another huge set of Kauai waves with their boogie boards. Sophie's back was
crisscrossed with tan lines; her legs were long and strong from all the outdoor exercise. When had she grown so tall?

Another big wave came, and Colin heaved Sophie forward on the board so that she could get the longest ride possible. She rode the slipstream, shouting, “Whoo-hoo! Mom, watch! This is so cool!”

A jagged outcropping of black rock framed one side of the beach. It was beautiful—more beautiful than any postcard. Colin caught the next wave, riding up alongside her as if they'd planned the whole show. I smiled and waved, wondering whether to trust the bubble of joy I'd suppressed all week. It was, he was, this was, all too good to be true.

The warm sand underneath my thighs was real. The air, its moist, reassuring humidity, reminded me to drink it all in, the beauty, the water, the incredible fruits and vegetables.

But this joy? Could I trust it? Would I ever get over the feeling that another huge wave would come along and wipe out everything I loved?

Sophie ran from the water, dripping, her skin glowing and her long hair bleached an even lighter shade of blonde from the sun. “Mom,” she said, trying to catch her breath, “you've got to come try it.”

“I am having so much fun watching you do it, Soph,” I said. “I want to get some more video before we have to go to dinner.”

Sophie leaned down, put her two arms on my shoulders, and said, “Thanks for bringing me, Mommy. This is the most amazing vacation I've ever had.”

I caught my own breath and smiled back. “I'm so glad, sweetheart. It wouldn't be the same without you.”

Sophie rejoined Colin in the water, the two of them jumping up in the air every time another wave came, making their way farther and farther out, to the big waves that make the best rides. The drift was strong, and Colin kept his hand on Sophie's board or her hand to keep her close. Then he positioned her toward the beach and pushed her fast so she could ride the crest of another magnificent wave. Sophie screamed all the way in. “Whoo-hoo! I'm flying!”

She waved at me from the ocean, her long arms reminding me again of David. It left me wishing he could see Sophie again, so happy, so beautiful.

David—if only. What if I'd . . . ? Why?
I would never answer those questions. No matter how hard I tried to enjoy at least one day without his memory, or the guilt of his death, or the profound absence made by his loss, I hadn't succeeded. His remarkable genetic influence on Sophie was even more profound as she aged. Her looks, her sense of humor, even her stubbornness, were David's. I missed him terribly. His memory, and my current state of hopefulness, were too raw a combination. The tears came up from nowhere, surprising me when they squeezed out the sides of my eyes.

I looked up to see Sophie and Colin climbing up the black rocks. They jutted out like a spit along the beach, a perfect place for jumping into the ocean. Colin climbed behind Sophie, careful to make sure she had every handhold and foothold before she took the next step upward.

My heartbeat quickened. “Colin,” I yelled, wiping my face with a sandy hand. “She's afraid of heights!”

He couldn't hear me. The wind had come up, and the waves were too loud. I sprinted to the rock, awkwardly running in the sand and the slope, desperate to get to them before they jumped. “Colin, don't,” I shouted. “Sophie is afraid of heights!”

They were at the top of the outcropping now, an immense cluster of rocks that stood maybe ten feet above the water. Sophie would be terrified.

She stood on the rock, holding Colin's hand. Her shoulders were back squarely, and her stance was like a warrior's. She yelled back to me, “I really want to do this, Mom. Let me go!” Her goggles were on her eyes, her chin jutting out defiantly, and suddenly, she looked another year older to me, not just physically, but emotionally—more confident, on the verge of something important.

Colin shrugged his shoulders, apologetically, and shouted, “It is really safe, honey.”

“Okay,” I said. “Please hold her hand.”

The two of them walked gingerly to the edge of the rocks and then started a countdown together: “One, two, three!” They swung their arms back and forth, then
whoosh
, they leapt into the air, the blue Pacific sky behind them, hands and arms outstretched to the setting sun, a god and goddess, their trim bodies disappearing like long spears into the surf. I ran to the edge of the water, my hands to my lips.

After what seemed like several seconds, their heads finally bobbed back to the surface, smiling and laughing together. I exhaled and jumped into the air. “That was beautiful!” I said, running into the surf to join them, the unexpected chill of the water splashing up against my legs and chest and finally across my forehead, soaking my hair, soaking me with their joy, our joy, until I was finally baptized into a new beginning.

Epilogue

One of the reasons I wrote
All the Things We Never Knew
was to more clearly understand the genetic risk of bipolar illness and suicide. For too long, I'd missed it entirely in David. I need to be vigilant about my daughter and her inherited risk of having the illness.

In this book, I've painted a picture—one that illuminates many of the signs and much of the foreshadowing of serious mental illness. I hope that my choice to share this personal journey might help families and friends be aware of those signs and might encourage those at risk to seek treatment before depression or substance abuse takes away that option.

Many people view suicide as preventable and avoidable, and some hold that because I was married to David, a measure of the inevitable blame was mine to bear. But too few realize the toll mental illness has on a marriage, in anger, resentment, sexual infidelity, hopelessness, and verbal abuse. David's doctors believe he suffered from the illness from the onset of puberty, but because of his intellect, he was able to compensate for his illness until the profound stressors of life became too much to bear. College is also a particularly risky time for the onset of depressive illness—the use of alcohol and drugs, and radically altered sleep patterns, can precipitate psychotic episodes.