All the Sharps

I sit on my bathroom floor, listening as my husband tries to make an appointment with his doctor, any doctor, for tomorrow. The charcoal tile, cool beneath me, marches between us in perfect lines. I remember picking out the tile slabs during our home remodel half a decade ago. All those decisions, the endless choices of kitchen drawer pulls, nursery paint color, tint of the hardwood floor stain—they make up this home.

He reluctantly describes his symptoms and history to the consulting nurse: severe depression, hospitalized for suicidality two months ago, not sure the meds are working, paranoia, thoughts that he would be better off dead. He is simultaneously annoyed by and apathetic about the nurse’s questions.

My bottom aches, sore from sitting so long on a firm surface. My stomach rumbles but I don’t feel hungry. I have spent the better half of this Sunday trying to convince my husband to get help and consider readmittance to the psychiatric hospital. His back is leaned up against our bathtub. I sit between him and our master bathroom door.

The nurse goes through the PHQ-9 and GAD-7 questionnaires, commonly used tools for measuring a person’s level of depression and anxiety. He’s answered the questionnaires dozens of times by now, daily yardsticks when hospitalized in a psychiatric ward. How often in the last two weeks have you been feeling down, depressed, or hopeless? Poor appetite or overeating? Feeling afraid, as if something awful might happen? As a primary care physician myself, I’ve administered these questionnaires to hundreds of patients; I have them memorized. Even though I can’t hear which question she asks, he glances in my direction with each inquiry. He uses the standard 0–3 scale to respond. “Uh, two. Three. One. Three, I guess.” He is weary in the answering. As if he were swatting at a fly that won’t leave him alone.

Realizing he does have active suicidal ideation, she screens for safety: Do you have a gun in the home? A plan for self-harm? Have you bought or collected anything to help you carry out this plan? I think of all the things he’s thrown himself into over the years: bamboo furniture, landscaping, marathons. He qualified for a duathlon world championship with Team USA years ago, before we had children. We both flew to Australia so he could compete. He marched in a parade with the other athletes, lined up behind their respective national flags. He ran and cycled and ran some more through the Newcastle streets, a road that wound alongside a tan, jagged rock face. I barely caught a glimpse of him as he sped by on his sleek bike, hugging the sheer cliffs.

The nurse tells him there are no appointments with psychiatrists until later this week. I feel a swell of rage at the nurse, at my husband’s psychosis, at a medical system—which I am a part of—that would drug him up, spit him out, and create the paranoid stranger sitting before me on our bathroom floor.

I grab the phone from his hand. “He needs an appointment tomorrow, with anyone. They can consult the psychiatrist on call.” I know how the system works, that any clinician can consult the psychiatrist about medical management or plan of care. I don’t know if the nurse knows that I know this, but something in the tenor of my voice must convey my desperation. “Okay, let me see what I can do.” 

He won’t meet my eyes, my husband. He won’t say a word to me as we wait. He has been convinced to seek help when all he wants is for it to end, to all be over. 

They find him an appointment for tomorrow. I let out a breath, just a sliver of a sigh. It escapes into the air between us, dissipating into a rift. He takes the phone, listens to the instructions. “Okay.” He replies as if he couldn’t be less all right with the plan, with the fact that he is still breathing, cornered by his wife, who stands between him and his exit from his bathroom, from his house, from his life.

He hands me the phone. “This is Ann,” she says, “one of the social workers. Your husband agrees not to harm himself tonight. I suggest you get everything sharp out of the house, anything he could use to hurt himself.” I can hear the apology in her voice, a bow of intonation I have become increasingly familiar with since my husband’s descent into severe depression.

“Okay. Yes. I’ll get them all out.” My mind races. Our whole house. The kitchen knives I use to cut the kids’ fruit in the morning. The razors I use to shave my legs. The blades to his power saw in the basement, the one he used to fashion a backyard swing from a two-by-four. Those tiny scissors I use to trim my eyebrows. The ones I’ve just caught him tracing along his forearm, sharp tip angled toward a pulsing artery, as I walked back into the bathroom after nursing our eight-month-old baby downstairs. “What are you doing?” I asked him, my pitch high. “Nothing,” he said, and shoved the scissors back into the cabinet drawer alongside my lip balm, my mascara.

I look at my husband. His gaze is down, his jaw defiant. “How can I . . . ?” My voice trails off, but the social worker interprets my question. “Just do the best you can. Get all the razors and the knives and the pills. You can only do the best you can.” She repeats it, and the mantra rolls over in my mind, through my empty gut.

I hang up the phone and he brushes by me, doesn’t look up. “I’m going to the appointment tomorrow alone.” He disappears out of our bathroom, leaving a weight in his wake. I say nothing. I find a bag and begin gathering all the razors, all the pills, all the sharps to hide away.