According to Korean tradition, after a baby is born, mother and baby do not leave the house for the first 21 days. Long cords of peppers and charcoal are hung in the doorway to ward away guests and evil spirits. At the end of the 21 days, a prayer is given over white rice cakes. After 100 days, there is a large celebration of survival, with pyramids of fruit and lengths of thread for long life.
When my son was born, I was reminded of this tradition by my family and by my in-laws, because we were breaking all the rules. I took a shower after birth, ignoring the week-long rule of no water on the mother’s body, and my first meal wasn’t the traditional seaweed soup, it was sushi. We let in guests, bundled my son in layers and took him on walks in the falling snow. And then we did a fateful thing: we left our home.
My son Cato was two months old when we embarked from London on an extended trip across the US. My husband James was a professor, I worked at a literary agency, and I had come up with a plan to use our shared parental leave: we would make a cross-country tour of family and friends and introduce them to our son. I didn’t see why we had to pay attention to Korean traditions – or superstitions, as I thought of them. Born and raised in the US, my husband and I had never paid much attention to the rules, and I always thought our families didn’t, either. Except that suddenly, with the birth of a baby, the rules seemed to matter.
By the time we arrived in New Jersey, we’d been travelling for 31 days, via California and Virginia, and I was exhausted. The sleep deprivation, the constant moving from place to place, meant I always felt a breath away from weeping. We had been in my in-laws’ house for only a few hours when I realised something didn’t feel right. I could hear a noise, a tinny buzzing and beeps that sounded like monitors. “I feel like we’re being watched,” I said to James. “Do your parents have cameras, too?” We had just stayed with James’s brother in California, whose entire house was fitted out with motion detectors and surveillance cameras.
“No,” he said. “But don’t worry, I’ll check.”
My in-laws were concerned about the effects of travel on a baby so young. My father-in-law, a paediatrician, checked Cato’s temperature with a thermometer and worriedly counted his fingers and toes, as though he might have lost one on the way. I tried my best to assuage their fears, but it was as though I were speaking into a void. Why was Cato so big? We must not be exercising him enough. Why wasn’t he rolling yet? Why did he cry so much? He must be stressed because of all the travel. Why wasn’t he sleeping through the night? It must be all the time changes.
“Maybe we shouldn’t have come,” I said to James. “We seem to be causing them a lot of stress. I’m doing everything wrong.”
“You’re fine,” James said. “They just worry, that’s all.”
I started being unable to sleep at night. I’d wipe my tears with the palms of my hands while I fed Cato, trying to keep them from falling on his cheek. I felt helpless and enraged, but confused and doubting. I had been selfish to make this trip. I was endangering Cato. I hadn’t thought about James’s family and their anxieties.
One morning after another sleepless night, James’s father sat with me. He gave me a smile, and I sensed that we were about to have a serious conversation.
“I know that having a new baby, this is difficult.” He paused. “Have you heard of postpartum depression?”
“Yes,” I said.
“It’s very common,” he said. “I think you might have depression. I notice that you are worried all the time, that you aren’t sleeping – this is dangerous, you need to take care of yourself. I think we are making you feel anxious.” I saw his hands shake, and realised what I hadn’t seen in my state of worry and fear. My father-in-law wasn’t worried because of anything we’d done; his anxiety was his own. He smiled at me, but ended the conversation with his usual tic, the worst-case scenario. “In most cases, postpartum depression is not serious, but you have to be careful. Because I had a patient who shook her baby, and the baby went blind.”
After this conversation, I started to feel the air was stiffening. I had trouble taking a breath. The ground shifted suddenly, as if someone had given a quick shake to the world. I went to feed Cato, holding him close, but noticed that my hands were clutching him tightly. Would I suffocate him? His eyes darted, looking at me with fear.
And then it happened. His eyes were devils’ eyes: dark eyes with flashing red pupils. “James,” I gasped. He came into the room, and I saw his eyes widen when he saw my face. I told him that we needed to leave the house. Now.
He paused. “OK,” he said. “OK, let’s leave.”
Cato was crying quietly. I picked him up without looking into his eyes, and sat on the bed holding him while James packed. He booked a hotel a few minutes away. What did it mean that Cato’s eyes had changed? Maybe I was having a panic attack, I thought; maybe I was just dreaming.
When we arrived at the hotel, I immediately wanted to leave. The room was all wrong, the walls too red. I could hear whispers from the hallway.
“Please sleep,” James begged me. “I just want you to get some rest. And then we can talk.” He put Cato into the cot, and we lay in bed. I’m not sure if I slept, but the next moment my eyes were open, and I heard a voice. It was a voice in my head but it spoke with clarity and strength. Each time it spoke, the room filled with light. Somehow, I knew it was the voice of God.
“Your son needs to die.” The voice was simple, straightforward. “What?” I felt panic taking over my body. “Please, no, please.”
“Are you trying to bargain?”
“No.” I started to cry. I didn’t know how to make it stop. I decided to let go. If this was the cost of my happiness, I would accept it. There was a dim light, and I could hear the sound of Cato breathing; it was steady but then it stopped. And somehow I knew, even without looking at him, that he had passed away.
I prayed. I hadn’t prayed since I was a child, but prayed now not to be afraid any more. I started to hear Cato breathing again. Then the voice was back. “Your son has to die, and it has to be your husband’s fault.”
“That will break him,” I said.
“Yes, but it will make him stronger. You need to be there to support him. You are his Beatrice.”
Did this mean we were in Hell? I heard James wake beside me. He smiled, his eyes tired, and looked at me with concern.
“Did you sleep at all?” he asked.
“I did,” I said. “Actually, I’m not sure,” I said truthfully. I saw James’s smile disappear.
“Cat,” he said. “I think I should call my parents, because I need them to take care of Cato. I want you to get some sleep today.” I nodded: anything to help James. He stepped out of the room. I noticed he took Cato with him.
In the hotel, time bent. I started to see things multiply, as if I was forming memories that would duplicate, each with a slight variation. I saw James pacing the hotel room in a loop. I saw him shaking with our son’s dead body in his arms. I couldn’t scream, I couldn’t move.
When we heard James’s parents in the hallway, he rushed out with Cato in his arms, and I started screaming: “I know, I know. We’ve failed. We are in your version of Hell.” I saw James’s mother’s face lined with worry, his father’s arms reaching out to me. And then, as if someone had pressed fast-forward in my brain, we were in a car. James was taking me to the hospital. When we got there, I had the feeling of being on a film set. The receptionist was a demon, with ink-dark eyes and a twisted, pointy face. She winked at me.
“OK, what do I need to do?” I said loudly. I addressed the demons around me, sitting in the waiting room. James shushed me and I tried to think about how we could escape. I looked over at the reception desk, and the nurse winked at me again.
When I collapsed, pulling at my clothes and screaming, James shouted for help. I felt the demons rush towards me, their faces pressing in gleefully, their hands on me as they twisted my ankle. I fought and screamed, scratched, bit, kicked. I felt the hands pull me down to Hell.
***
“Noona.” I heard my mother’s voice. “We are here. It’s me, I drove seven hours to see you.” She sounded as if she was crying. My father stood beside her.
The door opened again. James stood behind her, looking worriedly at me. When I looked at their faces they were blurred, as if someone had taken an eraser and smudged them out.
“Catherine, I need you not to be scared, OK?” a demon said to me. “I know you miss your baby.” Was I Catherine? I touched my hands to my stomach. Was there a baby? Maybe I’d lost it. I could feel a jagged scar along my stomach. I begged James for paper and a pen. I started frantically writing down everything we were saying, until the pen ran out of ink.
I remember James told me they were going to have to take me to another hospital. A doctor with a grave voice stood next to him. “She’s been here for four days, and she hasn’t slept,” he said to James, ignoring me. “She doesn’t seem to know who she is. She isn’t getting better. Each time I’ve spoken to her, she is still confused.” What did he mean by four days? When had we spoken?
The world was a wash of colour, blurred shapes of light and dark; I could barely see anything. Where were my contacts? Where were my glasses? “It’s because you were trying to chew on the glass,” James told me.
I remember singing in French and pulling at my clothes. I remember a gurney. I remember a white room, plain. Was I going to be here for all eternity? My legs were wet: was that urine? There were concerned faces at the slot in the door.
I woke up feeling I was underwater. I was in a general psychiatric facility, and there were 20 of us, men and women. I spent my time pacing the hallways, trying to untangle what had been real and not. I learned to follow the rhythm of the ward – to stand in line for medication, to wait in the TV room for the telephone to ring. I wrote in a notebook my husband had left for me; he had written the date at the top of the page, the year underlined in thick ink. I hoped that no one had guessed that I was a mother.
***
By the time I was released, I had spent 12 days away from Cato: four days in the emergency room and eight on the ward. James took me to a hotel overlooking the Manhattan skyline, close to the hospital. It was unspoken, but the words hovered in the air: just in case.
I learned that my parents were at my in-laws’ house, taking care of Cato. They brought him to the hotel on the second day. I didn’t recognise him. I searched myself for some emotion, but couldn’t find any.
“Don’t you want to hold him?” my mother asked. I forced myself to nod.
He felt heavy, an unfamiliar weight. I tried to remember how to hold him, but he was much bigger than I remembered. He didn’t look at my face; he just looked over my shoulder, struggling back and forth. My father quietly took him back from me, and I saw my parents look at each other with concern.
The days passed slowly. We’d walk along the harbourfront, trudging through the snow. My parents would come with Cato and stay for a while. I’d hold him sometimes; he didn’t seem to be getting used to me, but I’d touch his face and the softness of his hair.
A few days later, on a February day, we flew to London. Back home, I let James take care of Cato, while I lay in bed and read my frenzied notes. My memories felt sharp, raised like a scar. I still had to take my medication: an antipsychotic that made my brain feel numb and my hands shake; a pill that countered the side-effects; and a sedative to help me sleep.
Eventually James and I talked about those days. He told me that by the time he took me to the hospital, I was manic, stripping my clothes and screaming in the waiting room. He told me the hardest moment was watching me fight with the nurses as they clamped me in restraints.
I read obsessively about postpartum psychosis. I joined an online forum and read about the fear, the isolation. I learned that for most women, postpartum psychosis occurs a day or two after the birth. It was unusual for it to occur when the baby was already a few months old. My official diagnosis was stress-induced postpartum psychosis. While the reasons aren’t fully understood, the symptoms are usually similar: paranoia, racing thoughts, delusions, an inability to sleep. I knew that the weeks of broken sleep, the fears I had about protecting Cato, had been amplified by being in my in-laws’ house, but that the roots of psychosis had begun long before.
I heard from women who had been convinced their baby was a demon, or who thought their baby was going to catch fire. There was a woman who had forgotten she’d had a baby, and wept every time she discovered her C-section scar, and another who was convinced that her baby was not her own. One thing that was shared by all these women was a feeling of separation from their child, and a deep sense of shame.
I read news stories, sensationalised ones, and my breath caught when I read of a woman who had jumped off a bridge with her newborn baby. I learned that if we’d been in the UK, I would have been admitted to a mother–baby unit, and not as a regular psych patient, as I had been in the US. My psychiatrist told me that the medication I’d been prescribed, haloperidol, was a first-generation drug and not commonly used. Treatment in the UK is focused on keeping mother and baby as close as possible, in order to minimise emotional separation. When I read this, I felt angry. The rules had felt so trivial and arbitrary, and they had had such an impact on our lives. I had come back a stranger, and the distance I felt from Cato wasn’t something I could grieve; it went beyond loss. It was a severance, a removal that was complete.
I was assigned a team to oversee my recovery. James and I met with a perinatal psychiatrist, who listened quietly to what had happened. I remember that I told her our story in the past tense, as though it was behind us. We were optimistic. I asked her about coming off my medication, but she told me that we needed to wait. I think she knew there was more to come.
A few weeks after our meeting, I fell into a deep depression – a common occurrence after postpartum psychosis and taking haloperidol. It seemed instantaneous, like the descent of darkness under an ocean, immediate and complete. I had never known anything like it.
The crisis team visited me every morning at my flat. I forced myself to get out of bed when I heard the bell ring. Sometimes I’d be able to brush my hair, smooth my clothes, but most days I couldn’t. “How are you feeling today?” they’d ask. I would try to form words, but most of the time I couldn’t answer. They would look at my face and say, “You will get better,” and smile. I tried to believe the promise in their smiles.
They told me to write down goals for each day. There were pages of lists in my shaky handwriting. Each task seemed insurmountable. “Get out of bed. Make a cup of tea. Play the piano. Make a phone call. Hug Cato.” These visits lasted only a few minutes but they were precious minutes, a promise of light in what felt like an abyss. I felt grateful for each task they gave me, and marked them off my list, my hands shaking as I tried to hold the pen.
My depression lasted several months, during which my interaction with Cato was a few minutes each day at most. I held him in the mornings while James got ready for work. He was working part-time, and the university had hired a nanny who was helping to cover the other hours. Holding Cato still felt wrong, unnatural, even painful. I’d count the seconds until I could get away with giving him back.
It was May, four months since I was released, before I was able to move my body without effort. I was becoming myself again, though I couldn’t remember what it felt like to love Cato. I had thought that in becoming myself, I would find my son, too. Surely being a mother was something that had been imprinted on me? But when I looked at Cato, he could have been anyone’s.
I didn’t understand how our relationship could be so fragile. Those months of carrying him in my body, the hours when he’d slept in my arms, that fierce possessiveness: how could it all be erased? Perhaps I had somehow sent him away from me, an instinct to protect him from a mother who couldn’t be trusted. Perhaps, I thought, it was an act of love.
The thought didn’t comfort me. So I went through the motions. I reminded myself to reach for him, to smooth his hair when it fell across his face, to stroke his cheek. I practised smiling at him, thinking: this is what a mother would do. I wondered if there was a way to build love and, if there was, did that mean that it was manufactured?
I would stay on the antipsychotic and antidepressant for a year. I watched my body change from the medication, swelling until it no longer felt like my own. The doctors adjusted the dosages, and then started the process of taking me off them completely.
As for Cato, I asked him to wait for me to come back. And while I waited, I looked for joy in the moments I spent with him. I listened to his laughter. I clapped when he learned to take his first steps, and I held his hand when it was outstretched for mine. I knew that the love I had felt for him wasn’t something I could find again – it wasn’t lost, it was gone. And I knew I had to forgive myself for leaving him, for breaking when a mother was not meant to break.
I kept trying. I was trying to find a way back to my son, to look at him and not feel hollow. And then one day, an ordinary day, as I was holding him, I realised that I wasn’t pretending, that I wasn’t waiting to let go. I recognised him as my son: he was mine. And I could remember what it felt like to hold him in those early days – his smile, the feel of his breath on my arm, the weight of his body on my own. And in remembering, I knew that what I was feeling wasn’t the same, it was new. It was a discovery, sudden but familiar – like the wonder of a new star, an unfolding of sky. Somehow, I was a mother again.
• Extracted from Inferno, by Catherine Cho, published by Bloomsbury at £16.99. To order a copy for £14.27 go to guardianbookshop.com or call 020-3176 3837. Free UK p&p on all online orders over £15.
Anyone suffering from postpartum psychosis should seek urgent medical help from their GP, A&E, or by dialling 111. Further information is available from the national charity APP (app-network.org).
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