I’m a decade older than my baby sister Mariam. Due to this, my position in her life surpassed being just a big sister – I was also motherly in many ways as I tried to bridge the divide between my immigrant mother and my first-generation Pakistani American-born sister.
There were no signs of her mental illness growing up.
Just like her older Khan siblings, Mariam was a smart, beautiful child. By the time she was in high school, she was a confident and popular young woman as she took part in lacrosse, field hockey, and basketball. Regardless of her busy life with sports and friends, she maintained great grades. As I prepared myself to move out of the Khan household within half a year to attend Harvard University for my masters, there was very little doubt that not only would my little mini-me follow in my footsteps, she would surpass any and all expectations that I had of her.
Perhaps I should’ve told her then, but I was so, so very proud of her.
This was all before her world crushed upon her.
Out of respect for Mariam, I will not speak of a specific event that we believed triggered the change within her. There is very little doubt in my mind that this violent and crushing situation was what changed her life – and the Khans’ lives – forever.
Although I was the eldest with a sense (albeit very limited) of how this event affected Mariam, I failed her in many respects.
When she told me that she did not want to see a therapist about it, I believed her and breathed a sigh of relief, because I assumed it would be extremely hard to find her help without a huge amount of bills piling up.
When we spent nights in the bathroom crying as I held her face in my hands and assured her over and over that she would get better and would eventually become a successful person in every aspect of her life, I thought it was enough. When I frequently texted her asking her if she was okay, I believed her even though my gut told me she wasn’t.
She needed help, she wanted help.
But as she watched me prepare for a new chapter in my life, she didn’t ask for it. As her oldest sister, I should’ve sensed it. I should’ve done more.
When I finally moved out of the Khan house and moved 500 miles away to Boston, I believed everything would somehow work itself out. And never, ever did I think that she would attempt to take her own life. I never understood the gravity of the situation of her mental illness. I was in denial.
Three years later, our Khan Sibling iMessage chat rang with simple, but the most alarming words someone can see from a loved one.
“I’m sorry. I can’t do this anymore.”
As my husband, brother-in-law, and I drove home from a Redskins game, I attempted to reach her. I sent countless texts, and my many calls were sent straight to voicemail after a few rings. Panic gripped at my throat as I started thinking the worst. When she finally answered the phone, her muffled cries immediately brought hot tears to my eyes.
She told me she was standing on a bridge and ready to take her own life.
She apologized over and over as I begged and pleaded for her to step down from the ledge. I started sobbing as I yelled “Mariam, please don’t do this, you are my everything,” again and again. Eventually, I was reduced to just begging “please” over and over, as she told me that she had to do it.
We were still ten miles away when the phone cut. My cries turned into hiccups that gripped at my lungs as I buried my face into my hands. I didn’t want to believe that this would be last time I would ever hear Mariam’s voice ever again. I didn’t want to believe that I could quite possibly never see my baby sister ever again.
The next seven minutes were the longest minutes of my life. When it would take her three seconds to hit the street from the ledge, it didn’t matter if I was a few minutes away or three years too late. What mattered is that regardless, I was too late.
Mariam had cut our call as she stepped one foot off of the ledge.
And the next few seconds were, I believe, filled with nothing but God’s grace.
As she proceeded to let go, somebody grabbed her.
And when I say that it was nothing but God’s grace, I mean it – because at the very same time she decided to cut our call, an ambulance had driven up behind her. A quick-thinking paramedic jumped out and pulled her to safety.
Now, months later, as my family has reshaped our lives in order to fight alongside Mariam in her battles, I have often reflected how mental illness in American and Pakistani subcultures shaped my sister’s fight and how we treated it. In a country in which the social construct is built upon the fact that “people from marginalized communities are among the most likely to face discrimination and hardship contributing to mental illness, but least likely to seek, receive, or even have access to medical care,“ I wondered where Mariam, a young brown girl, fit into this.
This question swirled at the back of my head as just two days after her suicide attempt, she was denied extremely affordable advanced medical care, because she was deemed as not “high-risk” – even though she had just attempted to take her life less than 48 hours before, and had admitted, during her 24 hour institutionalization, that she had been silently attempting suicide for months.
Would she have been approved if her race was different? Would she have been approved if she was a man? Would she have been approved if she had been, say, a young white man? Would her situation be even worse if she had been a young black man or woman?
Most importantly, how is the medical attention needed by a person in order to not end their life so limited and expensive?
And while therapy and counseling seem to be “luxuries” offered to the privileged (in more ways than one), the stigma of mental illness in the Pakistani community runs prevalent. There have been plenty of times in which my mother, lacking any real knowledge on mental illness and the reality of it, has accused Mariam of being a “drama queen” and doing things for attention (although, in her defense, she is learning more about mental illnesses every day and figuring out what can be done in order to help Mariam).
From what I’ve seen and experienced, within the Pakistani community, mental illness doesn’t exist. We have never even brought the subject up of Mariam’s illness to family members outside our immediate six members, because, in our community, one is either normal or crazy – and if they’re crazy, it’s their fault for not being able to control their insanity.
Two years ago, my distant uncle committed suicide because of his mental illness – partly because he couldn’t get the help he needed and partly because others didn’t believe him when he said he was sick.
If people did believe him, they didn’t understand.
In retrospect, due to Mariam’s fight, I see many things more clearly about why and how he lost his battle. Not only was he a victim of the system of America, but the cultural implications of mental illness within Pakistani society and communities also prevented him from being saved.
Now I see that they were also the things that were not only keeping Mariam from getting the help she needed, but they were also keeping us from realizing just how close she had been to the edge. And thankfully, we were given a chance to realize it before we lost her forever – thankfully, the wool has been lifted from over our eyes.
We are not in denial any longer.
This means that now we realize that when we think she needs help, she does.
It means that we are not enough to keep her alive – our simple telling and assuring her that it’ll be okay isn’t enough – because she needs professional help… and that is okay. It means realizing that her outbursts and changes of mood aren’t entirely her fault.
It means making sure she is making it to therapy and has the emotional and financial support to do so. It means allowing us to be human too. We aren’t superheroes, and it can be exhausting – although nowhere near as exhausting as it is for her.
The mental illness stigma and inequality of treatment in American and Pakistani society be damned – we will not let Mariam become a statistic.
And when the time comes that we have a stronger grasp on her suffering, we will make sure others don’t become a statistic as well.