In her deeply stirring memoir, “In Love,” Amy Bloom recounts the emotional journey she takes with her husband, Brian, who chooses to end his life after being diagnosed with Alzheimer’s. The story is told through an archipelago of relevant backstory and episodes that chart the brutal process of helping a loved one die in a way that is not painful, frightening, traumatic or illegal. The couple’s exhaustive and often desperate quest eventually leads them to Dignitas, “an organization based in Switzerland that empowers a person to end their own life with dignity and peace.”

To manage such hefty subject matter, Bloom artfully divides the book into manageable chunks of very short chapters that are titled with either a date and place, or something playful, such as “Birdseed” and “Ring the Bells.”

Review

Cover courtesy of Random House

“In Love: A Memoir of Love and Loss”

By Amy Bloom

Random House. 240 pages. $27

Bloom summarizes the early stages of her husband’s disease through scenes of marital disruption – “Suddenly, it seemed, we argued endlessly about everything” – and the more commonly known symptoms of Alzheimer’s, which in Brian’s case meant “names disappearing, repetition, information turned upside down, appointments and medications scrambled.”

There are also medical charts and illustrations (mostly related to how neurologists score a patient’s level of severity) but any scientific data is limited to that which enhances the reader’s experience of Bloom’s struggle to honor her husband’s wish.

“I don’t want to end my life,” Brian admits in one of the early telephone interviews with Dignitas, “but I’d rather end it while I am still myself, rather than become less and less of a person.”

Philosophical questions regarding the self and ethics orbit the largely secular narrative without dominating it. Wisely, Bloom remains in the trenches of daily life, where the juxtaposition of normalcy with what’s happening to her husband maintains emotional torque for the reader, who is never asked to “wait outside” – even for the 20 minutes after Brian has drunk the sodium pentobarbital that will end his life.

That said, there are moments of humor. “A few months ago, (Brian) got me a very expensive and very odd present, a hooded marled sweatshirt with tulle trim for five hundred dollars,” Bloom writes. “I’m still surprised that I didn’t look at that sweatshirt and think, I see that you have Alzheimer’s.”

Bloom’s technical prowess is evident in her conscription of banal details to preface profound and sobering insights into love, marriage and death. En route to Switzerland, Bloom describes the couple’s experience at a steakhouse in JFK Airport. “At the Palm, Brian ordered onion rings and a rare rib eye with a side of hash browns and a Caesar salad and garlic toast and he would have ordered a shrimp cocktail, except that I whispered, like the circa-1953 stage Jewish wife I seem to have become, missing only my home perm and rickrack-trimmed apron: Really? Shrimp in a steak place, in an airport? Brian shrugged, to say: I’m not that excited about airport shrimp anyway and, also, what’s the worst that could happen?”

But the worst case is that he could get food poisoning and miss the flight to Zurich – where, after months of arduous paperwork, he is scheduled to die in four days’ time.

“At this, he folded the menu and looked at me the way he often did now, with resigned understanding, fatigue, a little worn humor.”

Perhaps the two most challenging issues for Bloom as a wife appear at opposite ends of the memoir. The first is, if denied assistance by Dignitas, what alternatives are available? The author recounts how she considered drowning, procuring fentanyl from a drug dealer, DIY suffocation, and VSED (voluntary suspension of eating and drinking), which in the case of her husband (a former Yale football player) could take as long as a month. “Right to die in America,” according to the author, “is about as meaningful as the right to eat or the right to decent housing; you’ve got the right, but it doesn’t mean you’re going to get the goods.”

The second dilemma is how they should inform children, siblings, grandchildren, even Brian’s elderly mother, who turns out to be an unexpected ally. Disclosures to friends and relatives lead to some unusual reactions.

“Brian’s dearest oldest friend, his fishing buddy since 1979, says to Brian, ‘If you think you don’t need to go right now, and you want to wait awhile, I can just shoot you myself, in a year or two, in a field.’ Brian hugs him.”

Is this a coping mechanism or a practical solution? Bloom consistently leaves enough room for readers to make up their own minds.

The most powerful scenes occur, understandably, in the closing chapters. The reader knows the end is coming, but when it does, the fact that it still feels like a shock is a testament to Bloom’s clear, lyrical prose about a subject that would cripple many of her peers.

As with all great books about dying, “In Love: A Memoir of Love and Loss” does not terrorize with grim statistics and forewarnings but rather destigmatizes euthanasia and enriches the reader’s life with urgency and gratitude. It renews those joys of being “In Love” with the people around us – despite the numbing effects of routine and familiarity which so often cause happiness to lapse in middle age.