Amy Bloom

There are some books that stay with you after you’ve read them. Amy Bloom’s In Love: A Memoir of Love and Loss, is one of them.

“‘Please write about this,’ my husband said.” He thought it might help others. Bloom, an accomplished writer (eight novels) did so, keeping a meticulous notebook of her husband’s Alzheimer’s journey and its ending. The right choice, Bloom is renowned for her inveterate focus in her writings on the human need to connect and capacity to meet life’s vicissitudes with honesty and acceptance.

A happy couple who met each other in their early fifties, they had walked away from existing marriages, finding affinity in the maturity time often yields. She brought three children into the marriage. Brian, who didn’t have any, became the children’s beloved Babu:

“Brian and I fell in love the way some middle-aged people in unhappy partnerships and in small towns do…. ‘I know who you should be with. You should be with a guy who doesn’t mind that you’re smarter than he is, who doesn’t mind that most of the time, you’ll be the main event. You need to be with a guy who supports how hard you work and who’ll bring you a cup of coffee late at night. I don’t know if I can be that guy,’ he said, tears in his eyes, ‘but I’d like a shot.’ We married.”

At first glance, you might wager odds it wouldn’t last, a man from a devout Catholic family wedded to a divorced Jew with three children. But for fourteen fulfilling years, it did.

They had their quarrels, but being opposites gave balance. What they shared—politics, a love for the arts, traveling, good dining, and the children—was compensation overflowing. Both were keen on helping others: Amy, also a licensed social worker; Brian, an architect with sensitivity to the needs of others, active in Planned Parenthood and with a football frame, providing escort for women past jeering protestors. They shared a commitment to humanity, not religion.

Brian was 67 in 2019 when Alzheimer’s dropped like the sword of Damocles upon their happiness. Less than a week after the neurological findings, he decided “that the ‘long goodbye’ of Alzheimer’s was not for him and less than a week for me to find Dignitas, at the end of several long Google paths.” Dignitas, a private Swiss right-to-die entity, doesn’t impose a six month terminal illness mandate or residency requirement as in right-to-die states in America. It does, however, charge a $10,000 fee, with personal responsibility for travel and accommodation expenses.

Some might think Bloom a willing accomplice. Not so, as the memoir makes abundantly clear: “Brian knew what to expect. I talked to him about living with the illness until the end—that, of course, I would love and take care of him. He was very kind and very clear. He just said, ‘That’s not for me.'”

In often alternating chapters contrasting past and present, Amy faithfully narrates the perambulations of Brian’s final journey. While an individual’s story, it’s also a genre, the stories of this dread disease’s malice retold numerous times, replayed orally in YouTube and the film Still Alice (2014), for example.

What distinguishes Bloom’s memoir from other renditions is the mastery of an astute writer and eye witness. We are present with every detail right up to the final holding of hands and last words in the austere Dignitas apartment in the Zurich suburb of Pfaffikon. It is told with blows landed, fools not suffered gladly, yet punctuated with cathartic humor.

Why read a book like this? Because in doing so, as Brian intended, it may help others know their options:

“‘Please write about this.’ He wanted people to know that they have far less choice in America about their end of life than they may think. Some of us can’t bear to think about it at all, but Brian felt strongly that people should have conversations and do more planning,” Bloom shared with a People interviewer.

Though not explicitly said, In Love implies our need to implement a new strategy of pervasive compassion over religion’s bias and even medical opposition against assisted suicide. It’s highly informative as well for Alzheimer’s co-victims who live with their afflicted loved ones, suffering daily anguish and disruption of routines and options once taken for granted.

The struggle for the right to die has been a slow, arduous one, but not unhopeful. Just a few decades ago, passive suicide, i.e., removing a terminal patient from life support, wasn’t allowed under any circumstance.

Ten U.S. states now allow for physician administered suicide, but this is a misnomer. It’s for state residents only. The patient must have a maximum life expectancy of six months. Two physicians must give approval some time apart. While a physician can prescribe the sodium pentobarbital drink, neither the physician nor anyone else, can hand it to the client. In short, the recipient is fully in charge and must be aware.

This means an early Alzheimer’s diagnosis entails racing against the clock. Bloom quips, “Right to die in America 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.”

Should early diagnosis indicate any semblance of depression, you are excluded. This is true of Dignitas as well, although it does allow for advanced age or interminable, unbearable pain, as long as you are fully aware and make your decision without coercion. In such circumstances, no terminal diagnosis is needed.

At present, nearly six million Americans struggle with the illness, its occurrence doubling among those over 65 every five years. Although you can acquire the illness at younger ages, when finally diagnosed, its onset may have begun a decade earlier, or even more. By the 2060s, it’s projected the number will triple. Two-thirds of victims are female, perhaps because of their longevity. With Alzheimer’s, one loses not only memory, but control over body functions. One may even forget how to swallow.

Bloom had noticed changes in Brian’s behavior. Normally laid back, he had become quarrelsome and withdrawn, forgetful of appointments, unable to remember names and faces, spatially disoriented, and inability to focus, culminating in his dismissal from his employer for being too slow.

Brian would tell Dignitas, “I don’t want to end my life, but I’d rather end it while I am still myself, rather than become less and less of a person.”

As is, it took five months of liaison with Dignitas before they gave him the coveted green light. Seventy percent opt out. There followed the flight to Zurich and a physician’s repeated interview to affirm that he hadn’t changed his mind and was consciously able to make the decision for himself.

In Love isn’t simply a memoir of dying, but a testimony that lends joy to life and transcends mortality:

“I take both of his hands and he lets me. IloveyouIloveyouIloveyou, I say. I love you so much. I love you, too, he says, and he drinks the sodium pentobarbital. I kiss him, all over his handsome, weary face, and he lets me.

“Middle-aged women are supposed to look for the safe harbor, for the port in the storm of life. We are supposed to look for the calm and the comfortable. You are the port in the storm. And you are the storm. And you are the sea. You are the rocks and the beach and the waves. You are the sunrise and the sunset and all of the light in between.

“I whisper to him, Every day of my life, and he whispers to me, Every day of my life.”

–rj