Counting Backwards

A married couple deals with the husband’s decline from Lewy body dementia in a profound and deeply moving novel shot through with Kirshenbaum's lacerating humor. It begins with hallucinations: of a man on stilts, an acting troupe, Ghandi. At first, these seem benign, almost comical, and are likely connected with an ocular issue. It’s something he and his wife can make jokes about. But soon he starts to experience other cognitive symptoms, memory problems, disorientation. He’s a scientist, an auto-immune researcher, and still middle aged. Too young for Alzheimers. She is a moderately successful college artist. They live together with a cat — a pleasant, quiet New York City marriage. Then he receives the diagnosis of Lewy Body Disease, and its march of symptoms: aphasia, difficulty with simple tasks, losses of lucidity. He has a life expectancy of 3 to 8 years. There are moves as his care becomes more difficult, or he lapses into periodic and uncharacteristic acts of violence: from Leo and his wife’s apartment, to his sister’s house, then an assisted living, then another assisted living, then hospice. Health aides, a continual outflow of money. His wife does what she can, but is able to do so much less than she wants. Watching him die — too fast, and yet not fast enough. Kirshenbaum captures the couple’s final years and months together in short scenes that burn with anger, humor, love, and pain. With no sentimentalizing whatsoever, she tracks the brutal destruction of the disease, as well as the small moments of beauty and happiness that still exist for them amidst the larger tides of loss.