“A memoir of love and loss” is the subtitle of my book, Twelve Thousand Days, about my life with my late husband, and his final illness in 2013. I doubt if Amy Bloom knows this. I imagine Memoir of Love and Loss is a common title for this sort of book, since love and loss go together like a horse and carriage. In Love, however, is a memoir with a difference, one with an ethical, emotional and philosophical edge on most grief memoirs.
The story of Amy Bloom’s life with her husband in a marriage of 15 years is engaging, just like any well-written account of a good marriage between two interesting people – the well-known writer and her architect husband, Brian Ameche. It is also an Alzheimer’s story. Around 2016 Brian became forgetful and eventually an MRI scan and tests diagnosed Alzheimer’s disease. Brian immediately decided he would like to take control.
“Here’s my first choice,” Brian says. “ . . . whenever it is that I reach the point that it seems like I’m going really downhill, you tell me and then we’ll lie down together and you give me whatever will kill me.”
“I can’t do that, darling. It’ll be murder.”
So the big difference between this and most memoirs of love, loss and Alzheimer’s is that its key theme is assisted suicide. Amy Bloom loved her husband enough to help him die, but (sensibly) not enough to commit murder. “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.”
She learns that although in some American states individuals have the right to end their life, for the most part nobody is allowed to help them. She also finds out that it is harder to die by suicide painlessly than she imagined. And by the time you are legally permitted to do it, you will be so far gone in your illness that you won’t be able to do anything unaided.
A Swiss organisation, Dignitas, provides an assisted suicide service – the patient takes the drug himself, under medical supervision. Dignitas is a not-for-profit but the procedure is expensive, ruling it out for many. And the regulations are strict. As well as requirements regarding protection against manipulation by relatives and so on, the patient must be competent to make the decision to die, up to the final moment.
What this means is that if an Alzheimer’s sufferer waits until they are “really downhill”, it will be too late. For Brian to carry out his wish, he had to die with dignity while he was still mentally competent or drop the idea.
He didn’t give up.
The long wait for an acceptance of his application is described, and finally the journey to Switzerland, the few days’ sojourn in Zurich, during which the couple sight-see and shop, and the procedure itself. The extraordinary story is told with humour and humanity. Brian was mostly in good form, they ate at nice restaurants, and generally had as pleasant a time as possible for the last months of his life.
Amy Bloom provides colourful detail about food, clothes, places and just enough about medical procedures. Apart from being a refreshingly frank account of a marriage (they quarrel sometimes, they use Viagra) it is an exploration or even a definition of true love. Most significantly, it opens the way for a discussion about the right to die – a debate we should have right now in Ireland, where the Dying with Dignity Bill has been before the Oireachtas since September 2020.
However, as Amy Bloom writes, “Dr Schwartz [End of Life Choices New York] says: ‘When any kind of right-to-die legislation is proposed – the opposition shows up with ten million dollars as soon as it’s about your right to choose.”
Tell us about it!
Lively, accessible and deeply thoughtful, In Love is a truly important book.
Éilís Ní Dhuibhne’s latest books are Little Red and Other Stories (Blackstaff 2020) and Look! It’s a Woman Writer! (Arlen House, 2021)
