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 a man on stilts, an acting troupe, Gandhi. 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 and disorientation. He’s a scientist, an autoimmune researcher, and still middle-aged—too young for Alzheimer’s. 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 dementia, and its march of aphasia, difficulty with simple tasks, and losses of lucidity. He has a life expectancy of 3 to 8 years.

There are moves as his care becomes more difficult; they move from Leo and his wife’s apartment to his sister’s house, then to an assisted living facility, another assisted living facility, and finally hospice. There are health aides and a continual outflow of money. His wife does what she can, but is able to do 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.