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A heartfelt memoir about choosing death with dignity.

Winner: 2022 Best Nonfiction Award.
In 2019, author Amy Bloom and her husband of 12 years, Brian Ameche, received life-altering news: a neurologist diagnosed Ameche with Alzheimer's disease. Although he'd been experiencing symptoms for years, Ameche's cognitive decline was still at the mild stage, enabling him to fully understand his predicament. He knew the disease was degenerative and debilitating, and he made it clear that he had no desire to spend his last years gradually losing his memories and sense of self. Bloom agreed to help him find a way to end his life early, and her memoir, In Love, describes their experiences during the months between the diagnosis and her husband's death.

Bloom quickly discovers their options are limited. They discuss methods of suicide they could accomplish themselves, but Ameche doesn't think those will work for him. They investigate physician-assisted suicide, a procedure permitted in 10 US states and Washington D.C., but find Amache doesn't meet the criteria. Finally, they discover Dignitas, a Swiss non-profit that offers "accompanied suicide" using sodium pentobarbital (see Beyond the Book).

Bloom's account vividly describes what it was like to embark on this journey: "Every day is an up-and-down," she writes, "Roller-coaster ride makes it sound thrilling; it is not thrilling. The ups and the downs both hurt, it's a mistake to scream, and nothing moves quickly." Ameche seems certain of his decision, never wavering, while all Bloom can do is support him in every way possible. It's evident that she loves him and is loath to lose him, but at the same time she realizes his death is inevitable.

One of the most engaging aspects of the memoir is Bloom's willingness to lay her feelings bare. She freely admits that there were times when she was angry or frustrated with her husband, even while realizing their time together was coming to a close. She talks about the need to "practice being a widow," doing things like taking down the holiday lights, which soon she'd have no choice but to do on her own. And she describes the many times all she could do was hold her husband in bed and cry. She achieves a candidness that few authors convey.

The account also relays in fascinating detail all the decisions and considerations one must make after choosing death. The pair has to determine, for example, what or how to tell their four young granddaughters. (They opt to tell them nothing; Ameche writes each a goodbye letter, and Bloom figures they can read her memoir when they are older.) Ameche particularly dreads informing others because he is concerned that they won't understand, and will try to talk him out of his decision; several people close to the couple weren't informed until the pair were at the airport headed for Zurich.

It seems a bit callous to critique such a personal narrative, but I felt that for the most part, the work lacked emotional depth. I found it an informative and, above all, an honest account, but to me, the author seemed to keep the subject at arm's length. It almost appears to have been written by an outside observer, one reporting on the facts but failing to fully capture the pain beneath them. Empathetic readers will likely be able to put themselves in Bloom's shoes and imagine what she must have been going through, but the story generally wasn't as visceral as I would have expected. Given the subject matter, that lack of emotional connection may be preferred by some, allowing the reader to understand the process without becoming overwhelmed with grief.

In Love is a fine addition to the genre of books that deal with the decline of a loved one. Those who enjoy memoirs will likely want to put this one on their list, and it's recommended for anyone interested in exploring death with dignity. Book groups in particular will find it offers many topics for discussion, such as assisted suicide and how one copes with knowing their time with a partner is reaching its end.

This review was originally published in The BookBrowse Review in March 2022, and has been updated for the March 2023 edition. Click here to go to this issue.

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