Heller McAlpin, NPR, asks potential readers of the new book by writer/psychotherapist Amy Bloom, In Love: A Memoir of Love and Loss, “Would you agree to help your beloved end his life when he receives a hopeless diagnosis?” The issue of assisted dying is what Bloom faced in her own marriage.

The diagnosis in question is early-onset Alzheimer‘s, which struck Brian Ameche in his mid-60’s.

Not everyone will agree with Brian’s decision, or with Bloom’s agreement to support his wishes. Bloom understands that euthanasia is a controversial subject, and she addresses it with the gravitas it deserves. At various points, she worries ‘that a better wife, certainly a different wife, would have said no, would have insisted on keeping her husband in this world until his body gave out.’ In Brian’s sharper moments, she worries that they’re acting too soon. She also, rightly, rails at a system that allows animals to be put out of their misery, but not human beings.

The bumpy road to assisted dying, or in this case legally “accompanied suicide” (involving drinking sodium pentobarbital) brings the couple to an organization in Switzerland called Dignatas. But you can’t just access Dignatas because you want to. One of the stumbling blocks was proving Brian’s level of “discernment and determination”:

The couple know that if they wait too long, he will no longer be capable of passing this test. They hit an upsetting delay when they learn that Brian’s neurologist had written on the MRI report that the reason for the test was a ‘major depressive episode.’ Depression is a deal-breaker for Dignitas, which does not want to be in the business of helping clinically depressed people commit suicide. Brian and Bloom have to prove that the neurologist’s note is simply not true.

Simon Van Booy, Washington Post, believes In Love demonstrates that “perhaps the two most challenging issues for Bloom as a wife” are finding alternatives to Dignatas if rejected and deciding how to tell loved ones.

While the latter, i.e., telling others, produces “some unusual reactions,” the former involves pondering various other methods of assisted dying: “The author recounts how she considered drowning, procuring fentanyl from a drug dealer, DIY suffocation, and VSED (voluntary suspension of eating and drinking), which in the case of her husband (a former Yale football player) could take as long as a month…”

In Love is currently on many critics’ must-read lists. The following review excerpt from Publishers Weekly echoes the sentiments of many, including my own: “With passion and sharp wit, [Amy Bloom] jumps back and forth between the beginning of their relationship, the Herculean effort it took to secure an agreement with Dignitas, and the painful anticipation of the final trip to Switzerland. Most poignant are the intimate moments they share as they make the most of their last days together. As she writes, ‘I imagine that Brian feels as alone as I do but I can tell he isn’t as afraid.’ The result is a stunning portrayal of how love can reveal itself in life’s most difficult moments.”