Cover Image: In Love

In Love

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This is the honest and raw story of the end of life of someone with a terminal illness and the quest for a dignified death. It is a beautiful story of love and loss.
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This book is beautifully written and emotional.  Amy Bloom tells the story of her husband, Brian, who decides to use the services of Dignitas, an end-of-life company in Switzerland. The way Amy describes Brian allows you to feel him jump off the page.  He's the out going former football player who is devoted to Amy, her kids and grandkids.  He's smart, funny and likes his partner's independence.  
And then Brian learns that he is slipping into Alzheimer's.  And he makes the decision that he wants to end his life before his mind and memories are out of reach.

Obviously, this is a difficult topic. In truth, I don't know how I personally feel about it, but that does not matter.  This book is beautifully done.  It explores the couple's journey (not an easy one) to Dignitas, their love, their family and difficult decisions.  What was striking was how Brian had the ability to chose to end his life on his terms, although it was s difficult process.  Whether we agree with his decision is not the point.  The point is he was in control of his life and its terms.
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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 article).

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.
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Amy Bloom wrote a courageous account of the months and days prior to her husband's assisted suicide. I applaud the endeavor and thinks she does accomplish describing her husband and her own plight without reservation . It is food for thought about the topic , a discussion with loved ones and how we proceed to change the course of how we die with dignity . Will read more of her works.
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What a powerful book about the love between a couple and the devastation of disease.
I learned so much about the medical system and death with dignity from this book.
Thank you for writing it and publishing it and sharing it.
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I loved this book, particularly Amy Bloom's audiobook narration. She is not only a gifted writer, but also a licensed social worker.  Her thoughtfulness shines through as she makes available her experience to her readers.
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Amy Bloom is magnificent…. 
       ….Her voice is authentic and true, honed to perfection! 
It’s one of the few memoirs that feel as though they have made a difference in the world. 
Barriers have been broken…. boundaries stripped away….
Amy invites us to look beneath the surface with her unsparing, yet compassionate narrative. Her husband, Brian has us looking  closely at ‘right-to-die choices’, laws, his illness with Alzheimer’s, and his choice to die peacefully on his own terms.  
          ……but not as a ‘self-serving’ endeavor…..rather a generosity ….
not as an isolated situation…..but as many situations.
Brian said to Amy:
         “Please Write About This”
Magnificent she did!!!  
I think both Amy and Brian knew people ‘needed’ to hear this story.  
She had Paul and I (married 43 years)….discussing this book - adding our thoughts about compassionate assistance suicide for over an hour last night…
     …..from many points of view.  We have Amy and Brian to thank. 

This slim powerful love story between Amy and Brian and the reality they were faced with is packed filled with useful instructive, revealing, informative information.   

As Michael Cunningham has been quoted: 
        “Prepare yourself to be heartbroken, expanded, unsettled, and filled with hope” 

Amy’s story opened up a dimension of feelings in me that I didn’t even know I had!
It’s a story that sings, cries, exults, and mourns. 

A deeply serious book…an important book.  
The facts about Alzheimer’s are frightening.   Right to die choices with peaceful support in America is also frightening….
At its core “In Love” …. is a love story….(with grief, loss, death, more grief, more loss, more love) 
Amy Bloom is as real as any one person could possibly be — 
      —tender, passionate, angry, funny, self doubting, intuitive.

Absolutely it’s going down as one of the best books of the —-
It’s breathtaking experience love and sorrow is overwhelming ‘felt’.  

So courageously written and utterly important!!!! 

A few excerpts ….

It was January 26, 2020, Zürich Switzerland….
Amy and Brian were traveling
to Zürich, Switzerland…..
They were headed to Dignita’s office in Zürich, a Swiss nonprofit organization offering accompanied suicide. 
     “For the past twenty years, Dignita’s has been the only place to go if you are an American citizen who wants to die and if you are not certifiably terminally ill with no more than six months to live. This is the current standard in the United States, even in the nine right-to-die states plus the district of Columbia, about which many older or chronically ill Americans harbor end-of-life fantasies and which I researched, at Brian’s direction, until we discovered that the only place in the world for painless, peaceful, and legal suicide is Dignitas, and the suburbs of Zürich”. 

     “There are around six million people with Alzheimer’s in the United States. This doesn’t include the people with mild cognitive impairment who might or might not become demented (statistically, 80 percent of people with MCI do go on to develop Alzheimer’s within seven years, and although reevaluation every six months is recommended to people with MCI, no website can tell you why frequent reevaluation is recommended, as there is no FDA-approved and successful treatment for MCI or for slowing the progression of MCI to Alzheimer’s or, really,  for Alzheimer’s itself). The six million also doesn’t include people with TBI (traumatic brain injury). which often leads to some form of dementia, or the people currently suffering from several different forms of dementia, which and just as badly as Alzheimer’s but may progressed differently. Almost two-thirds of these 6 million people are women. 
Almost two-thirds of the caregivers for those Al heimer’s patients are also women.  More of the patients and more of the caregivers”. 
     “Women in their sixties are twice as likely to develop Alzheimer’s as they are to develop breast cancer”. 

“He has turned me into a wave-from-the-porch-person, and I do it for everyone who pulls out of my driveway”. 
Now people who don’t do that for their guests seem to me to be lacking something, as I was”. 

     “I know that when you contemplate sending me out on tour, you all wish you could send Brian instead— and no one disagrees”
                      Amy Bloom > had me in tears with her above sentence!!!  I wish I could meet you both.

THANK YOU AMY for this beautiful gift.  I’m deeply sorry for your loss. 

I fell in love with both Amy & Brian …. how could anyone NOT?
      Amy made Brian come alive: absolutely charming, big hearted, funny, fearless, and incredibly lovable (as candy man to his grandkids—I was taken).

      ……because of this book — I’ll make a donation this week to planned Parenthood….
      …..I’ve already listened to Bill Evans 
      …..I’ve marked the book “As I Lay Dying” , by William Faulkner to read.
     …..I’ve made a note for myself to watch the series ‘Brooklyn Nine-Nine’.
     …..I’ve purchased book to read by Jane Hirshfield (thank you Amy)
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Very important conversation on delicate topics which are generally known to be hard to discuss.  Amy Bloom's memoir about her husband's diagnosis of Alzheimer’s and their brave decision to end his life before the disease will completely alter his personality. The book is very well written, It is instructive, heart-wrenching and joyful at once. It traces their life together and gradual changes in Brian's personality leading them up to the doctor's office where they learned the very bad news. The details of how Brian had been diagnosed, the tests, the choices they've made, the steps they had to take to carry out Brian's wishes would be of great interest to many readers especially to those who are interested in the topic of right to die. Amy's husband wanted her to write  about it, so other people could benefit from their experience, and the book is an amazing and courageous act on Amy Bloom's part. Excellent, valuable book.
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Many thanks to NetGalley and Random House for gifting me this amazing memoir by Amy Bloom - 5 stars!

Amy started noticing changes in her husband, Brian, that became too hard to ignore.  When a diagnosis of early-onset Alzheimer's came, they were both devastated, but Brian was determined to exit life on his own terms.  Together, they made the decision to travel to Dignitas in Switzerland who facilitates assisted suicide.

No matter your feelings on assisted suicide, this is a beautifully written love story.  Unfortunately, all great love stories end in death - something none of us are comfortable thinking about.  Amy alternates chapters dealing with preparing for and their trip to Switzerland with their love story, family life and her grief.  It's a story she tells with humor, truth and compassion.  I couldn't put it down and my heart aches for all involved!
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In Love was a book that I could not put down once I started. I read until 2:30 am to finish it, something that I haven't done in a very long time. I knew how it ended, but the story was just too immersive to put down. Amy Bloom has written quite a few works of fiction, but this is a memoir of how she accompanied her husband Brian with his suicide after he is diagnosed with Alzheimer's disease. It's as gut-wrenching and heart-breaking as you might imagine, but it's also full of questions, love, humanity, and dignity. Amy Bloom has written a moving account of everything it takes to legally die with some dignity - at least $10,000, the ability to travel to Zurich, the ability to swallow, and someone to help you with the exacting process.

This book felt personal to me, but it will feel personal to each of us at some point in our lives. My father was ill for at least twelve years with multiple comorbidities - heart disease, kidney disease, Type II diabetes, bladder and prostate cancer, and depression. My sister and I were the ones charged with taking him to doctor appointments and rounds of daily radiation. I'm not sure he had any quality of life, and in fact, he said he "just wanted to die" many times during those twelve years. Towards the end, I used to rant that we treated our pets better than we treated fellow humans because we were sympathetic to our pet's pain and suffering but every one of my father's twelve doctors was on a mission to preserve his life no matter what the cost (human, emotional, and financial) was to the patient. In Love is the story of how Brian Ameche and Amy Bloom met, married, and their lives together until Brian made the decision that he didn't want to suffer through a long, painful decline and how Amy Bloom and an organization called Dignitas in Switzerland helped him carry this through, told with strength and love.

Thank you to Random House Publishing Group and NetGalley for providing me with a copy of this book.
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A story by a wonderful writer whose husband is dying of Alzheimer’s. Amy Bloom explores their relationship, Brian’s demise and their exploration of assisted suicide in Switzerland. There are some really difficult pages especially if you’ve lost someone close to you and I’m sure this book will raise a lot of controversy. It’s tough to rate this book and memoirs in general, but it’s somewhere in the 3.75/4 range for me. .
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This is a memoir about a topic that is not often talked about: accompanied suicide.  Amy's husband Brian, after being diagnosed with Alzheimer's, has decided that he wants to decide how and when he ends his life.  However, he puts Amy in charge of making all the arrangements, which is a position I cannot imagine being put in.  

Amy is incredibly understanding and respectful of Brian's decision.  I don't know what I would do in her position and cannot imagine having to make that kind of choice.  Her respect for and loyalty to Brian are commendable. 

The book really dives right in, not giving the reader any buildup or backstory (at least not initially).  Some chapters focused on the diagnosis and progression of Brian's disease while others focused on the process of getting approved for and carrying out the accompanied suicide.

One thing that really struck me was the lack of sentimentality during their final days together.  It seems that they lived their days as they normally would - and I have to imagine that was an intentional choice, but it still surprised me.  

I fully expected this book to break my heart and was prepared to be sobbing by the end.  However, I never reached that point.  I don't know if I just have a cold, dead heart, but something about the writing style didn't elicit a very emotional reaction in me.  To me, the writing was more clinical, factual, and not overly emotional.  

That all being said, what I do feel is that this book was honest and real.  While to me, Amy sometimes came across as cold and unaffected, it is absolutely clear and evident that she loved Brian deeply.  As I write this, it's just now hitting me that she didn't want this to be a book about her own grief and heartache. The focus of this book was Brian and his experience, his decisions, and the way she supported him through to the very end, which explains why she didn't dwell on her pain and heartache through the process of saying goodbye to her husband.  While for me, that meant that the book didn't elicit an overly emotional response, it doesn't take away from the book at all.  I'm still glad that I read it and learned their story.  I have never known anyone that went through something like that, and I think what was most surprising to me was Brian's steadfast commitment to his decision to go the route that he did.  He never once wavered or faltered in his decision - and I certainly can't say that I could do the same.

Thank you to NetGalley and Random House for the eArc of this book.
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This memoir tells the story of Amy Bloom and her husband Brian after his diagnosis of Early onset Alzheimer's disease.  Brian makes the decision to end his life before the Alzheimer's takes his choices away.  It is a straight forward telling of their love and the process that they need to do to have his final decision fulfilled.  As heartbreaking as a story it was - I found it beautiful and compelling. I will be encouraging many library patrons to read this compelling memoir.
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This is a beautifully written wrenching memoir of love and loss.  And grief.  And if it's hard to read- and it is-imagine how hard the decisions were for Amy and Brian.  Lovers who found each other later in life but still young, they find themselves gobsmacked when Brian is diagnosed with early onset Alzheimers. This is their love story of how they met, how they lived and how Brian died at the time of his choice with the assistance of Dignitas in Switzerland. Amy cries, a lot, as we all would when faced with knowing their future but she and Brian both have a sense of humor. Thanks to Netgalley for the ARC.  A terrific thoughtful and thought provoking read.
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Amy Bloom's In Love is incredible and heart-wrenching.  As her husband is diagnosed with Alzheimer's, they both make extremely difficult decisions about their future.  This book is raw and moving, highly recommend it.
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I have read every book by Amy Bloom. I have loved every book by Amy Bloom. In Love is heartbreaking,, devastating, yet I read on.because it is also mesmerizing. I  remain amazed by  this courageous story of  love and   loss. My condolences to the author. May Brian’s memory be for a blessing.
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So much love for this brave, compassionate book.

With candor and humor (how does she do it?!) Amy Bloom shares the experience of helping her husband Brian, diagnosed with early onset Alzheimer's, figure out a way to end his life with dignity. A book about taking control of one's life as things are seemingly heading out of control. 

It is also a deeply felt love story. 

This is a must read.   

Discussed on Episode 147 of the Book Cougars podcast.
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In Love will shred you internally. Bloom’s husband was diagnosed with early onset Alzheimer’s and chose not to let it wither him away. Bloom traces the hard decisions they made for Brian to end his life in Switzerland, where there are a couple of organizations for just such decisions.
Brian went out on his own terms. Alzheimer’s is a nefarious and very cruel disease, robbing its victims of their minds and leaving husks. 
Keep the tissues handy.
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Amy Bloom's beloved husband Brian Ameche has Alzheimer's and has decided to end his life with dignity before the disease robs him of all cognitive powers. Dignitas, the organization that will undertake this transformation,, is located in Zurich, Switzerland. But first Brian must undergo psychological interviews to verify that this is what he wants and he is capable of making this decision.  Bloom shares with us their powerful love story, a later-in-life relationship of two people from very different backgrounds who fall in love and share a wonderful life together until Brian falls ill. Heartwarming without being depressing.
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A moving, heartfelt, but courageously honest memoir about Amy Bloom’s lived experience, from her first realization that her beloved husband, Brian, was showing symptoms of early-onset Alzheimer’s through the devastating diagnosis and finally, his decision to choose assisted suicide through Dignitas, an organization in Zurich, Switzerland that empowers a person to end their own life with dignity and peace. She supported him throughout the process even as she jumped through legal red-tape and frustrating obstacles to make it happen, while occasionally succumbing to overwhelming grief at the thought of letting him go.   

This was a blisteringly moving account, brutal to read but so necessary in today’s world. It’s a love story of a woman who cared enough to let her partner die peacefully rather than force him to tolerate gradual deterioration and humiliation. You will find yourself wishing for a different outcome even though you know what is coming, you will find yourself crying as you imagine the scenario with your own loved ones, and you will thank whoever urged you to read this unforgettable and important book.

My thanks to NetGalley for letting me read an advanced reader copy of this memoir that releases coincidentally on the same day as my own debut, March 8, 2022.
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