Counting backwards

Kirshenbaum (Rabbits for Food) offers a deeply moving and playfully arch narrative of an artist dealing with her husband's mental and physical decline. A typical "internal weather report" for Addie, a middle-aged New Yorker, is "overcast with anxiety." Her husband, Leo, who runs a university medical research lab, begins showing signs of dementia in his early 50s. Addie tries to meet his changes with humor, as when he hallucinates Mahatma Gandhi outside their window ("Is he wearing anything more than a dhoti?" she says, adding, "You might want to bring him a coat"). At a low point, she calls a suicide hotline. She finds occasional relief by going out for drinks with a suave man named Z, whose departure for Europe angers her, and she mocks Z for calling Europe "the continent." After Leo is diagnosed with Lewy body dementia, Kirshenbaum sardonically outlines the disease's seven stages, showing how Addie's reaction to the news mirrors the various stages of grief, beginning with denial. The bulk of the story is delivered in Addie's crisp second-person narration and her interstitial journal entries, in which she remarks on Leo's transformation ("Asks if I want to go to Times Sq. to watch the ball drop* / *Stark raving mad question"). Kirshenbaum puts her lively wit to good use, tempering the sadness of her drawn-out depiction of Leo's deterioration and Addie's attempts to wrap her head around the ultimately lonely nature of existence. It's a tour de force. Agent: Joy Harris, Joy Harris Literary. (Mar.)

In Kirshenbaum's (An Almost Perfect Moment) latest, Leo is a professor at a prestigious university; his wife, Addie, is a collage artist. Their life, as a middle-aged, childless-by-choice couple in New York City, is fulfilling and peaceful, until Leo starts experiencing hallucinations. They start off as halos around streetlights and graduate to Gandhi stirring a pot of lentils. Leo consults ophthalmologists, neurologists, and other specialists, but none can pinpoint the cause of the visions. His symptoms and behavior worsen, until he finally gets a diagnosis of early-onset Lewy body dementia. When Leo stabs his nephew during a family visit, Addie must find a care home for Leo. This starts a long process of Addie struggling to find care for Leo and stay financially afloat while mourning a husband who is still physically present. In Kirshenbaum's raw novel about loss, caretaking, and love, biting humor is used to relate searing observations on marriage, art, friendship, and disease. VERDICT Kirshenbaum invites readers to consider who they are without their memories and how we make decisions about prolonging life. An important novel about dementia, highly recommended for all libraries.--Lynnanne Pearson