One Hundred Names for Love: A Memoir

by Diane Ackerman

No other writer can blend the science of the brain with the love of language like Diane Ackerman. In this extraordinary memoir, she opens a window into the experience of wordlessness—the language paralysis called aphasia. In narrating the recovery of her husband, Paul West, from a stroke that reduced his vast vocabulary to a single syllable, she evokes the joy and mystery of the brain’s ability to find and connect words. Deeply rewarding to readers of all kinds, Ackerman has given us a literary love story, accessible insight into the science and medicine of brain injury,
and invaluable spiritual sustenance in the face of life’s myriad physical sufferings.

Genres: Memoir, Nonfiction, Biography, Biography Memoir, Health, Language, Science

336 pages, Paperback

First published April 4, 2011

About the author

Diane Ackerman has been the finalist for the Pulitzer Prize for Nonfiction in addition to many other awards and recognitions for her work, which include the bestsellers The Zookeeper’s Wife and A Natural History of the Senses.

The Zookeeper’s Wife, a little known true story of WWII, became a New York Times bestseller, and received the Orion Book Award, which honored it as, "a groundbreaking work of nonfiction." A movie of The Zookeeper’s Wife, starring Jessica Chastain and Daniel Brühl, releases in theaters March 31st, 2017 from Focus Features.

She lives with her husband Paul West in Ithaca, New York.

Reviews

[Jenny Brown · Rating 3 out of 5]

Since my "day job" is being an expert in diabetes, the thing that got to me most about this book was the tragically poor medical advice the author followed, especially as she prides herself on doing medical research.

She lovingly feeds her husband a diet of sugar free, low fat, high carb foods which, unbeknownst to her, since she never tests her husband's blood sugar after meals, ensures the high blood sugars that worsen his neuropathy, heart disease and the likelihood of more strokes.

It's a shame her husband didn't visit a good endocrinologist back when he was first diagnosed with diabetes rather than the beloved family doctor whose diet and treatment advice shows that her training in diabetes was decades old and way out of date. For example, at one point the author mentions that she tests her husband's blood and injects long acting insulin if the reading is over 150 mg/dl. This would have been standard advice in 1995, but not 2005.

The key to controlling blood sugars safely is to cut carbohydrates out of meals, not fat. And "sugar free" foods are toxic, being as they are full of starch and Maltitol both of which raise blood sugar. If you are coping with diabetes please read the one page, very simple explanation of how to safely lower blood sugar you'll find at http://bloodsugar101.com/how.php .

Otherwise, the author's depiction of what her husband goes through and the way it affects his use of language is interesting, and may give hope and some ideas to others dealing with an aphasic loved one. At times the author's obsession with her idea of being a poet leads her into flights of purple prose that get as word salady as any production of her afflicted spouse, particularly early in the book. Skip those paragraphs and go on to the account of her husband's recovery, which form the latter half of the book, and you will get good insights into what can happen to language after a stroke and how you might be able to help someone coping with severe damage to the language areas of the brain.

[Rebecca · Rating 5 out of 5]

(Saddened to hear of the subject’s recent death via this NYT obituary.) I was hugely impressed with Ackerman’s story of her husband Paul’s stroke and subsequent loss of speech (aphasia). To a pair of eloquent writers, the loss of shared language seemed especially cruel. The book chronicles Paul’s remarkable recovery, from having only one spoken syllable (a Garp-like Mem-mem-mem) to – within four years (long past what many doctors would have called the golden window of opportunity) – publishing several novels and having essays printed in magazines again. His brain damage had been such that a neurologist said his scans were indicative of someone in a vegetative state.

Ackerman recreates Paul’s state of mind throughout his recovery, but also reveals the particular challenges of being a carer to a disabled spouse. I especially loved her thoughts on adjusting to her family’s ‘new normal’:

How tempting to live in limbo and wait for my real life to return. But this was my real life now. Life is a thing that mutates without warning, not always in enviable ways. All part of the improbable adventure of being alive.

The joy of this book is double: it’s not just a warming emotional story, but also an extraordinarily playful take on the language Diane and Paul could no longer take for granted. Ackerman’s every metaphor feels fresh; added to their inventive word play and bizarre pet names, plus Paul’s erudite academic vocabulary and the circumlocutions he used to get round his aphasia, these make for fascinating and inspiring reading.

[Carol · Rating 5 out of 5]

One Hundred Names for Love ~ Diane Ackerman, at it's heart is a love story. Though this was a book group selection, I had the book on my list after reading a review. The premise of using fun, loving names to help stimulate memory of a stroke victim intrigued me. I had thought that Diane used the names in speaking to her husband, Paul West, but the reverse was true. Diane challenged her husband to come up with a new, loving name for her each day. He had often used these names of endearment prior to his stroke so it seemed like a good way to spark his brain and encourage communication between them.

But I get ahead of myself. Paul West, in his mid-seventies suffered a severe stroke which left him aphasic. A man, whose life was filled with words and writing, this seemed an especially cruel fate. Diane, younger by eighteen years, is determined to help her husband regain his voice. Her story outlines their journey together to regain "Paul's voice".

This is almost like reading a journal as Diane documents daily happenings, frustrations, disappointments and triumphs through the five years the book covers. We learn how they met, he was her college professor, and much about their lives together, their dependence on the other, their love of language and the part it plays in their strong bond. Paul is a bit of an eccentric to say the least and these little human stories are what kept the book from dragging me down.

Some in my book group found the book depressing. I was not depressed. Don't get me wrong, I do fear how inevitable aging might throw my husband and I a curve. I worry if I could step up to the plate and
meet the challenges of caregiver as Diane had to do. Some in my book group felt Paul was able to make the progress he did due to their financial ability to hire aides who worked with him daily and gave Diane respite, allowing her to continue her own life. Though I think they were fortunate to have the means, I still think much of Paul's eventual recovery was due to determination on both their parts.

This is an inspirational book for caregivers, offering hope; a book for word lovers, a book for lovers. I found it fascinating, for its examination of the workings of the brain and the resiliency of the human spirit. I recommend it highly.

[Craig Dube · Rating 3 out of 5]

I'm a bit torn on my review of this book. On one hand, I found the author to be a very talented writer. Her choice of words and phrasing was unique and creative. At time abstract, I think she had some very descriptive ways of thinking of things.

I also found the subject matter very interesting. This book is really an account of dealing with her husband after he suffers a serious stroke that impairs him both physically and mentally (or more precisely verbally). Both the author and her husband are writers and have a strong love of words and language, so the verbal impairment really upsets her world greatly. The author gives a full sense of exactly how daunting her tasks at caregiving were and how hopeless and helpless she felt at times.

My issues with the book are two fold. First off, you learn very early that her husband recovers greatly. Although it takes years for him to reach that stage, it almost completely removes the tension she feels when the stroke first happens and she worries about what the future may hold.

Secondly, it feels like the book goes on a bit too long often repeating sections. Within each chapter, there is a restatement of how important words meant to both Diane, her husband Paul, and their relationship. While trying to make a point of emphasis, it feels repetitious and gets a bit dull.

Lastly there is a great deal of words within the book that are obscure and archaic; with the author making the point of how well-read and intelligent both her and her husband really are. While I'm impressed that anyone can have such a strong affection for words, at times it felt like a vocabulary test.

[Ilona · Rating 3 out of 5]

A fascinating story of one man's recovery from a devastating stroke, and the changed, but still full, life he lived thereafter, told through the eyes of his wife. In fact, there are two stories here, one the surface story (recovery from stroke) and the under-story, the relationship between husband and wife.

While the first story is miraculous and inspirational, the second is disturbing, and, ultimately, gripped me more than the first. The wife, Diane, claims (and apparently believes) that she has a close, nurturing and loving marriage to a wonderful, quirky, creative man. I started out quite willing to share that assumption. I wasn't far into the book when I decided that the husband (Paul) probably wasn't a very nice man, but, still, I reasoned, that didn't mean she couldn't be happy with him, and that he couldn't be loving and nurturing with her, no matter how difficult he might be with others.

A little bit further, and I decided that they'd probably be hard to take as a couple, smug and self-satisfied in their superiority. Their wordplay, though undeniably clever, was too often precious and over-wrought, though I suppose that as long as they didn't burst out with "my precious snugglebunny" in company, their intelligence and wealth of quirky knowledge would make conversation with them interesting and entertaining. But still, I was beginning to find Paul-and-Diane a bit tedious.

And then I came to this paragraph, a few chapters from the end:

Something I found especially odd, but also merciful, was that Paul's temperament had sweetened since the stroke. No longer dealing with the frustration of teaching of publishing, he wasn't waking up in a high blood pressure rage, or barely containing a volatile anger. When we met, he'd been a charming alcoholic with a violent temper.... I'd grown used to never knowing when Paul would explode... But he wasn't always combustible; most times he was quintessentially loving, a real sweetheart. The lurking land mine was part of a pattern: his unpredictable explosions, my fright and crying, our coming apart, his regret and promises, my forgiveness, our reunion. For year of our marriage, I'd walked on eggshells around him, because it took so little to trigger what he described as his "Irish temper".

So much for the doting, uxorious lover she'd pretended, to herself and to the reader, that he was. That pattern she cites is textbook abuse. Perhaps he never actually hit her, but if you have to "walk on eggshells" -- for years, no less -- you are in an abusive relationship. Much as she might like to believe it, he was no "real sweetheart".

An interesting book, not only for the information it gives on the miracle of the human brain and its incredible physical resilience, but also for the unintended display of the levels of self-protective reality-denying of which the human psyche is capable.

[Lynne Spreen · Rating 3 out of 5]

I had mixed reactions to the book. On one hand, how can anyone but root for Diane and Paul, and suffer along with them as they struggled through the horror of these circumstances? I felt happy as clarity surfaced in Paul's damaged brain, and wanted to give Diane a hug during the early days when she went through her caregiver role as a zombie.

Yet there were some difficulties in the book. At times, Diane overused metaphors in a way that obscured rather than clarified her points. Here's an example of overwriting, wherein she describes her mannerisms changing to accommodate Paul's limitations:

"I now seemed to quarry words, one by one, presenting them like bright bits of jasper—not slurred in a wash of flurried adjectives—when I spoke to Paul. Sometimes with a flutter of agitated worry that felt like a beetle was trapped inside my ribs. But I savored the delicious warm touch-ribbons of silent affection, uniting and comforting us, even when words failed. And I followed the stew of sympathy from friends, whose faces flickered with unrefined sorrow-compassion-pity."

Also, I was disappointed that Diane, while knocked back by the overwhelming load of caregiving, adapts to it somehow, yet she declines to explain those successful strategies. What a great service that would have been. Here's an example of what most of us either have gone through or will in the future:

"My body also felt derelict and unlived in. Every little thing, no matter how small—putting on makeup, changing my clothes, washing my hair—seemed to add boulders to an already unbearable weight. I felt as if a spare particle would make me collapse. I kept forgetting to eat, and, anyway, the refrigerator was bare because I hadn’t the energy to shop." Like many people, I've been there. What did she do about it? How did she handle it? Not said.

And: "...caregiving had its hopes and charms, but on the downside, this meant that every hour was interruptible. My days no longer contained adjoining hours in which to work. Yet I had a new book to write...So while Paul was straining mentally to reclaim language, I was straining to learn the peculiar skill of concentrating on my work in attention gulps...while keeping one ear open for signs of discord or trouble." Again, I know that feeling of interruption, and the frustration that makes one want to throw everything in the trash and say the hell with it, I'll just give up being a person and dedicate my life to caring for you. Diane struggled with this, but she doesn't say how she surmounts it.

She also reveals in small bits that she's married a man who is quite a bit older than her, who was in the past given to alcoholic rages and verbal abuse. The distribution of power in this relationship is striking. I say this realizing I'm commenting on the apparent nature of their relationship, which is none of my business and not the point of the book. Still, it's like an unacknowledged third
protagonist.

In summary, Diane Ackerman has done a good job of describing one stroke, one man, and one dedicated wife. The potential for teaching others how to deal with a similar situation remains unrealized, regrettably.

[Bev · Rating 3 out of 5]

After reading Ackerman's book, A Natural History of the Senses, I found that I didn't like this book so much. All that I loved in A Natural History (i.e. rich detail, flowing descriptions, a sort of movement within the pages), I found One Hundred Names way over the top. As a matter of fact, I didn't even finish it - it was too sweet, too flowery, too many words, words, words.

[Melanie · Rating 5 out of 5]

This is a stunning account of how Diane Ackerman and her husband, novelist Paul West, dealt with the devastating stroke that left him aphasic. For two people who had loved, lived, breathed, snacked, and feasted on words in their long marriage, aphasia was the worst possible condition that could befall a person. With love, patience, imagination, more patience, and sheer faith in the human brain's ability to continue to forge new connections way beyond what current medicine believes, they overcame the worst of the calamity. West, no longer aphasic, describes in vivid terms what he experienced in a mind suddenly chaotic. Ackerman, her love never wavering and her scientific research never waning, describes the process she and countless helpers devised to enable West to re-animate his inner and spoken language. This book's rating on the Sheer Joy Scale: Incalculable.

[Nannie Bittinger · Rating 5 out of 5]

An amazing love story with so much knowledge and information as well. Very readable and often poetic and lyrical phrasing. Ackerman and her husband are wonderful wordsmiths. Highly recommend it for anyone. The first few chapters were really the hardest for me...Ackerman is able to convey her fear, confusion, and aloneness so well that it is painful to read. As the story continues however, it becomes such a journey of discovery in so many ways for everyone in the story as well as for the reader.

[Cris Gómez · Rating 4 out of 5]

3.5⭐️
Creo que es de los libros más preciosos que he leído en mucho tiempo y está maravillosamente escrito. Pero ha sido precioso como ir a hablar con tu bisabuela de 98 años que para contarte una sola historia pierde el hilo 130 veces y aunque disfrutas y sabes que vas a recordar el momento con ternura toda tu vida, en ese momento acabas un poco desesperado y pensando en que has quedado con tu amigo para ir a jugar al tenis y no sabes si con tanto rollo vas a llegar.
Desde el punto de vista humano y romántico es precioso, y como historia de superación tanto como enfermo, como cuidador cuenta una historia absolutamente épica que no voy a disfrutar.
Lo dicho, me ha gustado, pero no se si la prosa de los poetas es para mi por norma general. En resumen, libro muy recomendable si no te importa que con tanto afán poético la tia se vaya por las ramas cada 2 segundos.

[Nancy · Rating 3 out of 5]

If I had been in the middle of a crisis with a loved one suffering a stroke, I might have found this book very worthwhile, because if would have offered encouragement and talked about one couple's experience of a devastating stroke in the husband. It even offered information about methods of helping people recover from strokes that might have been helpful to me and/or the stroke victim's doctors.

As a piece of writing, I found this book a mess. I was bothered by the author's frequent use of metaphors and similes that seemed out of place. For example, she talked of walking down the hospital corridor in a state of crisis while waiting for results of tests on her husband. In her description of the corridor, not as a statement of what she was thinking at the time, she described the physics of the fluorescent lamps that lit the corridor, using a metaphor. I wondered at times if she repeatedly did such things because she wanted to be recognized as someone who understood science and/or was a poet rather than because it served a purpose in the story. She also repeated many stories or ideas. I got very tired of hearing how wonderful her relationship with her husband was before the stroke. Again, I felt her need to impress the reader.

That all said, I didn't stop reading the book. The story kept me engaged: How far would her husband come in his recovery? How was her life impacted in the long run? How did she manage? The information about stroke recovery and possible medical treatments that she suggested seemed important. Her example of suggesting ideas to her husband's doctors based on her research may encourage others to do research and be assertive with the medical establishment. Her observations about how poor standard treatments of post-stroke aphasia can be, may empower others to try to develop techniques based on decades of knowing the stroke victim and keyed to the victim's interests and needs.

If it were possible in this system, I would probably have given the book a 2+. I don't particularly recommend it unless you are dealing with a partner's stroke.

[Wren · Rating 5 out of 5]

A celebration of language, artists and love! A detailed account of the loss, grief and then restructuring of two complexly intertwined lives.

Ackerman builds an ornate bridge between the humanities and the applied sciences when she describes the struggles that she and her husband faced in the wake of his stroke. Paul lost his ability to speak (aphasia), except for the single nonsense phrase "mem." Ackerman uses her gifts as naturalist and poet to describe in rich, lyrical detail the effects this had on Paul, on her and on their marriage. Over the course of years, Paul and Diane found new ways of being, new ways to communicate and new ways to heal. As highly verbal and creative people, Paul and Diane recoiled from the conventional therapies, which relied too much on cliches and common-place language use. They had to devise forms of speech therapy tailored to Paul's interests and abilities. He beat the odds, largely due to their drive, their language-saturated home life, and their innovations.

Ackerman is very forthcoming about the challenges caregivers face as well. Like Paul, Diane suffers these trials in ways unique to her as an author. She never raised children, so plunging into caretaking really rattled her sense of self and threatened her work as a writer. Thus, she had to find a way to balance her marriage and her writing vocation.

Ackerman writes with such excesses: every paragraph is packed with images, some of them contrasting to the point of becoming mixed metaphors. She writes like a woman wearing too much make up and jewelry. But somehow I don't mind because she is brilliant in marrying concrete images to imaginative concepts. I actually met her at a book reading years ago in an indpendent bookstore in Milkwaukee; she's very charismatic. However, this is the first I've read her writing. I have a few other books on my nightstand right now, but I'll probably be adding some of her other titles soon.

[Karen Charbonneau · Rating 5 out of 5]

This is the story of a successful May-September marriage in its later, very difficult, years, after Paul West, novelist, and the husband of author, Diane Ackerman, has a stroke in his mid-70s, losing his ability to speak, understand words, read, identify objects - and yet is still a thinking person. And at his advanced age, under the care of his wife, he slowly recovers some of these abilities, enough so that he can again write and communicate verbally. You must accept this couple for what they are, a highly gifted man and woman whose love for each other is connected by language, so that life together without words would be more than tragedy. Ackerman simply won't allow her old husband to molder away in silence. Intensive therapy ensues, and then therapy devised by Ackerman, because she really does understand her husband's anguish and his needs. It is an amazing story and, yes, she was able to pay to have a clever nurse not only give medical care, but the type of constant verbal stimulation Paul West needed for his brain to build new pathways. And yes, sometimes she felt trapped and unhappy and yearned to lose herself in her own writing (and managed to complete The Zookeeper's Wife during this period),but she stuck it out, as did he. Her writing is beautiful, humorous, and gives hope. Life isn't necessarily over when one has a stroke. Highly recommended.

[Charlene · Rating 5 out of 5]

Diane Ackerman writes beautifully -- I've read many of her books and enjoyed them, particularly A Natural History of the Senses and Cultivating Delight. But this book is special to me personally . . .my school teacher mother, at age 85, had a devastating left brain stroke that seems very similar to the one suffered by Ackerman's husband, novelist and former professor of literature, Paul West. How I wish this book had existed when I was attempting to help my mother with her loss of language. Paul West is now 6 years past his stroke, having regained at least some of his language abilities. So much seemed familar, so much I could relate to.
But personal experience with aphasia isn't necessary to appreciate this book. It is a story about the brain, language, Diane and Paul's thoughts about life without language, Diane's adjustment to the role of caregiver. Diane's ideas range widely -- about the structure of the brain, its ability to change and grow even in late life, its variability among individuals and about the role of language in "self" or consciousness. She writes with the best skills of a literary author on fascinating and meaningful subjects.

[Bea · Rating 3 out of 5]

Well, I didn't learn very much since I've been through this with my own husband, but he was only 57 when he had his stroke and the man in the book is around 70, if I remember correctly. It might be a good book for someone who is just starting to go through this, though, because you can see that recovery continues on years after the stroke. My husband's stroke was 8 years ago, and he is still making progress. I, like the author, was fortunate enough to have the time to spend (at least just being there constantly in the beginning) helping him learn to walk and talk again. Our doctor told us that whatever he could do by six month's after the stroke is what he will be left with the rest of his life, and it certainly wasn't true in our case. He looks and acts normal and, except for his afternoon fatigue and naps, does just about everything he did before, just not as fast or as much. Knowing this would have lessened the panic, given us more hope for the future and made the whole thing a little easier.

[Antonia · Rating 5 out of 5]

Fascinating. I'll return to reread and copy out some of the beautiful passages. The story is beautifully told. That said, it was perhaps a little repetitive at times. And a bit too heavy on the adjectives, though not as excessive as some of her Ackerman's writing.

As one reviewer (at Amazon) put it, "Ackerman at times seemed to be trapped in a thesaurus. Thus, such off-putting sentences as, 'Yet somehow his brain slowly spelunked for his literary self, and found the rappel of sentences, the traverse of paragraphs, the slingshot of grammar, how clauses might be felicitously rigged.'"

And I'm astonished that such a word maven as Ackerman would write "wreck havoc" -- twice! She also misspelled zyzzyva (as zyzzva) when she was using it as an example! No proofreader? Most writers and people fascinated with language know the word zyzzyva, because it's such a delightful and unusual word, not to mention its being the last word in the dictionary (though that may depend on your dictionary).

[MacDuff · Rating 3 out of 5]

What a beautifully boring book.

Ackerman can write, there's no doubt in that. But to what lengths she goes to push herself as a writer (nay, a poet) gets a little chalky. She can never tell you what's specifically happening; she has to explain it in befuddling terms of her personal perspective. "The swish of pant legs down the hall reminded me of whales breathing."

Every sentence is like that. You either love it or you don't. I guess I didn't. It's obvious that she and her husband love each other deeply, but after a while you stop seeing their relationship as a great love affair and instead as an obtuse, weird couple who probably don't get invited to many dinner parties.

[Kim · Rating 3 out of 5]

Book could have been 1/3 shorter with all the fluff added in the lists the author included throughout the book. Read as if she had written the book and then used a thesaurus on every word in the book. Interesting story but not a fan of the writing.

[MBG · Rating 4 out of 5]

Self read March 2020. Sensitive and interesting. Amazing recovery from stroke. Huge colorful and deliciously creative words and images. You can see the depth of this literary world. Some redundancy of story, long slow recovery. DA shows depth of what recovery was in her life.

[Lannie · Rating 5 out of 5]

This is one of my favorite reads of all time. It’s rare to be able to be fully immersed in a book, to wade and swim in the story as I pleased. The author changed the way I viewed nonfiction and brought about my love for memoirs, especially those that intersect two seemingly different realms, and particularly when two passions of mine are at that intersection.

This book is a treat for those who are fascinated by science, and language. For those that love love, and suffer when others suffer. This book was everything I could want in a book. The author balanced the sound science with the relatable real life so seamlessly that it was just a joy to read through her and her husband’s journey, both from a medical standpoint and from a human, emotional standpoint.

If I were a book, this would be it. I hope everyone finds a book they love and that resonates with as much as this book did for me.

[Emily Enos · Rating 5 out of 5]

This was by far the most well-written personal account from the spouse of a stroke survivor suffering from global aphasia and the techniques and optimism she utilized to challenge his language recovery and neuroplasticity. Must read for all SLPs and caregivers

[Lulu · Rating 5 out of 5]

Beautiful.

[Sharon · Rating 4 out of 5]

A personal primer on a caregiver’s role in helping a loved one with the challenges of dealing with a stroke. I must admit I did skim through some of the more complex word dense paragraphs as the author is considerably more literate than I am, however this would be an excellent book for anyone with a loved one dealing with the challenges of a stroke.

[Holly · Rating 3 out of 5]

Ackerman fascinatingly depicts how her own brain is working in the aftermath of her husband's stroke: I'd already noticed how my own voice had changed: losing some of its sharp peaks and bounce, and gaining firm new ridges. My phrases were smaller, slower; my rhythms thick and clumsy, not light and dancing. I now seemed to quarry words, one by one, presenting them like bright bits of jasper -- not slurred in a wash of flurried adjectives -- when I spoke to Paul.[p89-90] This masquerade [of being hopeful, positive, supportive when with Paul] meant splitting my personas between hospital and home, leaving despair outside his room and sharing it only with friends and doctors. Yet I found myself shutting down and drifting on autopilot, losing resiliency in my voice and animation from my face, as my brain tried to spare me unbearable pain by making it less thinkable. [...as a caregiver ...] one needs to become the mental equivalent of aerodynamic, create as little drag as possible and strip down to essentials. [p111]

Their relationship, while extremely intimate, isn't really something I wish for myself: their way of talking to each other in private, sappy endearments is how I speak to pets. But I didn't feel that Diane Ackerman was suggesting it for her readers, anyway. And Paul West sounded like a difficult person to live with before the stroke: waking up with a high blood pressure rage, or barely containing a volatile fury ... a charming alcoholic with a violent temper ... his unpredictable explosions, my fright and crying ... for years of their marriage she'd walked on eggshells around him. [p212]. I think this sounds awful. (Will not live that way again.)

Knowing that a loved one's reveries enfold you can feel reassuring. Even if they're not thinking about you at a particular moment, you still exist in their mind. [p222] This idea made me think of my mother's death.

Laughed when Ackerman nonchalantly remarked that Paul began to place some essays and fiction he'd written since the stroke in Harper's, The American Scholar, Conjunctions, The Yale Review, and a few other literary magazines.

These two paragraphs near the end of the book were quite lovely (the first from the end of the narrative-proper, then second from the end of the postscript) -- although as I just typed them I realized they are somewhat repetitive, redundant; overwritten but still rather nice. Regarding life's unexpected changes and phases: Be fully awake for it, I tell myself, pay attention to all of its feeling and sensations, because this is simply another facet of being alive, of life on earth, and then there will be another era when Paul will be gone and you won't have these responsibilities and worries. ....When Paul is gone, the trees and sky will still be beautiful, I will still be poignantly aware of life's transience, and how lucky I am to be alive on this planet in space. It's all part of the adventure. I will still cherish being alive, even though I will miss him fiercely. [p302] Mind you, life will never be what it feels like at this moment either, because it's a whirligig flux all day long, as trillions of sensations bombard the brain, millions of ideas and feelings haunt the corridors of the mind. Less like a single tapestry, and more like spindrift spray blown by impetuous winds along the surface of the sea. All of those dramas adhere to the self, a quixotic animal that never stops revising and reimagining who it is, while changing second by second, as new sensations winkle in, new events challenge, new thoughts and feelings well up. Our lives together, our duet, also continues to evolve, and even if we can't go back to how it was, we're designed a good life for us, in spite of everything. [p310]

[DeeRae · Rating 2 out of 5]

I had mixed feelings on this book.

As a speech-language pathologist/medical professional working in the skilled nursing facility setting, I found parts of the book fascinating. Many descriptions seemed spot on and were told in layman's terms to help spread awareness of stroke, the associated deficits, as well as a myriad of other medical conditions. I actually have recommended some families check it out as a part of the education/grief process.

While Ackerman does a great job in some areas, I found some parts of her writing excessively flowery, abstract and likely lost on the average reader. At times I wondered if she wrote in such a way just to be fancy & for the sake of using big words, not because they actually fit. As an SLP, sometimes I look for message success, & with her style of writing, I felt like many times message success was lost. For example, I had a very high functioning stroke patient who would have loved to read this book and learn that others have gone through something similar; however, most of it would have been lost on her.

I'm going to add a disclaimer here in that I have not researched Paul's case at all or his writings post-stroke. However, based on professional experience, we often can see families significantly overestimate a loved one's abilities. Several times while reading this book I wondered if that were the case. Just a thought, maybe not as it's clear Ackerman & her team put extensive time into Paul's care & rehabilitation and that he had significant verbal skills prior to his stroke.

It was also hard to gauge her view on SLPs. It's clear she advocates a person-centered approach to rehab, which I hope we all strive to provide. She seemed to come down on the fact that they targeted everyday language and didn't address Paul's artistic side which defined him. While I agree, that was the part of him that defined his sense of "self", basic vocabulary is crucial for functioning in society.

Finally, I found the whole 3 voices thing strange. I'm not going to pass judgment as research & undestanding of the brain is often years behind. I just know that research & reading/learning about medical conditions (Diane Ackerman's preparation) is often vastly different that experiencing them daily.

[Diane Yannick · Rating 4 out of 5]

Lucky for us, the author was already a poet, essayist, novelist and naturalist before her husband suffered a debilitating stroke. Thus she could capture the nuances of rebuilding a life for both of them. Paul West, her husband, was also a writer and researcher. Never had I encountered a relationship so word centered---humorous, intellectual word play, esoteric research, creative juxtaposition of poetic elements, a myriad of personal endearments. When his language was severely compromised, he fought hard to communicate and navigate his new world.. Plowing through his many frustrations by his side,Diane carefully studies and records Paul's progress as an aphasic. (It is here where the story sometimes bogged down for me as her fascination with his use of unlikely word combinations and his word retrieval process was analyzed in great detail.) You also gain insights into the toll constant caregiving takes on the younger, healthier spouse.

Many passages made me stop and think about the inner workings of the brain in its quest to make sense of the world. Expressing himself creatively was essential to Paul's will to live. Finding his sense of humor and finding a routine he could count on also helped him to heal. Since suffering a mild brain injury, I know just a little about how frustrating and exhausting it is to search for the right words and compensate for memory lapses.

A few take aways for me:

"A bell with a crack in it may not ring as clearly, but it can ring as sweetly."

"Couples are jigsaw puzzles that hang ogether by touching in just enough points."

"Typically prescribed for depression, one of Zoloft's seldom-mentioned benefits is that it spurs the growth of new brain cell connections in the hippocampus, a rich site for processing memories, including the memory of words learned."

"There is a way of be holding nature which is a form of prayer, a way of minding something with such clarity and aliveness that the rest of the world recedes. It quiets the bitter almonds of the limbic system, and gives the brain a small vacation"

[Robin · Rating 5 out of 5]

The following review is from the fabulous 90-year old Elinor:

" Thanks you again for loaning your advance copy
of Diane Ackerman's book. As you know, I had a Stroke with Aphasia on May 1, 2010 so I was interested in comparing the author's husband' Pau''s recovery with my own.
I also was interested with all the details she
researched and included. This book is a valuable
guide for caregivers to care for patients of all chronic
diseases, not just stroke. The book's title is "One
Hundred Name For Love." The names were pet
names for Diane made up by her husband Paul.
Such names as "my little spice owl," "Celestial Elf"
and dozens more terms of endearment,
Diane returned his love by participating fully
in his care. When speech therapy was started
and he spoke words the therapists didn't understand,
Diane recognized them as real words from his
scientific studies, from literature or foreign language phrases. A doctor looking a brain scan
with a large dead patch in the frontal lobe from a previous stroke could hardly believe Paul had written several books since then.
Though his vocabulary was only "mem, mem, mem"
he learned to say "home" and "pool" as he longed to
leave the hospital.
Five years after his stroke he has built his
vocabulary and his speaking continues to improve.
He writes and revises by hand and an assistant
types his manuscripts to be published.
The book is fascinating for people that have
Aphasia like me, and to those with other conditons,
and their caregivers, as an inspiration to keep trying."

[Susan · Rating 3 out of 5]

When a neurologist looked at a brain scan of Diane Ackerman's husband, years after he suffered a stroke, the doctor opined that he must be in a vegetative state. But this is the story of how Paul West, a novelist and writer, was able to recover much of his ability to write and speak, so that he continues to write and publish, and how his improvement continues 5 years afterward although he continues to have some aphasia and other problems resulting from the stroke. It is also the story of how his wife Diane, a writer and poet herself, improvised strategies for helping him and coped with the changes in her life. There is a balance between the personal story that she tells and the science she presents, including factors that may partly explain why her husband retained so much of his linguistic ability. "...all a testament to how a brain can repair itself and how a duet between two lovers can endure hardship. This is what we have made of a diminished thing. A bell with a crack in it may not ring as clearly, but it can ring as sweetly."

[Shirley Brosius · Rating 5 out of 5]

If you enjoy words and language, this is the book for you. Written by the wife of a man, an intellectual professor and novelist, who suffered a stroke, it tells the tale of his voyage to the depth of confusion—and a good bit of the way back. But it’s far more than a chronicle of the loss of health. The author shows the playful relationship, built on pet names and word plays, that the two enjoyed, and how, to their delight, they regained much of it. “A bell with a crack in it may not ring as clearly, but it can ring as sweetly,” she writes.

Most if not all of us know someone who suffered a stroke. The book is worth the read just to glean insights that may help such an individual—if someone is willing to invest the time and effort required. Keep your dictionary handy as you read, for as the professor regains his speech, he uses uncommon words, sometimes in an uncommon way. Both the author and the patient have a terrific sense of humor, which adds to the book’s appeal.

[Natalie · Rating 5 out of 5]

One of the best books I read in summer 2011. Recommend to those who are interested in neurology as well as to those who love writing and words. Part memoir of Ackerman's writerly, intellectual, beautifully quirky marriage, part an account of her husband's stroke and recovery. Inspiring in her commitment to working with whatever language he could manage -- and her recognition that typical rehab exercises and verbal tests might not be so appropriate to poets or novelists used to enjoying surrealist combinations of words and those who have extraordinarily large vocabularies. What nurses thought were nonsense words were often, it turns out, archaic words that Paul's brain managed to come up with, entirely appropriate to the situation, but just not the typical words most people would use. Fascinating, moving, very compelling book.