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Counting Backwards
A married couple deals with the husband’s decline from Lewy body dementia in a profound and deeply moving novel shot through with Kirshenbaum's lacerating humor.
It begins with of a man on stilts, an acting troupe, Ghandi. At first, these seem benign, almost comical, and are likely connected with an ocular issue. It’s something he and his wife can make jokes about. But soon he starts to experience other cognitive symptoms, memory problems, disorientation. He’s a scientist, an auto-immune researcher, and still middle aged. Too young for Alzheimers. She is a moderately successful college artist. They live together with a cat — a pleasant, quiet New York City marriage. Then he receives the diagnosis of Lewy Body Disease, and its march of aphasia, difficulty with simple tasks, losses of lucidity.
He has a life expectancy of 3 to 8 years. There are moves as his care becomes more difficult, or he lapses into periodic and uncharacteristic acts of from Leo and his wife’s apartment, to his sister’s house, then an assisted living, then another assisted living, then hospice. Health aides, a continual outflow of money. His wife does what she can, but is able to do so much less than she wants. Watching him die — too fast, and yet not fast enough.
Kirshenbaum captures the couple’s final years and months together in short scenes that burn with anger, humor, love, and pain. With no sentimentalizing whatsoever, she tracks the brutal destruction of the disease, as well as the small moments of beauty and happiness that still exist for them amidst the larger tides of loss.
It begins with of a man on stilts, an acting troupe, Ghandi. At first, these seem benign, almost comical, and are likely connected with an ocular issue. It’s something he and his wife can make jokes about. But soon he starts to experience other cognitive symptoms, memory problems, disorientation. He’s a scientist, an auto-immune researcher, and still middle aged. Too young for Alzheimers. She is a moderately successful college artist. They live together with a cat — a pleasant, quiet New York City marriage. Then he receives the diagnosis of Lewy Body Disease, and its march of aphasia, difficulty with simple tasks, losses of lucidity.
He has a life expectancy of 3 to 8 years. There are moves as his care becomes more difficult, or he lapses into periodic and uncharacteristic acts of from Leo and his wife’s apartment, to his sister’s house, then an assisted living, then another assisted living, then hospice. Health aides, a continual outflow of money. His wife does what she can, but is able to do so much less than she wants. Watching him die — too fast, and yet not fast enough.
Kirshenbaum captures the couple’s final years and months together in short scenes that burn with anger, humor, love, and pain. With no sentimentalizing whatsoever, she tracks the brutal destruction of the disease, as well as the small moments of beauty and happiness that still exist for them amidst the larger tides of loss.
393 pages, Kindle Edition
First published March 25, 2025
150 people are currently reading
12615 people want to read
About the author
Binnie Kirshenbaum
21 books151 followersBinnie Kirshenbaum is the author of two short story collections, six novels, and numerous essays and reviews. Her work is noted for its humorous and ribald prose, which often disguises themes of human loneliness and the yearning for connection. Her heroines are usually urban, very smart, and chastened by lifetimes of unwelcome surprises. Kirshenbaum has been published in German, French, Hebrew, Turkish, and several other languages.
Kirshenbaum grew up in New York and attended Columbia University and Brooklyn College. She is the chair of the Writing Division of the Columbia University Graduate School of the Arts, where she has served as a professor of fiction for more than a decade.
Called, “a humorist, even a comedian, a sort of stand-up tragic,” by Richard Howard, Kirshenbaum has twice won Critics’ Choice Awards and was selected as one of the Best Young American Novelists by Granta Magazine. Kirshenbaum was also a nominee for The National Jewish Book Award for her novel Hester Among the Ruins. Her new novel, The Scenic Route, was published in May, 2009. Of the novel, Gary Steyngart says, “The Scenic Route is warm, wise, and very difficult to put down."
Binnie Kirshenbaum lives and works in New York City.
Binnie Kirshenbaum was born in Yonkers and grew up in Westchester County. After attending Columbia University as an undergraduate, Kirshenbaum earned her MFA at Brooklyn College. She taught at Wagner College before joining the faculty at the Writing Division of Columbia University's School of the Arts.
Kirshenbaum grew up in New York and attended Columbia University and Brooklyn College. She is the chair of the Writing Division of the Columbia University Graduate School of the Arts, where she has served as a professor of fiction for more than a decade.
Called, “a humorist, even a comedian, a sort of stand-up tragic,” by Richard Howard, Kirshenbaum has twice won Critics’ Choice Awards and was selected as one of the Best Young American Novelists by Granta Magazine. Kirshenbaum was also a nominee for The National Jewish Book Award for her novel Hester Among the Ruins. Her new novel, The Scenic Route, was published in May, 2009. Of the novel, Gary Steyngart says, “The Scenic Route is warm, wise, and very difficult to put down."
Binnie Kirshenbaum lives and works in New York City.
Binnie Kirshenbaum was born in Yonkers and grew up in Westchester County. After attending Columbia University as an undergraduate, Kirshenbaum earned her MFA at Brooklyn College. She taught at Wagner College before joining the faculty at the Writing Division of Columbia University's School of the Arts.
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Displaying 1 - 30 of 179 reviews
June 14, 2025
oof. this was a painful read especially bc it reminded me so much of my dad when he was diagnosed w brain cancer. beautiful and harrowing all at once
August 14, 2025
Addie and Leo are a middle-aged couple living in New York when Leo develops hallucinations which ultimately are diagnosed as Lewy body dementia. Addie, the narrator, struggles with the reality of caring for someone she loves as Leo slowly disappears to the point where he has to be fed, clothed, and bedridden.
This was an intimate portrayal of grief that begins even before death. The novel explores the hardships of caregiving, the strain on their relationship and decisions about prolonging life. Addie even wrestles with her decision of whether or not to take her husband off life support even as she wishes him to die.
It was a believable, unflinching and emotionally compelling novel.
This was an intimate portrayal of grief that begins even before death. The novel explores the hardships of caregiving, the strain on their relationship and decisions about prolonging life. Addie even wrestles with her decision of whether or not to take her husband off life support even as she wishes him to die.
It was a believable, unflinching and emotionally compelling novel.
March 13, 2026
I thought long and hard on how to rate this novel. What I eventually ended up with was the longest review I've ever written, and a rating of a single star. Although it has a bunch of redeeming qualities, which I will address below, I ultimately reserve my 1-star reviews for books that I feel are potentially harmful or downright piss me off. Both applied here.
Before we get into the Good-Bad-and-Ugly-style disection, I want to address two points:
First: I am NOT attacking the author, or her personal experiences around this subject-matter. My review is about the book, not the individual.
Second: I’ve seen people be proper vile in the comments of critical reviews on this book – more so than usual -, or attempt to silence these reviewers based on “you don’t know what you’re talking about”. So let me state my (unfortunate) credentials on the subject, to nip those comments in the bud.
- 7 years of caregiving for my mother, until her passing of a terminal neurodegenerative illness.
- another round of palliative caregiving for my foster-mother a few years down the line
- I work professionally in (primarily) oncology and palliative care in the Netherlands. That final point becomes relevant in The Bad section.
I feel so passionate about this book because I do personally care and feel for this topic. That’s why I am expressing my opinion; to show a different inside-insight that might be helpful to others.
The Good:
I desperately wanted to love this book. Representation of neurodegenerative illness (specifically the rarer ones like Lewy Body dementia) from an own-voice patient- and caregiver-perspective is unfortunately far to rare in literature. Understandably so, because this is a hard topic to speak of, let alone write about. I want to commend the author for doing it anyway and providing many readers with a story that they found recognition or even comfort in.
Although she mentions in multiple reviews that this book is not autobiographical, her experiences of losing her husband to Lewy Body dementia put an undeniable layer of authenticity into the story.
The power is in the smallest moments here. The every-day losses of a trivial task no longer being possible, a once-shared memory suddenly being yours alone, or that flash of realization that – in that moment - the person you once loved more than anything is suddenly unrecognizable to you (and vice versa). These small moments may seem featherlight on a day-to-day basis, until their cumulative weight sneaks up to you in crushing heartbreak. Kirshenbaum understands that, and portrays it in an understated manner, befitting of the experience.
I also really appreciate the choice of second person narrative for this story. This again, is not an easy choice, but it puts you as the reader straight into the shoes of our protagonist and forces you to engage in the question: what if this was me?
The ending paragraph ties the choice of second-person narrative into a neat bow, hitting me with a sudden rush of sadness when I realized what it was doing.
The Bad (dislikes from a factual and professional point):
Because representation of this topic is so rare, your voice is going to ring extra-loud once you dó speak up. Any one-sided- or factually incorrect information is amplified as a result too. Here’s where I have a problem with this book.
1. There are factual inaccuracies in the story. Some of them are small, like the nurses being the ones prescribing medication to Leo, without a doctor ever being present or signing off on it. (Nurses cannot legally prescribe medication, this is a task reserved for doctors). Some of them are bigger, like the portrayal of the doctors wait-and-see-policy as being “negligence” and his final diagnosis of LBD being made by a mental-health professional.
When Leo first presents with symptoms, he sees a neurologist for an MRI. This neurologist sends him home without a definitive diagnosis and recommends him a re-scan 6 months later. This is presented as him dismissing Leo’s concerns and being negligent and incompetent. In truth, this is medically the correct policy when suspecting LBD. Part of the diagnostic process is the progression of symptoms and scans in time. This time is necessary to rule out other illnesses that can mimic LBD, and diagnosing a patient with a terminal neurodegenerative illness without a cure based on 1 consult, is premature and potentially harmful.
This book presents the neurologists careful consideration of a serious diagnosis as “lazy/tardy caregiving” and dismissal. This is a far too prevalent misunderstanding in medicine already, and its perpetuation is harmful. A speedy but wrongful diagnosis can be far more harmful than a correct and thorough diagnosis with 6 months later.
Not to mention that the final diagnosis is made by a mental-health professional, who hasn’t seen Leo himself and only goes off his wife’s story. This is irresponsible and incorrect in so many ways, and I can’t believe how this made it past editing.
2. In line with point 1, all doctors and professional caregivers/aids are portrayed as one-dimensionally incompetent, uncaring and useless. This is literally stated by Larissa on page, and isn’t challenged by a single instance. Again: such a one-sided portrayal of an entire profession is harmful to both the profession ánd potential readers who might distrust professional care because of it.
The caregiving that ís praised to high heavens in the book, ironically is far more questionable. I had a huge issue with the portrayal of Larissa. The (professional/personal??) relationship she has as Leo’s full-time aid is very codependent and the dynamic between her and our protagonist borders on abusive. Larissa – a person of color, with a family she’s supporting aboard - is clearly being underpaid, and has literally 0 time off. In addition, she dismisses all other caregivers as useless and actually puts Leo in danger by sending them away or ignoring their policies. At one point, she takes Leo off his prescribes medication, because “she feels it’s not right for him”. As a professional aid without medical training, you cannot do this. Patients can be seriously harmed and professionals (deservedly) lose their jobs over behaviour like this! None of this is ever called out in the book.
3. Then there is the entirety of Chapter 11 titled Mixed Messages, which almost made me throw the book across the room. In this chapter, out protagonist contemplates how “civilized countries like The Netherlands and Canada just euthanize people like Leo”. She even likens it to “medical tourism” regarding plastic surgery in Argentina and Mexico, and how these countries promote this, because its good for business.
As a Dutch physician, I cannot even begin to explain how dismissing, disrespectful and filled with misinformation this entire chapter is. First off, I’m not blaming the character for thinking these thoughts. In fact; I commend the author for putting them to paper, as I feel many caregivers will encounter them at some point in their journey.
However, I do blame the author for the way she portrays and oversimplifies it here. Euthanasia is an incredibly difficult and complex topic that should be handled with the most care. I could write an entire paragraph about all the ways this book misrepresents, underplays and oversimplifies this, but let me leave it at these 3 points:
- no, we don’t euthanize patients willy-nilly here in the Netherlands and you certainly cannot come for “medical tourism” to get this done.
- comparing legal euthanasia to "putting down a dog" or a form of medical tourism is incredibly dismissive of the complexity of the issue and is an insult to relatives of patients who've passed in this manor ánd professionals who've been confronted with it.
- euthanasia is based on the explicit request from the patient, not the family. This makes euthanasia in cases of dementia so incredibly difficult, as the patient might not be able to express their wishes clearly anymore. The scenario that Addie fantasizes about (taking her husband to the Netherlands under false pretenses and having a doctor euthanize him, without his explicit and repeated consent is not euthanasia. It’s murder.
For a topic that is so sensitive and so misunderstood, misrepresentation like this is incredibly problematic and warrants my 1-star review on its own.
The Ugly: (dislikes from my personal perspective)
Here we get into my personal feelings towards the story. These are coloured by my experience of caregiving, and my own biases. They may not be “correct” and may downright be “ugly” in their own right. I’m aware of this, but they are a part of what made me dislike this book so strongly.
In short: I hated our protagonist and could not relate to how she chose to deal with the situation at hand. She chooses to ship her husband off to a separate apartment and hires a full-time live-in care-aid to completely delegate all care to. This couldn’t be further from my experience and choices in caregiving and the book did nothing to help me understand how Addie came to this point.
The moment of “rehoming my husband” comes very abrupt and the lead-up to this decision isn’t fleshed-out enough for the reader to reach that point with Addie. Because of that, her undoubtably complex grief comes across as disingenuous, and her decision to step away from her husband as selfish, callous and privileged. Again: I am not saying that delegating care for a sick loved-one is callous. I am saying that the way it was written here made it come across as such, and made it impossible for me to relate to our protagonists grief in the way I was supposed to.
If you made it to this point, I’m genuinely impressed and thankful for sticking with it. I’m well aware this was a monster of a review, but getting my thoughts on paper was therapeutic after this read. I’m glad this book seems to have struck the right note for so many other readers, but obviously it didn’t for me.
Before we get into the Good-Bad-and-Ugly-style disection, I want to address two points:
First: I am NOT attacking the author, or her personal experiences around this subject-matter. My review is about the book, not the individual.
Second: I’ve seen people be proper vile in the comments of critical reviews on this book – more so than usual -, or attempt to silence these reviewers based on “you don’t know what you’re talking about”. So let me state my (unfortunate) credentials on the subject, to nip those comments in the bud.
- 7 years of caregiving for my mother, until her passing of a terminal neurodegenerative illness.
- another round of palliative caregiving for my foster-mother a few years down the line
- I work professionally in (primarily) oncology and palliative care in the Netherlands. That final point becomes relevant in The Bad section.
I feel so passionate about this book because I do personally care and feel for this topic. That’s why I am expressing my opinion; to show a different inside-insight that might be helpful to others.
The Good:
I desperately wanted to love this book. Representation of neurodegenerative illness (specifically the rarer ones like Lewy Body dementia) from an own-voice patient- and caregiver-perspective is unfortunately far to rare in literature. Understandably so, because this is a hard topic to speak of, let alone write about. I want to commend the author for doing it anyway and providing many readers with a story that they found recognition or even comfort in.
Although she mentions in multiple reviews that this book is not autobiographical, her experiences of losing her husband to Lewy Body dementia put an undeniable layer of authenticity into the story.
The power is in the smallest moments here. The every-day losses of a trivial task no longer being possible, a once-shared memory suddenly being yours alone, or that flash of realization that – in that moment - the person you once loved more than anything is suddenly unrecognizable to you (and vice versa). These small moments may seem featherlight on a day-to-day basis, until their cumulative weight sneaks up to you in crushing heartbreak. Kirshenbaum understands that, and portrays it in an understated manner, befitting of the experience.
I also really appreciate the choice of second person narrative for this story. This again, is not an easy choice, but it puts you as the reader straight into the shoes of our protagonist and forces you to engage in the question: what if this was me?
The ending paragraph ties the choice of second-person narrative into a neat bow, hitting me with a sudden rush of sadness when I realized what it was doing.
The Bad (dislikes from a factual and professional point):
Because representation of this topic is so rare, your voice is going to ring extra-loud once you dó speak up. Any one-sided- or factually incorrect information is amplified as a result too. Here’s where I have a problem with this book.
1. There are factual inaccuracies in the story. Some of them are small, like the nurses being the ones prescribing medication to Leo, without a doctor ever being present or signing off on it. (Nurses cannot legally prescribe medication, this is a task reserved for doctors). Some of them are bigger, like the portrayal of the doctors wait-and-see-policy as being “negligence” and his final diagnosis of LBD being made by a mental-health professional.
When Leo first presents with symptoms, he sees a neurologist for an MRI. This neurologist sends him home without a definitive diagnosis and recommends him a re-scan 6 months later. This is presented as him dismissing Leo’s concerns and being negligent and incompetent. In truth, this is medically the correct policy when suspecting LBD. Part of the diagnostic process is the progression of symptoms and scans in time. This time is necessary to rule out other illnesses that can mimic LBD, and diagnosing a patient with a terminal neurodegenerative illness without a cure based on 1 consult, is premature and potentially harmful.
This book presents the neurologists careful consideration of a serious diagnosis as “lazy/tardy caregiving” and dismissal. This is a far too prevalent misunderstanding in medicine already, and its perpetuation is harmful. A speedy but wrongful diagnosis can be far more harmful than a correct and thorough diagnosis with 6 months later.
Not to mention that the final diagnosis is made by a mental-health professional, who hasn’t seen Leo himself and only goes off his wife’s story. This is irresponsible and incorrect in so many ways, and I can’t believe how this made it past editing.
2. In line with point 1, all doctors and professional caregivers/aids are portrayed as one-dimensionally incompetent, uncaring and useless. This is literally stated by Larissa on page, and isn’t challenged by a single instance. Again: such a one-sided portrayal of an entire profession is harmful to both the profession ánd potential readers who might distrust professional care because of it.
The caregiving that ís praised to high heavens in the book, ironically is far more questionable. I had a huge issue with the portrayal of Larissa. The (professional/personal??) relationship she has as Leo’s full-time aid is very codependent and the dynamic between her and our protagonist borders on abusive. Larissa – a person of color, with a family she’s supporting aboard - is clearly being underpaid, and has literally 0 time off. In addition, she dismisses all other caregivers as useless and actually puts Leo in danger by sending them away or ignoring their policies. At one point, she takes Leo off his prescribes medication, because “she feels it’s not right for him”. As a professional aid without medical training, you cannot do this. Patients can be seriously harmed and professionals (deservedly) lose their jobs over behaviour like this! None of this is ever called out in the book.
3. Then there is the entirety of Chapter 11 titled Mixed Messages, which almost made me throw the book across the room. In this chapter, out protagonist contemplates how “civilized countries like The Netherlands and Canada just euthanize people like Leo”. She even likens it to “medical tourism” regarding plastic surgery in Argentina and Mexico, and how these countries promote this, because its good for business.
As a Dutch physician, I cannot even begin to explain how dismissing, disrespectful and filled with misinformation this entire chapter is. First off, I’m not blaming the character for thinking these thoughts. In fact; I commend the author for putting them to paper, as I feel many caregivers will encounter them at some point in their journey.
However, I do blame the author for the way she portrays and oversimplifies it here. Euthanasia is an incredibly difficult and complex topic that should be handled with the most care. I could write an entire paragraph about all the ways this book misrepresents, underplays and oversimplifies this, but let me leave it at these 3 points:
- no, we don’t euthanize patients willy-nilly here in the Netherlands and you certainly cannot come for “medical tourism” to get this done.
- comparing legal euthanasia to "putting down a dog" or a form of medical tourism is incredibly dismissive of the complexity of the issue and is an insult to relatives of patients who've passed in this manor ánd professionals who've been confronted with it.
- euthanasia is based on the explicit request from the patient, not the family. This makes euthanasia in cases of dementia so incredibly difficult, as the patient might not be able to express their wishes clearly anymore. The scenario that Addie fantasizes about (taking her husband to the Netherlands under false pretenses and having a doctor euthanize him, without his explicit and repeated consent is not euthanasia. It’s murder.
For a topic that is so sensitive and so misunderstood, misrepresentation like this is incredibly problematic and warrants my 1-star review on its own.
The Ugly: (dislikes from my personal perspective)
Here we get into my personal feelings towards the story. These are coloured by my experience of caregiving, and my own biases. They may not be “correct” and may downright be “ugly” in their own right. I’m aware of this, but they are a part of what made me dislike this book so strongly.
In short: I hated our protagonist and could not relate to how she chose to deal with the situation at hand. She chooses to ship her husband off to a separate apartment and hires a full-time live-in care-aid to completely delegate all care to. This couldn’t be further from my experience and choices in caregiving and the book did nothing to help me understand how Addie came to this point.
The moment of “rehoming my husband” comes very abrupt and the lead-up to this decision isn’t fleshed-out enough for the reader to reach that point with Addie. Because of that, her undoubtably complex grief comes across as disingenuous, and her decision to step away from her husband as selfish, callous and privileged. Again: I am not saying that delegating care for a sick loved-one is callous. I am saying that the way it was written here made it come across as such, and made it impossible for me to relate to our protagonists grief in the way I was supposed to.
If you made it to this point, I’m genuinely impressed and thankful for sticking with it. I’m well aware this was a monster of a review, but getting my thoughts on paper was therapeutic after this read. I’m glad this book seems to have struck the right note for so many other readers, but obviously it didn’t for me.
July 27, 2025
Heartbreakingly honest story of a woman, Addie, living through the years of watching her brilliant loving scientist husband, Leo, slide into Lewy body dementia at just 54 years old and through to his death.
I had never heard of this author before, but it turns out she has been writing since the 1990s. I really like her way with characters and voice, and I am looking forward to trying some of her other works.
I had never heard of this author before, but it turns out she has been writing since the 1990s. I really like her way with characters and voice, and I am looking forward to trying some of her other works.
March 15, 2025
Counting Backwards by Binnie Kirshenbaum is a deeply affecting novel that explores the devastating effects of Lewy body disease on both the individual suffering from it and their loved ones. The story follows Leo, a scientist who begins experiencing hallucinations and cognitive lapses that gradually worsen. His wife, Addie, an artist, struggles to navigate the emotional and logistical challenges of his decline. Told in fragmented, sharply observed vignettes with a unique second-person narration, the novel captures the heartbreaking deterioration of their relationship, the frustration of unanswered medical questions, and the moral complexities of caregiving.
The use of second-person narration is a bold choice that adds to the novel’s immersive quality, placing the reader directly into the unfolding tragedy. The structure—brief glimpses into specific moments—mirrors Leo’s disjointed reality, reinforcing the impact of his neurological disease. The author does an exceptional job of portraying Leo’s decline, starting with subtle hallucinations and progressing to more severe symptoms like memory loss and auditory delusions. The pacing of his deterioration feels natural, making his condition’s worsening all the more poignant.
However, there are a few inconsistencies that stand out, which could be due to this being an advanced copy. The timeline is somewhat confusing; at one point, Addie references an eye doctor Leo has had since 1923, suggesting an earlier time period, but a later mention of a cell phone contradicts this. Similarly, there’s a discrepancy regarding Addie and Leo’s relationship—one passage states they’ve been together for 24 years, while another suggests they’ve been married for less than a year. These minor inconsistencies may be polished before publication, but they momentarily pulled me out of the narrative.
Addie’s journey is just as emotionally raw as Leo’s, though her character arc is at times difficult to sympathize with. Her growing resentment and exhaustion are understandable—caring for a loved one with dementia is an immense burden—but her emotional detachment feels abrupt. While it’s clear she struggles with guilt, her eagerness to move Leo into a facility and then a separate apartment, without fully exploring more measured options, raises questions. Her jealousy toward Larissa, Leo’s caretaker, also seems contradictory—she doesn’t want to be responsible for Leo’s day-to-day needs, yet she resents Larissa’s role in providing that care. These complexities make Addie a well-developed but sometimes frustrating character, which may be the novel’s intent.
Overall, Counting Backwards is a raw and unflinching portrayal of love, loss, and the emotional toll of degenerative illness. It’s not an easy read, but it’s deeply thought-provoking, offering a realistic, if at times painful, look at the experience of watching a loved one disappear before your eyes. Fans of literary fiction that tackles difficult themes with sharp prose and emotional depth will find much to appreciate here.
Thanks to Soho Press for the advance edition, received through a Goodreads giveaway!
The use of second-person narration is a bold choice that adds to the novel’s immersive quality, placing the reader directly into the unfolding tragedy. The structure—brief glimpses into specific moments—mirrors Leo’s disjointed reality, reinforcing the impact of his neurological disease. The author does an exceptional job of portraying Leo’s decline, starting with subtle hallucinations and progressing to more severe symptoms like memory loss and auditory delusions. The pacing of his deterioration feels natural, making his condition’s worsening all the more poignant.
However, there are a few inconsistencies that stand out, which could be due to this being an advanced copy. The timeline is somewhat confusing; at one point, Addie references an eye doctor Leo has had since 1923, suggesting an earlier time period, but a later mention of a cell phone contradicts this. Similarly, there’s a discrepancy regarding Addie and Leo’s relationship—one passage states they’ve been together for 24 years, while another suggests they’ve been married for less than a year. These minor inconsistencies may be polished before publication, but they momentarily pulled me out of the narrative.
Addie’s journey is just as emotionally raw as Leo’s, though her character arc is at times difficult to sympathize with. Her growing resentment and exhaustion are understandable—caring for a loved one with dementia is an immense burden—but her emotional detachment feels abrupt. While it’s clear she struggles with guilt, her eagerness to move Leo into a facility and then a separate apartment, without fully exploring more measured options, raises questions. Her jealousy toward Larissa, Leo’s caretaker, also seems contradictory—she doesn’t want to be responsible for Leo’s day-to-day needs, yet she resents Larissa’s role in providing that care. These complexities make Addie a well-developed but sometimes frustrating character, which may be the novel’s intent.
Overall, Counting Backwards is a raw and unflinching portrayal of love, loss, and the emotional toll of degenerative illness. It’s not an easy read, but it’s deeply thought-provoking, offering a realistic, if at times painful, look at the experience of watching a loved one disappear before your eyes. Fans of literary fiction that tackles difficult themes with sharp prose and emotional depth will find much to appreciate here.
Thanks to Soho Press for the advance edition, received through a Goodreads giveaway!
January 20, 2026
The subject matter is heavy but the tone of writing was not. It was easy to read, to move from one section to the next, but it was harder to reflect upon. I think that mirrors something in the protagonists experience. This was an honest look at watching a spouse diminish and die. Many of us will go through this and I appreciate the straight forward take on a difficult part of life. This was quite affecting and while it was predictable in some ways, it was not in others. The quality of writing really made this book work, it was well crafted.
tldr - This was easy to read but harder to feel.
tldr - This was easy to read but harder to feel.
July 27, 2025
I watched a family member suffer from lewy body dementia. This book is raw and realistic in the depiction of the disease. It was not an easy book to read, but it was relatable.
June 6, 2025
A strange way to talk about dealing with a spouse's dementia. The details of watching the husband fall prey to the stages of the disease were very real and interesting. However the wife's reaction to it all was surprising. Little to no grief was shown. She just kind of checks out and does a lot of whining about how it affects her life, without letting the reader feel the sadness and loss. She also makes a lot of odd decisions - wasting money was killing me - and she seems to get by for years with almost no contact with any friends or family. Yet she can't be bothered to spend more than a few minutes with her spouse. Odd, yet still an interesting book.
April 1, 2025
What a heartbreaking book. I knew this would be a difficult read, but I figured that that would be because of Leo's decline - and while that's part of it, most of it was because of Addison's reaction. I was grateful for the way the book is structured out of short vignettes, which provide a bit of a breather and make everything easier to take.
April 6, 2025
There may be no medium as self-conscious or self-absorbed as writing. Every book is about writing, something I’ve come to take for granted so much that I don’t notice it. Until a book like Binnie Kirshenbaum’s Counting Backwards comes along and shows what can happen when a skilled writer puts her craft to work for a purpose other than demonstrating what a good writer she is. Counting Backwards achieves the emotional intensity and connectedness of theater while still drawing on the unique powers of literature to create vast interior landscapes. The identification achieved by this novel had me feeling the protagonist’s discomfort, impatience, guilt, and love, before she articulated them herself. I sometimes thought I was feeling her emotions with her in real time, a trick of the mind I’m sure.
It would have been easy for Ms. Kirshenbaum to tell the story of early onset dementia (specifically, Lewy body disease) and its inescapable trajectory and destination, wrapped in sentimental, “life affirming” tropes. She doesn’t. She gives the reader an honest experience of life as lived through an honest, imperfect protagonist, who can say she is alive and not need to put a bow on it.
This wonderful book may be too subtle, too self-effacing, for its own good. Ms. Kirshenbaum doesn’t draw attention to the skill that makes her novel work, so the reader may feel the emotional knots without realizing how difficult they are to tie. And I suspect Ms. Kirshenbaum would say that’s just fine, that she didn’t write the novel to show off her knot tying ability or anything else.
I hesitate to add this, but for point of view nerds (I count myself among you) this novel offers a rare second person narrator and protagonist, demonstrating what this difficult point of view can accomplish, bring the reader uncomfortably close to the narrator, feeling the story through and in the narrator in a way I don’t think could be done in straight first-person or the popular third-person limited points of view.
It would have been easy for Ms. Kirshenbaum to tell the story of early onset dementia (specifically, Lewy body disease) and its inescapable trajectory and destination, wrapped in sentimental, “life affirming” tropes. She doesn’t. She gives the reader an honest experience of life as lived through an honest, imperfect protagonist, who can say she is alive and not need to put a bow on it.
This wonderful book may be too subtle, too self-effacing, for its own good. Ms. Kirshenbaum doesn’t draw attention to the skill that makes her novel work, so the reader may feel the emotional knots without realizing how difficult they are to tie. And I suspect Ms. Kirshenbaum would say that’s just fine, that she didn’t write the novel to show off her knot tying ability or anything else.
I hesitate to add this, but for point of view nerds (I count myself among you) this novel offers a rare second person narrator and protagonist, demonstrating what this difficult point of view can accomplish, bring the reader uncomfortably close to the narrator, feeling the story through and in the narrator in a way I don’t think could be done in straight first-person or the popular third-person limited points of view.
October 4, 2025
Maybe a 4?
I read it quickly and I was engaged: woman narrating her husband’s decline from Lewy body dementia.
However, I had concerns. First off, this woman’s friends are so terrible, I just don’t know what to say. There is a difference with a friend struggling over how to react and a friend saying what the character Z does here. Second, the caretaker is lovely. Like out of a utopian novel lovely. And finally, the wife? Maybe I just don’t like cats, but this woman needs to get a grip and look her life head on. And her art seemed too ditzy. But I get that is rude of me to say. So imagine I did not include that. Maybe a 2?
I read it quickly and I was engaged: woman narrating her husband’s decline from Lewy body dementia.
However, I had concerns. First off, this woman’s friends are so terrible, I just don’t know what to say. There is a difference with a friend struggling over how to react and a friend saying what the character Z does here. Second, the caretaker is lovely. Like out of a utopian novel lovely. And finally, the wife? Maybe I just don’t like cats, but this woman needs to get a grip and look her life head on. And her art seemed too ditzy. But I get that is rude of me to say. So imagine I did not include that. Maybe a 2?
November 2, 2025
This is the difficult story of the illness and death of the protagonist's husband from Lewy body dementia.
Those who've cared for a loved one dying will definitely relate to the conflicted emotions of the wife in this situation. There is a pull between wanting to be with the ill person and the desire to get away from it and have your own time. Also the difficult balance of hiring a caretaker to relieve some of the burden, only to feel conflicted when the ill person becomes very close to the caretaker. ("Is this the intimacy with a dying person that I want or not?")
Overall, well-written and hard to put down. A difficult story, told well.
Those who've cared for a loved one dying will definitely relate to the conflicted emotions of the wife in this situation. There is a pull between wanting to be with the ill person and the desire to get away from it and have your own time. Also the difficult balance of hiring a caretaker to relieve some of the burden, only to feel conflicted when the ill person becomes very close to the caretaker. ("Is this the intimacy with a dying person that I want or not?")
Overall, well-written and hard to put down. A difficult story, told well.
March 30, 2026
I'm looking for recommendations of books similar to Counting Backwards, that deal with dementia-induced psychosis. Not looking for horror or mystery/suspense, just regular people dealing with this type of illness in a loved one in a real-to-life setting.
February 7, 2026
When her husband, Leo, a medical researcher in his fifties, starts having hallucinations, collage artist Addie is concerned but not alarmed.As his confusion worsens, however, Addie feels increasingly alone and desperate with no explanation for the changes in Lo’s behaviour.
COUNTING BACKWARDS is the story of Addie’s journey through Leo’s diagnosis with Lewy body dementia, a disease that eventually robs him of his ability to care for himself and even to speak.
I have mixed feelings about this book. On one hand, Binnie Kirshenbaum did an excellent job of keeping me interested. Between the short chapters and skillful use of the second person, I read this story wanting to know what would happen. Although Leo’s deterioration is undoubtedly sad, it was also interesting to see how some aspects of his pre-dementia personality remained. Addie’s struggle to access and pay for the care Leo needed also seemed realistic.
I understood and to some extent applauded the way Addie was able to delegate Leo’s care. However, in my opinion she was very quick to conclude that she couldn’t possibly care for him herself in any way, renting an apartment for Leo to live in with a paid caregiver while she lived in her own apartment. Also, she seemed to show remarkably little interest in how Leo’s disease was progressing, noting with surprise when he lost skills but never discussing it with his caregiver or a doctor.
Perhaps the strangest aspect of this story has to do with the way Addie interacts and handles her relationship with Leo’s live in caregiver, Larissa. Shortly after moving Leo and Larisa into their apartment, she gives Larissa her credit card and never addresses the fact that Larissa is ordering Door Dash several times a week or that she has purchased an expensive recliner, instead opting to ask Leo’s sister for a $15 000 dollar loan and lamenting that she is in debt.
To me, that situation constitutes financial abuse, but instead of doing anything about it, Addie gives her a Christmas gift of 10,000 dollars. It does seem as if Addie is willing to let Larissa do absolutely everything for Leo and takes a lot of time away from him even as he’s dying. She does do a load of laundry for Larissa near the end, but then leaves again, thinking she deserves a vodka martini. Addie comes across as a selfish character who more than anything is repulsed by her husband’s disease and disability, wishing he would just die. It’s not presented as if she’s wishing for an end to his suffering, more that this whole ordeal has been so hard for her even though all she really does for Leo is bring expensive cookies, which is OK because he never gains weight.
The writing is OK, but that’s it. This is a problematic portrayal of illness and disability at its core. I recommend you give this one a miss!
COUNTING BACKWARDS is the story of Addie’s journey through Leo’s diagnosis with Lewy body dementia, a disease that eventually robs him of his ability to care for himself and even to speak.
I have mixed feelings about this book. On one hand, Binnie Kirshenbaum did an excellent job of keeping me interested. Between the short chapters and skillful use of the second person, I read this story wanting to know what would happen. Although Leo’s deterioration is undoubtedly sad, it was also interesting to see how some aspects of his pre-dementia personality remained. Addie’s struggle to access and pay for the care Leo needed also seemed realistic.
I understood and to some extent applauded the way Addie was able to delegate Leo’s care. However, in my opinion she was very quick to conclude that she couldn’t possibly care for him herself in any way, renting an apartment for Leo to live in with a paid caregiver while she lived in her own apartment. Also, she seemed to show remarkably little interest in how Leo’s disease was progressing, noting with surprise when he lost skills but never discussing it with his caregiver or a doctor.
Perhaps the strangest aspect of this story has to do with the way Addie interacts and handles her relationship with Leo’s live in caregiver, Larissa. Shortly after moving Leo and Larisa into their apartment, she gives Larissa her credit card and never addresses the fact that Larissa is ordering Door Dash several times a week or that she has purchased an expensive recliner, instead opting to ask Leo’s sister for a $15 000 dollar loan and lamenting that she is in debt.
To me, that situation constitutes financial abuse, but instead of doing anything about it, Addie gives her a Christmas gift of 10,000 dollars. It does seem as if Addie is willing to let Larissa do absolutely everything for Leo and takes a lot of time away from him even as he’s dying. She does do a load of laundry for Larissa near the end, but then leaves again, thinking she deserves a vodka martini. Addie comes across as a selfish character who more than anything is repulsed by her husband’s disease and disability, wishing he would just die. It’s not presented as if she’s wishing for an end to his suffering, more that this whole ordeal has been so hard for her even though all she really does for Leo is bring expensive cookies, which is OK because he never gains weight.
The writing is OK, but that’s it. This is a problematic portrayal of illness and disability at its core. I recommend you give this one a miss!
September 4, 2025
Save your time and money. I read a couple of reviews that praised this book - a woman's diary/feelings as her husband goes more and more into Alzheimers or Lewy Body Disease. I learned nothing new - yes, these diminished brain diseases are difficult to diagnose and there is no medication that seems to help, yes - it is exhausting for the caregiver and family who really care about the person who is fading and diminishing before our eyes.
I felt that the focal person, the decision maker, the speaker was not very patient or understanding. She would bring her husband's favorite candy and not pay attention to what he was interested in at the moment. The book demonstrated a lot of attitudes that are negative. She was always so tired after being with him --- so what?? All of us are tired after being with a loved one after any health problem. AD is just like many other diseases, especially terminal ones; they are tiring for all parties involved. The medical community does not always give careful information. Problems seem to abound and never ease up.
I kept reading thinking there would be some light at the end of a long dreadful tunnel - there is not. I read the entire book, including the ending where the focal person (the wife) gives up and leaves the paid attendant to stay with the patient
This book is not worth reading if you have any experience with people who have AD or something similar. There is nothing new here - we have lived it, read it all before. Skip the book.
I felt that the focal person, the decision maker, the speaker was not very patient or understanding. She would bring her husband's favorite candy and not pay attention to what he was interested in at the moment. The book demonstrated a lot of attitudes that are negative. She was always so tired after being with him --- so what?? All of us are tired after being with a loved one after any health problem. AD is just like many other diseases, especially terminal ones; they are tiring for all parties involved. The medical community does not always give careful information. Problems seem to abound and never ease up.
I kept reading thinking there would be some light at the end of a long dreadful tunnel - there is not. I read the entire book, including the ending where the focal person (the wife) gives up and leaves the paid attendant to stay with the patient
This book is not worth reading if you have any experience with people who have AD or something similar. There is nothing new here - we have lived it, read it all before. Skip the book.
July 24, 2025
Not an easy read emotionally - how a debilitating illness in a partner impacts a marriage. I found the story telling excellent - short narrative snapshots of moments giving a glimpse of the larger whole.
April 5, 2025
4.5 stars: In Manhattan, the narrator’s husband descends into Lewy Body dementia, an affliction I am somewhat familiar with because my FIL had it. The thing about LBD that Kirshinbaum gets exactly right is the day-to-day variability: one day fine, the next “who is that little girl standing on the table?” And eventually, trying to eat napkins with a knife and fork. She has an amazing eye for detail, and the emotion shines through the trenchancy.
A half marked off for a section about the narrator’s struggling career as a professional collage artist desperate to fund her husband’s care which was not very interesting (possibly because collage art is not very, but possibly because in the middle stages of the disease life go this way). Otherwise narrator is funny and moving by crabwise steps.
A half marked off for a section about the narrator’s struggling career as a professional collage artist desperate to fund her husband’s care which was not very interesting (possibly because collage art is not very, but possibly because in the middle stages of the disease life go this way). Otherwise narrator is funny and moving by crabwise steps.
May 3, 2025
I received an ARC from RBmedia.
A heart-breaking book, Counting Backwards gives an insight into the impact of Lewy-bodies dementia on carers and loved ones.
The book tells the relationship of married couple Addie and Leo as they slowly learn Leo has dementia with Lewy bodies. Kirshenbaum uses 2nd person narration which took some time for me to settle into but draws you into the narritive. There’s no getting away from the fact this book is sad and there’s a feeling of hopelessness, but there are also funny comical moments, giving some relief. Kirshenbaum doesn’t shy away from the complicated feelings and emotions of being a carer and the moral and philosophical questions that emerge when someone you love has a degenerative illness.
A heart-breaking book, Counting Backwards gives an insight into the impact of Lewy-bodies dementia on carers and loved ones.
The book tells the relationship of married couple Addie and Leo as they slowly learn Leo has dementia with Lewy bodies. Kirshenbaum uses 2nd person narration which took some time for me to settle into but draws you into the narritive. There’s no getting away from the fact this book is sad and there’s a feeling of hopelessness, but there are also funny comical moments, giving some relief. Kirshenbaum doesn’t shy away from the complicated feelings and emotions of being a carer and the moral and philosophical questions that emerge when someone you love has a degenerative illness.
May 12, 2025
A quick and pithy read. Having lived with my father who lost everything to Alzheimer’s Disease this book rang true. It is the story of an upwardly mobile New York couple: Leo a research scientist and Addie an artist. Told in brief chapters the book is told in Addie’s voice and she doesn’t mince words. Leo starts exhibiting strange behavior; it progresses in stages and robs him of his self. It is sad and real, a tale of transformation not just of Leo but of Addie as an artist. Well written and compelling; I intend to read more by this author. Highly recommend for the writing and the insight into what happens when one loses a loved one who still exists but is not and will never be the same.
November 7, 2024
Husband and wife Leo and Addie are living a comfortable life when he is diagnosed with early-onset Lewy Body dementia. The first signs are hallucinations, and Leo being a scientist, is self aware enough to realize that they are not real. A real and raw look at a marriage rocked by a horrible disease and heavy burdens on the surviving spouse. Kirshenbaum is such a talented writer that readers will believe that they are reading a memoir.
*I read an advance copy and was not compensated.
*I read an advance copy and was not compensated.
March 19, 2025
I received this book as an arc. It was truly an amazing and heartbreaking story. Addie watches her love Leo turn into someone she doesn’t know when he’s diagnosed with lewy body dementia. I couldn’t imagine the love of my life losing himself. I highly recommend this book!
August 4, 2025
I have a friend who was recently diagnosed with Lewy body disease, so I was interested in this book by author Binnie Kirshenbaum. The beginning of “Counting Backwards” was compelling with an intelligent, thriving couple coming to grips with this devastating disease. My Dad died of Parkinson’s disease so I can attest to the reality of the author’s description of the slow degeneration into dementia with its hallucinations and erratic behavior. On some days a patient seems to be perfectly normal and the next they become a stranger in your home. This frequently results in family and friends rationalizing the bad days and while focusing only on the good days.
The author takes this slide one step farther when the victim becomes violent and even engages in sexually deviant behavior. This is an area I’m not familiar with so I can’t comment whether it is typical of such cases. Nevertheless, the author’s ability to capture the atmosphere in nursing homes is spot on. They can be so utterly depressing it is difficult for even sane people to cope with the hopeless environment in so many of them.
Perhaps my biggest issue with this novel is the miraculous caregiver the wife manages to find to take care of her husband in the last stages of his life. Such caregivers are extremely rare. In most cases such level of individualized care is extremely expensive and out of reach of most families. To me this is where the well-written novel becomes untethered from reality.
Nevertheless, this novel will evoke deep emotions for most readers, many of whom have probably experienced their own similar tragedies.
The author takes this slide one step farther when the victim becomes violent and even engages in sexually deviant behavior. This is an area I’m not familiar with so I can’t comment whether it is typical of such cases. Nevertheless, the author’s ability to capture the atmosphere in nursing homes is spot on. They can be so utterly depressing it is difficult for even sane people to cope with the hopeless environment in so many of them.
Perhaps my biggest issue with this novel is the miraculous caregiver the wife manages to find to take care of her husband in the last stages of his life. Such caregivers are extremely rare. In most cases such level of individualized care is extremely expensive and out of reach of most families. To me this is where the well-written novel becomes untethered from reality.
Nevertheless, this novel will evoke deep emotions for most readers, many of whom have probably experienced their own similar tragedies.
May 25, 2025
This novel explores the difficulties a loving couple encounter when the husband, Leo, develops Lewy Body Disease, which leads to hallucinations and dementia-type behaviors. His wife, Addie, struggles as Leo requires increasing levels of care. However, it is her responses to his decline that make this novel so difficult. She is quick to move her husband to a care center then to a personal apartment with private care giver, all while worrying about the expense. Her emotional connection to her husband is lost and she avoids seeing him at times. Addie initially struggles in her professional work as an artist, then finds a way to use her art to express her distress. She also turns her back on her social circle. By the end of the book, Addie is a completely different person than she was before her husband became ill, showing that serious medical issues impact more than just the affected individual.
April 5, 2025
Kirshenbaum delivers a story at once insane, sad, funny, and hopeless due to the circumstances involved. As I read the book I kept wondering how crazy I would become were I in Addie’s shoes. (I don’t think I’d get a cat but….). The reader is apprised of the myriad difficulties involved caring for someone who is slowly losing connection with life and dying, not the least of which is the cost involved. Addie did make me clench my jaw numerous times but all that did was point out the situation she was involved in more clearly. It would have been fun to know how Addie and Leo got together.
January 6, 2026
This one was so close to home. Wow. I felt like I was reading about my life while trying to figure out all of dad’s care. Be warned that this is very hard to read if you have a loved one with a neurological dementia like disease. It was a good read because the honest inner thoughts of a caregiver need more attention and shouldn’t be considered taboo, but still very very sad.
May 8, 2025
This story is about a New York couple and the husband starts having visual hallucinations, and after a long series of testing and misdiagnosis is found to have advanced Lewy body disorder. The husband’s dementia increases and the wife goes through the process of trying to find assisted living to the tune of $12k a month which depletes their financial resources and alienates their friends as the wife can no maintain her previous social life. The author’s writing style reminds me of Joan Didion’s The Year of Living Dangerously.
July 21, 2025
A poignant and moving novel about a loving married couple’s struggle with the husband, Leo early onset Levy body dementia. One can relate to to so much of the dementia impact on someone that we love dearly. It is so difficult to come to terms with and the author’s depiction is so révèlent to those of us who have felt and witnessed the insidious ravages of this horrendous disease on our loved ones. She was lucky to find a wonderful caregiver who gave her and Leo so much love and compassion in their most dreadful years of their marriage. It was sad but yet in many ways a heartwarming novel….one that will not forget soon.
September 3, 2025
this book made me audibly weep
June 11, 2025
Wow. Roller coaster of emotions with this one. Dementia has touched my life personally, so I felt as if I could relate to both Leo and Addie. I appreciated the humor used throughout much of this book because the subject matter is far from humorous. Towards the end I was getting very annoyed with Addie, but who am I to judge?
March 14, 2026
The premise and first half of the book were great. The last half of the book left me despising the main character/narrator, and the end was flat.
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