Last Nerve: A Memoir of Illness and the Endurance of Family

by Mindy Uhrlaub

One woman’s story of confronting the monster under the bed

Last Nerve is much more than a trauma memoir. The story begins as Mindy Uhrlaub learns that she carries a gene for the fatal neurodegenerative disease amyotrophic lateral sclerosis (ALS). The news, while not surprising, is compounded by the fact that she is caring for her husband, who is undergoing chemotherapy for stage four lymphoma, raising a child with serious behavioral issues, and watching her own mother die of ALS. As she navigates the new territory of having three close relatives with life-threatening situations, she also has to come to terms with the fact that she may have passed the fatal gene to her two sons. Not one to fold, Mindy faces her circumstances head-on, realizing that her race for the elusive cure for ALS is not only for herself but also for her kids, her cousins, and the thousands of other carriers of the fateful gene.

Despite the incredible strain of all these challenges, Mindy manages them with amazing tenderness, persistence, and love. Far from a depressing story of misfortune, Last Nerve is as uplifting and witty as it is raw and real. It’s a testament to hope, the endurance of family, and the resilience of the human spirit.

Genres: Memoir, Nonfiction, Mental Health, Medical

204 pages, Paperback

Published May 19, 2025

About the author

I have traveled twice with Human Rights Watch and Eve Ensler’s V-Day to the Democratic Republic of the Congo and has taken testimony of rape survivors and child soldiers. My interest in preventing the pillage of resources in Congo has also led meto visit Virunga National Park and to sit on the committee for Human Rights Watch’s Voices for Justice Dinner.

Prior to writing Unnatural Resources, I wrote and produced STALLED, a feature-length film (distributed by Concorde New Horizons). I was also a music reviewer and copy editor for Denver’s PULP magazine.

I was a contributing author in the anthologies Mamas Write and She’s Got This (named 2019 Foreword INDIES Book of the Year Finalist, Kindle Book Awards Reader’s Choice, and Best Book Awards Finalist).

Reviews

[Laura · Rating 4 out of 5]

I won this book through a Goodreads giveaway in exchange for an honest review. Thanks to Greenleaf Book Group for choosing me.

Although its not very long, this book packs a lot in its short pages. There's a lot of heartache, and yet also a ton of resilience and grace and an unwillingness to give up - it is absolutely inspiring.

I'll be thinking of Mindy and her family forever.

[Laura · Rating 5 out of 5]

I found Last Nerve to be inspiring. I couldn’t put it down. Mindy Uhrlaub does not withdraw when she finds out she carries the gene for ALS while her own mother is in late stages of the disease, she becomes a champion for the cause. This is especially amazing with all she also has to deal with on the home front. This is definitely a book worth reading and sharing. Spread the word.

[Jennifer L Speidel · Rating 3 out of 5]

ALS, cancer, raising children through tough year and where they vacationed.

Although I enjoyed the overall content of this memoir, it felt more like a list of things her family did or did not do over a period of time. The story she had to share is an important one. I wish there was more of a flow to the overall narrative and less details about where they vacationed.

[Mandy K · Rating 4 out of 5]

I was excited to win this Goodreads Giveaway. As a hospice social worker, I work with complex family dynamics and terminal diagnoses daily. I also felt connected to the difficulties of parenting and finding a family unity balance. Last Nerve is a raw personal account of what it’s like knowing you have the potential to develop a terminal diagnosis, watching your mother’s health decline as she struggles with the active diagnosis herself, being a support to a partner with cancer, and being a successful parent and individual on top of that. At only 200 pages, this is a quick read and feels like a personal dive into a journal. I hope to continue to follow author Mindy’s journey as she continues to advocate for advancement of ALS treatment.

[Christine · Rating 4 out of 5]

In this memoir, the author shares her struggles as she deals with obstacles in her life. Her husband is undergoing chemotherapy for the second time, her oldest son has sever behavioral issues, her youngest son is struggling with it all, and her mother is dying of ALS.

When the author decides to do the genetic testing to see if she also carries the gene for ALS and finds out she does, she know must deal with her own health concerns on top of everything else.

A very open and honest book about dealing with struggle and tragedy, taking car of others, and learning to care for yourself.

I received an advance review copy for free and I am leaving this review voluntarily.

[Jeanne · Rating 4 out of 5]

I won this in a Goodreads Giveaway. It is a memoir of a time in the author’s life when she was dealing with one crisis after another. It was well written and kept a good pace. I can’t help thinking about how different this story would be if the author wasn’t a wealthy, white American.

[Sarah Jensen · Rating 5 out of 5]

Last Nerve: A Memoir of Illness and the Endurance of Family – A Masterclass in Radical Resilience
Rating: 4.9/5

Mindy Uhrlaub’s Last Nerve is a seismic work of memoir-writing that transcends the illness-narrative genre to become something far rarer: a manifesto on how to love fiercely when the universe seems determined to break you. As someone who approaches caregiver memoirs with trepidation (often bracing for trauma voyeurism), this book shattered my defenses with its alchemical blend of wit, vulnerability, and unshakable humanity.

Why This Book Resonates
Uhrlaub’s prose is a revelation—she writes about ALS with the precision of a geneticist (that gene-passage reckoning scene left me breathless) and the lyricism of a poet. The intergenerational tragedy—caring for a dying mother with ALS while confronting her own genetic fate and her husband’s cancer—could feel manipulative in lesser hands. Instead, Uhrlaub transforms it into a prism refracting light onto universal questions: How do we live meaningfully under the sword of Damocles? Her dark humor (e.g., calling ALS the world’s worst subscription service) disarms despair without trivializing suffering. Most extraordinary is how she frames caregiving not as martyrdom but as creative resistance—a perspective that redefined my understanding of chronic illness narratives.

Emotional Impact & Revelations
This book wrung me dry and stitched me back together. The chapter where Uhrlaub researches ALS cures while her son sleeps nearby triggered a visceral, full-body sob—not from pity, but from awe at her tenacity. Her refusal to perform inspiration porn (she admits to rage-fueled Google deep dives at 3 AM) made her heroism feel earned. By the finale, I didn’t just admire her; I felt armed—with her hard-won wisdom about advocacy, genetic grief, and finding joy in “the meantime.”

Constructive Criticism
The nonlinear structure occasionally muddles timeline clarity (a family tree appendix would help). Some medical jargon lacks layperson translation—a glossary would broaden accessibility. The epilogue’s activist call-to-action, while stirring, feels slightly rushed compared to the memoir’s deliberate pacing.

Final Verdict
A landmark in illness literature—When Breath Becomes Air meets Furiously Happy, but with Uhrlaub’s singular voice blazing trails. This isn’t just a story about surviving; it’s about outliving despair through radical love.

Thank you to Goodreads Giveaways and the publisher for the gifted copy. This book didn’t just move me—it changed how I see resilience.

Pair with: The Bright Hour for complementary meditations on mortality or Crying in H Mart for another searing mother-daughter narrative.

For fans of: Paul Kalanithi’s philosophical depth, Jenny Lawson’s irreverent humor, and The Glass Castle’s unflinching family portrait.

Note: Keep tissues and a highlighter nearby—you’ll need both to navigate this heartquake of a book.

[Lori · Rating 5 out of 5]

AMAZING READ!

Where do I begin? (Isn't that the start of an old song?) This book is exquisite and as a voracious reader and fellow writer who has had her own share of challenges, I don't say that lightly. It is really multiple stories within one book in a sense because it is about a family and like all of us, they too have a story to tell via the author Mindy Uhrlaub. Mindy's family includes husband Kirk, their two sons Ethan and Alex and Dusty the dog.
As we branch out there is Mindy's dad who is nicknamed "Dadder," her mom who they call "Nanee," her brother Brian, her stepfather Jimmy and more. Yet despite this, the writing is easily understood, captivating and the stories are pretty easy to keep track of. (I think Dusty's must be a mystery. I don't know what kind of dog he is and he's not talking, lol.)
We learn early in the book that Kirk has cancer and has battled it for several years successfully. Ethan has his share of teenage rebellion and angst; disrespectful, acting out, angry and bullying his brother. Alex is pretty even keeled, seems like a bright young man as is Ethan, enjoys music, kind and generally cooperative. And then on the periphery we find that Mindy's mom Nanee, has ALS which is also known informally as Lou Gehrig's Disease. It is fatal for many. Mindy decides to find out if she has the gene responsible for it and sadly, she does. But she doesn't let that stop her. She decides since she doesn't yet have the disease itself, she's going to join the fight in search of either a cure or a way to block the gene from activation so her boys don't get the disease.
The lives of everyone in the book are quite active and fulfilling for the most part and I love that Mindy doesn't let the news of having the ALS gene devastate her. She adds it to her schedule, writes about it, fund raises, enters trials for various treatments, speaks about it and keeps a positive attitude even as she copes with her mom's death from the disease.
One would expect this kind of book would be very depressing but because the author and her family are driven to succeed and have such great attitudes, it is inspirational and educational!
I highly recommend. She's an excellent writer!

[Paula Graham · Rating 3 out of 5]

Full disclosure I won a kindle copy of this book from goodreads giveaways for an honest review.

Some places this book was really strong. It was honest and had heart. It was not so much a memoir of ALS, but a memior of family life under pressure. The Uhrlaub family had a number of challenges: The father, Kirk battled cancer. The mother (the author) tested positive for the gene that caused ALS, of which her own mother, Nanee was dying. The older son, Ethan, was something of the black sheep and was going through programs and wilderness camps, but still violent and abusive towards his mother and younger brother. The younger son, Alex-the golden child-was over sensitive and overwhelmed. The book is largely about how they face these various problems.

I liked the honesty of the book.

The people were not the kind of people I could naturally relate to (woke coastal secular Jews). A lot of the resources they had would not be available to other caretakers. A lot of the decisions they made didn't make sense to me.

Overall, the book is readable, reasonably well written and covers things that people deal with.

#goodreadsgiveaway #LastNerve #MindyUhrlaub

[♏ Gina☽ · Rating 5 out of 5]

First of all, a huge thank you is sent out to author Mindy Uhrlaub, who penned this book and did not shy away from telling it like it happened during the years she faced unimaginable stress.

We learn right away that not only is she dealing with her oldest son having extreme behavioral difficulties, but having a mother suffering the effects of Amyotrophic Lateral Sclerosis (aka Lou Gehrig's Disease or ALS), a husband fighting cancer (again), and her own determination to find out if she inherited the gene that causes ALS despite advice that she may not really want to know. ALS is a neurodegenetive disease and there is no cure. It slowly robs a person, via the effects on the brain and nervous system, of a "normal" life.

I appreciate her truthfulness, her admittance that there were days she reached her own breaking point, and her devotion, not only to her family, but to finding a cure for ALS.

A must read.

[Julie · Rating 4 out of 5]

I won this ARC in exchange for an honest review. I was riveted by this memoir, maybe propelled to finish by sharing the author’s exact age group and parental and medical similarities (though I have not known any person with ALS). I was not aware the author had written a previous book. I mention this because I found her writing style concise and easily flowing, which I didn’t necessarily expect. To me, this is a story of a woman’s love for her family and pure grit and honesty. Her journey was at times quite stressful to read, but in the end this was a page turner and inspiring story. Thank you to the publisher for the opportunity to read this advance copy. I do think this story will live with me for a long time.

[Young Whan · Rating 5 out of 5]

Mindy Uhrlaub tells a powerful story of coming to terms with the news that she is a carrier of the gene for ALS. On top of that devastating news, she squares off against many other challengers (cancer diagnoses, familial strive, etc.). I am consistently impressed by how she digs deep inside to find the strength to not just face what life throws her way but to overcome so much. Uhrlaub is a narrator who is willing to express vulnerability, to acknowledge her fears, and to learn the important lessons of forgiveness. If you want inspiration to face a challenging health diagnosis like ALS, this book will give you that and more.

[Jenn Cromley · Rating 4 out of 5]

I received a kindle copy of this book as a Goodreads giveaway!

I highly appreciate the story and all the author has gone through - I read memoirs for exactly that reason. To expose me to things I may not otherwise come across and get a peek to learn into others’ lives. In that respect, I really enjoyed reading the book and seeing how her family grew through adversity.

HOWEVER, I do think the set up was confusing at times (moreso in the beginning) there were some jumps in timeline and backstory context that got me a little confused.

I almost hope she writes another book about her experience in all the things she says she is starting to do at the end of this book.

[Patricia Baker · Rating 3 out of 5]

ALS and family illnesses

This book pulls you into health worlds of ALS, cancer and what sounds like spectrum disorder. The author's mother is dying from ALS. The author finds she has markers for the same disease. But she does not know if it will cause her death. It is a good thing that she was a stay at home mom as her husband had cancer and underwent treatments for this. In the meantime her oldest son is acting out,what sounds like possible spectrum disorder. It would be great to find a cure for all of these diseases/ illnesses. good for her and her activity with ALS.

[Laura · Rating 3 out of 5]

I received this for free in return for an honest review.

Uhrlaub definitely has a lot on her plate - trying to get published, a difficult son, a partner with cancer, a mother with ALS. She does a good job of painting the picture of her life and her difficulties and my heart goes out to her. She does have the definite benefit of being financially flush and so able to afford a great many things the average person would not. This makes it a little difficult to relate to her as so many would not be in such position.

[Esther · Rating 5 out of 5]

This was one of the most vulnerable books I have read. It follows some difficult years in the life of the author but it isn’t depressing in any way. It’s open and hopeful. I appreciated reading about the challenges in raising her children in particular but also those in seeing her mother who was struggling with ALS, and managing her relationships with her step father and father.
I think it’s a book that would be helpful to anytime who has challenges in their family relationships. And who doesn’t?

[Susan Kurth · Rating 1 out of 5]

Gosh, this was like reading a third-grader's "How I Spent My Summer" essay. WAYYYYYYYYYY too much detail about her kids (yawn). And all the cutesy nicknames for her family members was . . . weird. I forced myself to get a little more than halfway through and had to quit. She does NOT know how to craft an absorbing memoir. Mindy, you might want to read "The Liars' Club" or "Eating Pomgranetes" (sp?) so you know how a GOOD memoir is done.

[Giulia · Rating 4 out of 5]

Mindy Uhrlaub's memoir tells the story of a woman and family facing many challenges concurrently with immense resilience and grace. The memoir is cohesive and open. However I did feel the book could have been improved with more explain what ALS/MND is, especially for potential readers coming in with no background.

[Melissa T · Rating 5 out of 5]

I won this book on Goodreads first reads, Thank you!

This book was simply amazing. Mindy hooks you into her life from the first sentence. I couldn’t put it down until I finished it.

Everyone should read this incredible book.

[AMAO · Rating 5 out of 5]

💯💯💯💯💯

[Janet · Rating 4 out of 5]

Very informative story of family life. This was a roller coaster ride with emotions. This was a Goodreads giveaway winner.

[Tami Huffman · Rating 5 out of 5]

I couldn’t put it down! Mindy is truly someone to look up to.

[Selma · Rating 3 out of 5]

3.5

[Heather · Rating 4 out of 5]

I won this book in a Goodreads giveaway.

Last Nerve is a powerful, honest story about living with illness and how the love of your family can keep you going.

[Sherri Westbury · Rating 5 out of 5]

I have a difficult time rating memoirs.
Not a long book..under 200 pages but it’s a good read. I know people who were affected by ALS and I pray for a cure .

[River Fleetwood · Rating 5 out of 5]

I loved this book. It was hard to read about the parts about ALS though as my grandpa just died from it. I hope to see a cure in my lifetime for this disease.

[Cathy · Rating 5 out of 5]

As a member of the sandwich generation myself I found this book highly relatable. it is a testament to resilience and the experiential fabric that weaves a family together. It also very aptly describes the urgency behind asymptomatic ALS and there is so much need for awareness on this topic. I highly recommend this book.

[Jenna · Rating 5 out of 5]

A very well written memoir about the struggles of daily life and challenges of family.