One Hundred Names for Love

West was 74 and in the hospital with a kidney infection when he suffered the stroke. Both the diagnosis (“global aphasia”) and the prognosis were grim: “In the cruelest of ironies,” Ackerman writes, “for a man whose life revolved around words … [Paul] could no longer process language in any form.” The only thing her husband could say was the nonsense word “mem,” repeated over and over in obvious frustration and anger.

West made little progress in the first few weeks. His wife, meanwhile, was consumed by terrifying worries. A swallowing problem put West at risk of aspiration; would he choke to death while trying to eat? His mood was black; would he find a way to take his own life? And assuming he survived the immediate aftermath of the stroke, would he need to be institutionalized?

Speech therapy in the hospital proved ineffective. But then, mostly unbidden, West began to voice a few words and phrases. (Eventually he would manage to retrieve sophisticated words — “plebian,” “cherubim” — while struggling to recall simple ones — “chair,” “table.”) Ackerman persuaded her husband’s doctor to add Zoloft and Ritalin to his medications, having heard of their promising results with stroke patients. Clamoring to go home, West was finally released after nearly six weeks.

The challenges didn’t abate there. West needed help with the most basic tasks: holding a spoon or fork, shaving, turning on the TV. (Never mind more difficult chores such as writing checks.) His first home health aide pilfered money and credit cards. And it was largely left to Ackerman to make sense of her husband’s strange utterances.

She was alternately hopeful and despairing. Often, by her own admission, she was in denial: “How tempting to live in limbo and wait for my real life to return,” she writes at one point. “But this was my real life now. Life is a thing that mutates without warning …”

The picture brightened with the appearance of Liz, a high-spirited, energetic woman who would serve as West’s part-time nurse — and, in time, his literary assistant and gal Friday. Still, Ackerman was in charge. That meant “locating my inner submarine commander” and taking charge of the situation, she writes. “But some days all I wanted was to curl up and be taken care of” — a wish that will surely resonate with any caregiver.

Always absorbing, One Hundred Names for Love bogs down a bit in the middle, where the time line turns fuzzy. Still, West’s recovery was nothing if not erratic, so it may be unfair to expect his wife’s account to unfold in linear fashion.

West longed to return to writing, and Ackerman paved the way: She became his transcriber (Liz would later replace her) as he dictated the story of the first months of his stroke. His recollections would become a memoir, The Shadow Factory, published by avant-garde press Lumen Books. Two years after his stroke, West was writing in longhand. Astonishingly, he went on from there to publish both essays and fiction.

Making up pet names for his wife (with her prodding) became another form of therapy — a way for West to practice speaking, to release his “padlocked mind” and, not incidentally, to reestablish his intimate connection with her. A few summers after his stroke, he resumed one of his greatest pleasures: swimming.

More than five years have now gone by. Medical emergencies surface from time to time, and Ackerman acknowledges that the couple’s life will never be the same. “What to make of a diminished thing?” she poignantly asks midway through 100 Names, echoing the final line of Robert Frost’s sonnet, “The Oven Bird.”

At the end, the author answers her own question: “A bell with a crack in it may not ring as clearly,” she observes, “but it can ring as sweetly.”

Evelyn Renold is a writer and editorial consultant in New York.