One Hundred Names for Love is an intermittently engaging and very useful book for millions of partners, parents, children, friends, and caretakers of stroke victims as well as anyone else interested in the workings of the mind.

One Hundred Names for Love: A Stroke, a Marriage, and the Language of Healing by Diane Ackerman. Norton, 322 pages, $26.95.

By Helen Epstein

Also in The Arts Fuse, Bill Marx pays homage to the maximalist prose of Paul West.

A friend of mine collects memoirs of marriage by and about wives and widows. Her library includes accounts of marital life, death, and adversity by authors as different as Lady Antonia Fraser, Anne Richardson Roiphe, and Queen Noor of Jordan, as well as Cynthia Asquith’s insightful biography, Living with Tolstoy.

I thought of them all as I read Diane Ackerman’s One Hundred Names for Love: A Stroke, a Marriage, and the Language of Healing. The title refers to the many pet names Ackerman’s husband, Paul West coined for her before and after his massive stroke and which appear in small print on the cover: “Carmine Postulant of the Pleasant Voice;” “Uxorious Bountiful;” “Sweet Opalescent Centrifuge”—you get the idea. The names, alluded to in the text, appear in barely legible, small print, as though the publisher couldn’t decide how prominent to make them, whether they would turn potential buyers on or off.

A similar indecisiveness pervades parts of the book itself. It’s possibly the most self-conscious memoir I have come across in the genre, sure and psychologically incisive at times, rambling, self-indulgent, and silly in others.

It is one of the few memoirs of couples under stress I’ve read in which the husband survives—alive, if not exactly kicking—and where the marriage not only survives but is spiritually enlarged. Like other recent end-of-life or almost-end-of-life memoirs, One Hundred Names for Love is a jumble of non-fictional forms: a portrait of a marriage, an account of a medical crisis, a how-to-survive-it manual, science journalism, a treatise on how the brain processes and plays with language, and personal essay—all in one.

It’s tricky to get the right balance of these elements, not to speak of a comfortable balance of intimacy and distance in describing one’s relations with one’s spouse. There were many passages of One Hundred Words for Love that I admired and others at which I cringed. But that’s par for the course in Ackerman’s work. She’s the opposite of a neutral, understated writer.

For decades she and Paul West (like novelists Joan Didion and the late John Gregory Dunne, and novelist Joyce Carol Oates and the late editor Raymond Smith) have been among a small number of America’s celebrated literary couples. Ackerman is a lyric poet,essayist, and naturalist; West is an extraordinarily prolific novelist. Both are veterans of literature and creative writing departments: reading, writing, and teaching have been at the core of their lives since they met at Penn State in the early 1970s.

Here’s how Paul West described it in his roman a clef, Life with Swan:

“A puberty ago, I watched from my office window one afternoon as she descended into baking sunlight on the library steps in a Spanish-looking straw hat (Eton boating style), drape-swinging her legs in polychrome-striped bell-bottoms, behind her the terminal moraine of black hair that set her out from the crowd . . . A huge raven perched on the back of the class, she had a look of profound astuteness, coming to me to ask if I would read her poems only after a six-semester wait. But I had read them already in campus magazines and been astounded by the real thing. Finally, when I got to review her first book, I wrote that she was the best living lyric poet.”

In One Hundred Names for Love, Ackerman describes their household as “saturated in wordplay” and her husband as “the most deliciously quirky person I’d ever met, a classic British eccentric of myth and legend, right out of a P. G. Wodehouse novel, with “a draper’s touch for the unfolding fabric of a sentence.”

In 2003 Ackerman was 58 and West was 74. They were, in Ackerman’s account, still passionately in love with words and with each other, professionally productive and personally playful. “When asked about the secret to our decades-long duet,” she writes, “I sometimes teased that we stayed together for the sake of the children—each was the other’s child.”

Ackerman was away on book tour, promoting An Alchemy of Mind, when she was called home to Ithaca, New York where West had been hospitalized with a kidney infection. For three weeks, she camped out in West’s hospital room. The day before he was to be discharged, she describes him in her signature style: “Trailing plastic tubes, Paul made his way across the room, steeped in twilight, and I was struck by how the body sometimes looks like the sea creature it is, a jellyfish with long tentacles, not really a fish at all but a gelatinous animal full of hidden symmetries, as well as lagoons and sewers, and lots of spongy and stringy bits.”

But instead of leaving hospital the next day, West then suffered a massive stroke causing a global aphasia that knocked out his ability to process language. Although his body was luckily spared major devastation, his ability to understand others and to convey his own thoughts was deeply impaired. At first the only sound he was able to produce was “Mem.”

Filmgoers may be reminded of Julian Schnabel’s very beautiful and unusual film The Diving Bell and the Butterfly, based on French magazine editor Jean-Dominique Bauby’s account of “locked-in syndrome,” also the result of a massive stroke. Bauby was entirely paralyzed except for his left eye, which he could blink at will. Using only that method of communication, he painstakingly composed a memoir of his experience in collaboration with an aide before dying of an infection.

West, unlike Bauby, not only has a devoted wife but one whose book tour involved promoting an exploration of the brain titled An Alchemy of Mind. Ackerman was more informed than most of us about theories of cognitive process, many based on studies of people with brain injuries such as those inflicted by stroke.

Because of early intervention, stroke has become the number one cause of long-term adult disability in the United States, and West became one of one million who live with various degrees of aphasia. In two of the few succinct sentences of One Hundred Names for Love, Ackerman summarizes her dilemma with uncharacteristic succinctness: “According to an old adage, the secret to a good marriage is communication. How do you manage that when your loved one has lost most of his language?”

Her answer is, despite an annoying tendency to wander, an intermittently engaging and very useful book for millions of partners, parents, children, friends, and caretakers of stroke victims as well as anyone else interested in the workings of the mind. In essence, it shows the reader how two people in love with words as well as with one another create a customized rehab program, sometimes with and sometimes in spite of their speech therapists and other certified professionals.

“Stroke changes everyone in a family,” she writes in a characteristic passage. “One normally plays so many roles—from paramour to parent, monkey baby, prom queen, warrior, florist, nosy parker, servant, savant, and a dozen more—all obvious, finite, and clear as switching between camp songs and flute solos. What had changed? I’d not only lost the old Paul. I’d lost those parts of myself that had related to those irretrievable parts of him . . . . In many ways I had become the functional part of him.”

At first it’s unclear whether West will be able to return home. A few days after the stroke, he was still “woefully confused,” couldn’t drink without choking, didn’t know his own name or that of his wife. His speech therapist noted:

“Unable to repeat single syllable words
Did not name common objects
No functional verbal communication”
When she gave West a thick crayon and asked him to write his name,
“With difficulty, starting and stopping several times, Paul scrawled
P-O-O-P.”

This is terrifying stuff and Ackerman does a good job reporting the facts. “In terms of language,” she asks the speech therapist, “what do you think?” “Long-term,” the therapist answers, “I hope he’ll be able to communicate his basic wants and needs verbally or in gestures or maybe using a communication board with about 80 percent accuracy.” Basic needs and wants, Ackerman thinks to herself, “As if that could be enough for normal people, let alone word-besotted creatures like us. How could Paul’s immense cosmos of words shrink to the size of a communications board? How could ours?”

Ackerman becomes her husband’s translator, advocate, confidante, and cheerleader, as well as primary caretaker, while trying to continue their many idiosyncratic marital routines. Some of the healing strategies she and friends conceive are ingenious; the narrative of West’s improvement is moving and often inspiring, enhanced by Ackerman’s observations as a naturalist and her comparing humans to plants and other animals. It’s fascinating to read about a marriage that seems to become stronger as it is more deeply challenged.

Unlike Didion and Oates, however, Ackerman is more of a poet than a consistent narrator. She’s often more interested in exploiting a metaphor than in characterizing a person or telling a sustained story. I found myself unable to read more than a few pages at a time—not because the content was too painful but because I didn’t wish to follow the author as she went off on another tangent.

For example, in a sketch of her pre-stroke relationship with West, Ackerman offers her side of Life with Swan.

“We had fallen in love at Penn State, in the early 1970s, when I was a flower-child undergraduate and he a professor with yards of education, wavy brown hair, and a classy English accent. Somehow, though just a sophomore, I’d signed up for his graduate Contemporary British Literature course.”

Then she goes off on a characteristic digression:

“There I perched in a back corner, surrounded by the familiar last-row smells of sweaty overcoats, chalky erasers, smoky-caramel-leather-bounds, musty old paperbacks and cloth-bounds redolent with mildew and book lice, tart newly-inked fare, more acidic editions printed on European papers. A few students had deckle-edged novels, whose virgin pages forced a reader to muscle in and possess them, slicing pages open with worldly-wise aplomb….”

This kind of thing recurs all too frequently in One Hundred Names for Love and made me wonder what Ackerman might have written in the margins if one of her MFA students had turned it in. On the other hand, it’s only after 200 pages that Ackerman drops the news that West had been “a charming alcoholic with a violent temper” when they met and that, for years, she had “walked on eggshells around him.”

Although I admired Ackerman’s indefatigable loyalty and resilience in response to her husband’s stroke, her creativity in in devising new exercises and therapies for her husband, and her intelligence as a writer, I found her a unreliable and often superficial memoirist. Her florid-to-the-point-of-gaudy style made me long for a dash of Didion. Her excesses made me appreciate the reticence of Oates. Read One Hundred Names for Love especially if you worry about what would happen if you or someone you love had a stroke but be forewarned!

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Author Helen Epstein is the editorial director of Plunkett Lake Press Ebooks.