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One Hundred Names for Love

A literary couple untangles a medical conundrum

“My Little Spice Owl,” he would call her. Or “Mistress of Wonderment.” Or “She for Whom All Flowers Bloom Early.” Recovering from the massive stroke he suffered in 2005, poet and novelist Paul West dreamed up these and dozens of other fanciful names for his wife, writer Diane Ackerman.

The endearments suggest how much he adored her. More than that, they demonstrate the extent to which West was able to regain his mastery of English, though the stroke had ravaged the key language areas of his brain.

Ackerman chronicles her husband’s epic struggle in her wise and luminous new book, One Hundred Names for Love: A Stroke, A Marriage, and the Language of Healing. Make that she chronicles their epic struggle.

A “word-besotted” couple, Ackerman and West met in the early 1970s at Penn State University, where she was a “flower-child undergraduate” and he a professor of literature 18 years her senior, with “yards of education … and a classy English accent.” Ackerman is at her most lyrical in One Hundred Names for Love when describing West’s gift for language: “Paul had a draper’s touch for the unfolding fabric of a sentence,” she writes early on, “and he collected words like rare buttons.”

Though Ackerman — an award-winning poet and naturalist — is best known as the author of A Natural History of the Senses (1990), she had also delved into the brain’s “marvel and mystery” for her 2004 book, An Alchemy of Mind. In One Hundred Names for Love she deftly explains how the brain compensates for physical insults and injuries, adapting and growing and forging new pathways.

Still, her husband’s journey was harrowing. And his recovery — though its scope defied the odds and baffled medical experts — will never be complete.

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.