Counting Backwards

by Binnie Kirshenbaum

Genres: General Fiction; Family Life; Marriage & Divorce; Black Humor; Humorous Fiction

Synopsis

A middle-aged couple struggles with the husband’s descent into early onset Lewy Body dementia in this profound and deeply moving novel shot through with Kirshenbaum’s lacerating humor.

It begins with hallucinations. From their living room window, Leo sees a man on stilts, an acting troupe, a pair of swans paddling on the Manhattan streets below. Then he’s unable to perform simple tasks and experiences a host of other erratic disturbances, none of which his doctors can explain. Leo, 53, a research scientist, and Addie, a collage artist, have a loving and happy marriage. They’d planned on many more years of work and travel, dinner with friends, quiet evenings at home with the cat. But as Leo’s periods of lucidity become rarer, those dreams fall away, and Addie finds herself less and less able to cope with an increasingly unbearable present.

Eventually, Leo is diagnosed with early onset dementia in the form of Lewy body disease. Life expectancy ranges from 3 to 20 years. A decidedly uncharacteristic act of violence makes it clear that he cannot live at home. He moves first to an assisted living facility and then to a small apartment with a caretaker, where, over time, he descends into full cognitive decline. Addie’s agony, anger, and guilt result in self-imposed isolation, which mirrors Leo’s diminished life. And so for years, all she can do is watch him die—too soon, and yet not soon enough.

Kirshenbaum captures the pair’s final years, months, and days in short scenes that burn with despair, dark humor, and rage, tracking the brutal destruction of the disease as well as the moments of love and beauty that still exist for them.

Release date: March 25, 2025

Publisher: Soho Press

Print pages: 400

Sample

Tonight or Tomorrow
You sit at the edge of the bed watching your husband who looks as if he were sleeping.
     Hooked up to a high-flow oxygen tank, he might be sleeping, but mostly he is dying. A high-flow oxygen tank is not a ventilator. When the subject of things such as ventilators would come up, apropos of nothing other than stories on the news, stories of lawsuits and family battles, Leo invariably said, “No matter what. No artificial means of life support for me.”
     You have the document: Do Not Resuscitate and No Artificial Means of Life Support.
     You, on the other hand, said, “I want to be freeze-dried. Or maybe one of those long-term induced comas.”
     The oxygen will not prolong his life, but it eases the pain of breathing.
     The pain of breathing.
     The oxygen eases the pain.
     For him, the oxygen eases the pain.
     But to ease the pain does not mean there is no pain.
     For you, there is pain.
     The hospice nurse says that if he shows indications of suffering, if he winces or groans or, because not all suffering is externalized, even if you just sense that he might be uncomfortable, you can give him morphine.
     Not all suffering is externalized.
     You eyeball the vial of morphine tablets.
     The hospice nurse tells you that he will, most likely, die tonight. Tonight, or possibly tomorrow.
     The hospice nurse leaves. She has other dying people to visit.
     You take your husband’s hand. You lean over, stroke his cheek, run your fingers through his hair. Such hair. Full. Thick. Boyish, the way it flops over his forehead, but not boyish because it’s white. Eighteen years ago, soon after his fortieth birthday, his hair started going white. Within nine months, it was all white. Prematurely white. “It’s you,” he teased. “Living with you turned my hair white.”
     White hair, disease, death, all of it premature.
     Now, you say, “I’m sorry that I wasn’t always good to you. But more than anyone, anything, ever, I loved you. Do you know that I loved you?” Loved. Past tense. He’s not yet dead, and already, you are in the in past tense.
     Tonight, or possibly tomorrow.
     Hurry up, not all suffering is externalized, please hurry up.
     Because, for you, there is pain.


Do You See What I See?
Leo is at the living room window, the curtain pulled to one side, and he’s peering out, like the nosy neighbor trolling for dogs peeing on flower beds or clandestine affairs, or—the snoop’s jackpot—some perv peeking into a woman’s bedroom. Except Leo is the opposite of a snoop. Insofar as the private lives of other people are concerned, he’s pretty much a So what? kind of guy. But, as of late, every night he’s posted himself there at the window. “Come here for second,” he says.
     Across the street, cars are parked bumper-to-bumper, and a sleek bicycle is chained to the streetlamp on the sidewalk in front of the red brick townhouse that’s been there since 1902. Come late April or early May, tulips and daffodils will sprout and bloom from the patches of dirt that ring the trees, but it’s neither late April nor early May. It’s mid-February. When summer rolls around, the full view of the townhouse will be eclipsed by the foliage of the silver maples.
     “What, who, is it now?” you ask.
     “Under the light,” Leo says. “You don’t see Gandhi?”
     “Gandhi?”
     Leo sees Mahatma Gandhi stirring lentils in a pot. An iron pot that hangs from a tripod.
     You don’t see Gandhi. “Is he wearing anything more than a dhoti? If that’s all he has on, he must be freezing. You might want to bring him a coat.”
     Because Leo realizes perfectly well that he is hallucinating, that Gandhi is not out there on the sidewalk stirring lentils in a pot, you feel free to add, “You might want to give him a pair of thick socks, too. I’m assuming he’s barefoot.”
     Leo lets the curtain fall, and, not for the first time over the last couple of months, he says, “I should give Sam a call.”
     Sam is his ophthalmologist, and the way Thanksgiving happens not on a fixed date but firmly on the fourth Thursday in November, Leo’s annual eye exam falls on the Tuesday after Labor Day. Sam examines Leo’s eyes for glaucoma, cataracts, astigmatism, swollen corneas, misshapen corneas, torn or detached retinas, sun damage, any changes in his visual acuity, but, other than nearly imperceptible and inconsequential worsening of common myopia and presbyopia—near- and farsightedness—the structural anatomy and physiology of Leo’s eyes are healthy.
     His eyes are healthy, although his vision stinks. His vision has always stunk. He got his first pair of eyeglasses when he was in kindergarten. Without them, Leo’s world would be an impressionistic wash, and words on the page as easily read as streaks of smudged ink. Contact lenses are out of the question. As far as Leo is concerned, to go poking around your eyes is to court infection, which is fine with you. His glasses become him, in that bookish Clark Kent way.
     Leo’s previous appointment with Sam happened to coincide with the onset of his eyes playing tricks with the light at night. Shadows, pink-colored halos, stripes on the moon, and the incandescent glow of the streetlights turned skyward illuminating the row of rooftops populated with what looked like angels holding hands. Angels is your word. Leo is dead set against the likes of angels. He described the angels as something like a blurry string of cut-out paper dolls.
     According to Sam, Leo’s eyes were on the dry side. Nothing serious. He recommended eye drops, Visine in the morning, and that you buy a humidifier. “And don’t forget your sunglasses.”
     Sunglasses because blue eyes are more sensitive to the glare of the sun than dark eyes.
     It’s not only the ophthalmologist. Leo maintains annual appointments with a full compendium of physicians: a dermatologist, gastroenterologist, urologist, primary care physician, and although he’s never had a cavity in his entire life nor any sign of gum disease, either—he brushes his teeth with a NASA-grade supersonic toothbrush, plus he flosses and uses a Waterpik—he wouldn’t dream of blowing off the date with the dentist. Then there are the flu shots, and not just for himself. Come autumn, Leo starts in hounding you, “Addie, did you get your flu shot? Did you get your flu shot?” until you have no choice other than to lie to him. “I got it this morning. You can stop now.”
     On more than one occasion, you’ve asked him when he is going to make an appointment with a gynecologist. You’ve also suggested he see a psychiatrist. But Leo needs a psychiatrist no more than he needs a Pap smear. He’s as sane as anyone who isn’t mentally ill. This medical checkup religiosity of his has to do only with the dictum: Early detection is the key difference between dying and living, and not merely living but living with all your vital organs intact, living free from pain.
     You bought a humidifier, and Leo incorporated Visine into his morning routine, but then one night, one of the angels took on the shape of a bald eagle, which flew from the roof and off into the unknown.
     “It must have been the movement of the shadows,” you said, and Leo agreed, but soon after the angel-turned-eagle, there came the man on stilts who walked the length of the block before turning the corner and out of view.
     You wanted to know if the man on stilts was young or old. Did he have a beard, and what was he wearing? But Leo didn’t catch the particulars. “He was moving at a brisk clip,” Leo said. “On stilts.”
     The hallucinations occur only sporadically, one per week, two tops, but Leo has been keeping track of them, dates and times on a sheet of graph paper, and in a small spiral-bound notebook with a green cover, he writes the narrative descriptions in pencil. It’s uncharacteristic of him not to document his notes on the computer, and his preference for using pencil and not a pen is equally baffling because of how, over time, pencil fades and how easily it is erased.
     People who see ghosts tend to see the same ghost wafting down the same staircase, but none of the characters populating Leo’s wacko hallucinations have returned for a repeat performance. However, a distinct pattern has emerged: these ornate, vividly articulated visions, like the earlier halos and angels, are seen exclusively from your living room window and they occur between nine and eleven at night, with two exceptions: the cauldron of bats emerged from a cave and flew en masse up to the moon at 8:32, and it was close to midnight when the troupe of actors arrived, smack in the middle of the street, illuminated by streetlamps like torches in an amphitheater, treating Leo to a snippet of A Midsummer Night’s Dream, Act IV, scene i, Titania, Bottom, and the whole slew of fairies.
     The following night, you called Leo to the window. “Look. It’s Hitler and Leni Riefenstahl. They’re making a movie.”
     “I’m not amused,” he said, but he was amused, and you laughed as if these hallucinations were nothing but one more example of Leo’s personality peculiarities, no different from the way he uses three towels, per shower, to dry off, or from that time he came home with eleven different kinds of salt: Himalayan pink, black lava, Alaskan flake, and who knows what else. They all tasted the same. They all tasted like salt.
     The frequency of the hallucinations remains more or less constant, but your level of concern is rising to the point where it’s become too tall to suppress, and now when, yet again, Leo mentions casually that he ought to check in with Sam, your response is not casual, as it was before. “Yes,” you say. “You do. How about tomorrow, okay? First thing. Promise me?”
     Promise. How many people keep, or even try to keep, every promise made? You know of no one, other than Leo. True to his word, first thing in the morning, he calls Sam’s office, only to learn that Sam is on vacation, a month in Belize.
     You suggest that, instead of waiting for Sam to return, maybe he should see someone else, but no. Leo is Boy Scout loyal to his physicians, all of whom have been carefully and critically vetted. Physician is Leo’s word. Not doctor. Physician, which does not necessarily connote respect. The same way the FBI flags any applicant who’s racked up frequent-flier miles with Aeroflot, Leo is highly suspicious of any physician who goes around blithely prescribing whatever newly approved FDA wonder drug that whichever pill-pusher from Pfizer happened to be selling that day. Leo’s physicians investigate, for themselves, things like trial reliability, statistical efficacy, and potential side effects because, yes, this drug decidedly alleviates cluster headaches, but it’s also possible that your liver will explode. Leo values their intellectual and professional curiosity, and he respects their expertise within their field, for the part of the body on which they’ve staked their claim, the same way he respects skilled electricians and the woman who cuts his hair.
     Now, regardless of his high regard for Sam, a month is a long time, and you remind him, “What about early detection and all that?”
     “He’ll be back in three weeks,” Leo says. “Whatever it is, it’s not an emergency. There’s no reason to worry. Trust me, okay?”
     You do trust Leo. You trust him implicitly and always, but nonetheless you have to wonder how, from a sixth-floor window down to the street, he was able to see the lentils in Gandhi’s pot.