To love – to marry – a partner older by many years contains, implicit within the commitment, two nearly inevitable provisos. The first: as the older partner’s body and mind begin to wear away, the younger’s most pressing role will become that of caregiver. The second: given the likelihood of outliving the elder, the younger spouse’s own old age may well be spent, in one important sense at least, alone.

Consider the effect of aphasia on the lives of two brilliant and highly prolific wordsmiths whose collective breadth of work exhibited nothing less than a polymathic repository of shared knowledge.

In 1970, as a “flower-child undergraduate,” the acclaimed poet and naturalist Diane Ackerman married the equally celebrated novelist Paul West, eighteen years her senior. She was only in her own thirties when West, aged fifty-five, developed heart arrhythmia and had to be fitted with a pacemaker. Twenty years later, while hospitalized for a kidney infection (when he became so bored that he composed an entire sonnet cycle), West experienced a massive stroke. With critical medication proscribed on account of his pre-existing heart trouble, severe damage to the neurological centers that govern language left him with a profoundly debilitating condition: global aphasia. Aphasics can understand some of what is spoken to them (although the ability to read, or recognize symbols, is highly compromised), and may believe they are communicating normally, but their actual speech is usually reduced to a single word or syllable. In West’s case, it was “mem.”

Consider the effect of aphasia on the lives of two brilliant and highly prolific wordsmiths whose collective breadth of work exhibited nothing less than a polymathic repository of shared knowledge. Overnight, West loses access to his own genius, his control over some of his body and his ability to think or interact at even the most basic level of functionality. Ackerman’s independence, including time for her own writing or worry-free travel, suffers. They do not have children or relatives with whom the burden of caregiving can be shared by default. Most devastatingly: they are no longer equals. And gone is the private language unique to every couple, with its terms of endearments and play.

Everything about day-to-day life changes: West must relearn how to swallow, how to speak on the telephone, and a catalogue of other prosaic things which, if done wrong, could result in terrible consequences. “Scrap by scrap, fragment by iota,” she writes, “life continued to evolve to accommodate his illness, which took on a life of its own, and became another inhabitant of the house, a central one, complete with special foods and routines.”

One Hundred Names for Love is Ackerman’s poignant yet very charming memoir of the five years that followed West’s stroke. Gradually, with daily concentration and support, and tremendous reliance on his wife’s intuitive understanding of who he is and what he wants, West finds his way back to speaking, swimming, and even reading and writing. His functional vocabulary extends well beyond “mem,” and probably comes to exceed even that of most readers. Samuel Beckett and Charles Baudelaire (whose own aphasic pronouncement was French for “goddamn,” a tragicomical detail given that he was left in the care of a nunnery), among other authors, suffered aphasia near the end of their lives; neither had a partner like Diane Ackerman nor the scientific advances of today.