I had mixed reactions to the book. On one hand, how can anyone but root for Diane and Paul, and suffer along with them as they struggled through the horror of these circumstances? I felt happy as clarity surfaced in Paul's damaged brain, and wanted to give Diane a hug during the early days when she went through her caregiver role as a zombie.
Yet there were some difficulties in the book. At times, Diane overused metaphors in a way that obscured rather than clarified her points. Here's an example of overwriting, wherein she describes her mannerisms changing to accommodate Paul's limitations:
"I now seemed to quarry words, one by one, presenting them like bright bits of jasper—not slurred in a wash of flurried adjectives—when I spoke to Paul. Sometimes with a flutter of agitated worry that felt like a beetle was trapped inside my ribs. But I savored the delicious warm touch-ribbons of silent affection, uniting and comforting us, even when words failed. And I followed the stew of sympathy from friends, whose faces flickered with unrefined sorrow-compassion-pity."
Also, I was disappointed that Diane, while knocked back by the overwhelming load of caregiving, adapts to it somehow, yet she declines to explain those successful strategies. What a great service that would have been. Here's an example of what most of us either have gone through or will in the future:
"My body also felt derelict and unlived in. Every little thing, no matter how small—putting on makeup, changing my clothes, washing my hair—seemed to add boulders to an already unbearable weight. I felt as if a spare particle would make me collapse. I kept forgetting to eat, and, anyway, the refrigerator was bare because I hadn’t the energy to shop." Like many people, I've been there. What did she do about it? How did she handle it? Not said.
And: "...caregiving had its hopes and charms, but on the downside, this meant that every hour was interruptible. My days no longer contained adjoining hours in which to work. Yet I had a new book to write...So while Paul was straining mentally to reclaim language, I was straining to learn the peculiar skill of concentrating on my work in attention gulps...while keeping one ear open for signs of discord or trouble." Again, I know that feeling of interruption, and the frustration that makes one want to throw everything in the trash and say the heck with it, I'll just give up being a person and dedicate my life to caring for you. Diane struggled with this, but she doesn't say how she surmounts it.
She also reveals that she's married a man who is quite a bit older than her, who was in the past given to alcoholic rages and verbal abuse. The balance of power in this relationship is striking. I say this realizing I'm commenting on the apparent nature of their relationship, which is none of my business and not the point of the book. Still, it's like an unacknowledged third protagonist.
In summary, Diane Ackerman has done a good job of describing one stroke, one man, and one dedicated wife. The potential for teaching others how to deal with a similar situation remains unrealized, regrettably.