A Matter of Death and Life: a book review by Geoffrey Zygier

April 28, 2021 by Geoffrey Zygier
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A Matter of Death and Life is an extremely candid and readable memoir about the painful, yet insightful and productive last months of a long, loving relationship that ended with the death of Marilyn Yalom.

Until contracting multiple myeloma, she and husband Irv had led seemingly blessed lives. Meeting as teenagers when Irv gate-crashed a party at Marilyn’s home, they were immediately drawn to one another. Their relationship blossomed and the Yaloms went on to share more than seven decades together, raising a family and appreciating many meaningful and fruitful years in their chosen professions.

As part of (and perhaps even beyond) their academic and clinical work, both were prolific and successful authors. Hence it was perhaps unsurprising that when Marilyn was diagnosed, she was prompted to suggest to her partner that together they “… document the difficult days and months before us. Perhaps our trials will be of some use to other couples with one member facing a fatal illness.” Hence A Matter of Death and Life was written in alternating accounts, tailed by Irv’s reflections on his first time, not just as a bereaved husband, but as a person living as an independent adult.

Of course, the “trials” confronting the partners were very different. Not only was Marilyn facing her release from this mortal coil, but she also was experiencing the terrible process of dying from a pernicious and very painful blood cancer that develops from plasma cells in the bone marrow. It is clear from Marilyn’s writings that she suffered greatly and looked forward to the relief that death would provide. As she bluntly told Irv,” … if you are up to hearing the truth, I’ve felt for a long time that I’m paying too great a cost to stay alive…. How much longer must I live before I am allowed to die?” And as State-sanctioned euthanasia is legal in California in situations where no further medical remedies or pain relief are available, Marilyn knew she had this option.

That Marilyn initially resisted this path was in large part due to Irv’s refusal to accept the impending loss of his life partner (in fact apparently the only one he had ever had). Despite being an internationally renowned psychiatrist, particularly skilled in dealing with the anxiety and grief of others, ironically Irvin Yalom (as Marilyn well realised) was unable to put himself in her pain-ridden situation. As he told her, “Isn’t it enough that you are still alive? That when you go, there will be nothing afterwards? And I’m not ready to let you go.”

As is perhaps too often the case, Marilyn’s female caring instinct was torn between her needs and those of her husband and also the perceived needs of her children and others. As she wrote, “It occurs to me, as it has many times this year, that my death is not mine alone. I shall have to share it with those who love me, first of all with Irv, but also with other family members and close friends.” And while Marilyn was grateful for their love, she came to realise that it was a package that burdened her with their expectations as well.

But Marilyn’s strength enabled her to divest herself of these encumbrances, the often oppressive hope of others that she would fight to the end and the material clutter one accumulates over a lifetime. As a former Professor of French, she had an impressive collection of French literature which she handed over to a friend at Stanford University, leaving “… a great emptiness in my heart.” Yet she understood this must be done. When Irv saw the empty shelves, however, he stated emphatically “… there is no way in the world I could have done as she has. I simply don’t want to witness a preview of how my most meaningful possessions will vanish after my death.”

At the end, Marilyn’s will prevails and her ordeal comes to an end. Yet we are only two-thirds of the way through this book. The rest is now entirely Irv’s task to complete, the writing, his thoughts and emotions on this momentous event and his attempts to deal with both loss and grief and the continuation of his new life on his own. It makes for fascinating reading.

A Matter of Death and Life covers a relatively brief yet turbulent period of time in the lives of two intelligent, thoughtful people. Its rotating authorship works very well and it is deftly and honestly written. While this book is deceptively easy to read, it certainly left me with a great deal to contemplate and I look forward to discussing it with my own life partner and other contemporaries. While it is a book that some may approach apprehensively, I urge readers to take the plunge. We cannot escape our ultimately solitary march from birth to death and a work such as this provides valuable signposts that facilitate our journey.

A Matter of Death and Life (Scribe, May 2021) Irvin D. Yalom and Marilyn Yalom

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