A Matter of Death and Life (Irvin D. Yalom and Marilyn Yalom)

A Matter of Death and Life by Irvin D. Yalom and Marilyn Yalom is a wonderful book on so many levels. Most anyone who picks up this superb “diary” will find their life enhanced, their understanding of a dying person’s interior life broadened, and deep insight into those who are walking with a dying family member and the requisite grief with which they wrestle.

Marilyn is diagnosed with multiple myeloma and the book opens with Irv writing about what that means for their relationship. The threat of death, which he acknowledges is with us always and is something that he has written and taught about throughout his career as a renowned therapist and professor at Stanford University now becomes real and not a concept to be viewed at arms-length. This confrontation, the abstract of what we know is inevitable versus that inescapable reality, is one of the powerful assets of the book. This is true for both Irv as the caregiver and spouse, as well as Marilyn as the one confronted with her death.

With alternating chapters written by each person, they travel the last seven months of Marilyn’s life. Irv finishes with the next four months of his grief. Marilyn’s chapters help us look over her shoulder as she struggles to be hopeful for one’s own self and those around her, while at the same time combating the exhaustion and suffering that often accompanies medical treatment for life-threatening diseases.  Upon deciding that it is time to move to hospice from treatment, she writes, “After ten months of feeling awful most of the time, it’s a relief to know that my misery will come to an end.” The title of Irv’s chapter reflecting upon this moment is, “Farewell to Chemotherapy – and to Hope.” This contrast in the real-life, real-time, experience of each of these people who know one another so well is powerfully enlightening and emotionally gripping.

Irv’s chapters about grieving Marilyn’s death are a lesson in the normal things that come to a person and provide a beautiful overview of a bereaved spouse. The movement through the rawness and emptiness of immediate grief toward its softening as he engages with the pain and the many empty spaces that Marilyn left in his life are beautifully written.