Nursing Book Club
Counting Backwards by Binnie Kirshenbaum
A novel about losing one's husband to dementia
A book for anyone who has ever cared for a dementia patient and thought to themselves, “How does anyone ever do this?”
It’s not often that I would recommend fiction as a way to learn something important about our healthcare system. But Counting Backwards by Binnie Kirshenbaum is that rare book.
The story is written in the first person, and I was nearly halfway through before I realized it was fiction, not a memoir. It’s so accurate that it seems impossible that the author could understand the situation so well unless she had actually lived through it.
The narrator is married to Leo, a university professor who has begun to hallucinate. She takes him to the best specialists she can find. They come up with a diagnosis — early-onset Lewy Body dementia.
Leo gets worse, and eventually loses his job and health insurance. They have no children by choice, which leaves the main character without help or anyone to share her emotional burden. We’ve all seen someone with this life and wondered how they cope. The narrator wonders as well.
A Biting Satire
Kirschenbaum, who has won several Critic’s Choice awards, has been called “a sort of stand-up tragic.” She is known for her biting social commentary, and this darkly funny book is a gem.
As the medical system fails the protagonist entirely, she runs into the arms of home care workers. She soon discovers that poorly paid but empathetic people with little training are actually better prepared for things like diapering a difficult adult.
Speaking from experience, I found that a degree in nursing in no way prepared me for dealing with my recalcitrant mother when she refused to eat. All the care plans in the world didn’t help. God bless the health aide that figured out what to do.
To tell more would give away the whole story, but let’s just say that the author got it right, and her book should be required reading for anyone involved in discharge planning or creating public health policy.
If it takes a village to raise a child, it might also take a village to care for that child’s elderly grandparents, and there are not nearly as many volunteers for the job.
Counting Backwards by Binnie Kirshenbaum (Soho Press, 2025)
CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.
In this Article: Mental and behavioral health
