In June 2004, on the day before he was to be discharged after three weeks’ hospitalization for a systemic infection, Paul West suffered a massive stroke that left him unable to say more than “mem-mem-mem.” Then in his mid-70s and the author of dozens of books, both fiction and nonfiction, West was no stranger to medicine, having lived with diabetes and a pacemaker for years. But in the words of his wife, poet and naturalist Diane Ackerman, this stroke seemed diabolically “tailored to his own private hell. In the cruelest of ironies for a man whose life revolved around words, with one of the largest working English vocabularies on earth, he had suffered immense damage to the key language areas of his brain and could no longer process language in any form.”

One Hundred Names for Love” is Ackerman’s memoir of how the couple, two “word-besotted creatures,” struggle to cope with West’s “ravaged brain” and global aphasia — not a loss of language but a problem with retrieving and sorting it, which affects both comprehension and speech. At once sobering and encouraging, it’s a tale of perseverance and accommodation, and an ode to playfulness and the brain’s plasticity. While it will no doubt join the literature of aphasia as an inspirational resource for those hit, either directly or tangentially, by this devastating disability, unaffected readers may find it less compelling.

Ackerman — whose many books include “The Zookeeper’s Wife,” “Deep Play” and “A Natural History of Love” — is, like West, an exuberant wordsmith. No minimalism for them. Describing their 35 pre-stroke years together, she writes, “When it came to literary style, we both preferred the opulent to the sparse. We prized books brimming with poetic descriptions, offbeat characters, and picturesque ideas.” This verbal effusiveness may have helped with West’s recovery, but it does not always serve literature well: Ackerman’s book teems with vibrant images but is marred by repetitiveness and overwriting, including groaners such as, “With a tender smile, I eased the memory from the heavy slate of my mind.”

Back in 1999, West published “Life With Swan,” which he called a “casually fictional account” of his life with Ackerman. It was such a gushing tribute that one wondered whether his wife was terminally ill. Reading “One Hundred Names for Love,” you realize that the appreciation was prescient: If you’re going to be afflicted with aphasia, whom better to have in your camp than a passionate, energetic, hyper-articulate spouse 18 years your junior whose last book, “An Alchemy of Mind,” lauded the intricacies of the brain?

“Swan” was just one of many endearments West coined for Ackerman pre-stroke — something she misses when he’s no longer able to romp with her “in the sandbox of language . . . building ornate castles.” She comments, “Once upon a time in the Land of Before, Paul had so many pet names for me I was a one-woman zoo. Now it was as if a mass extinction had taken place, all the totemic animals we shared had vanished.”

Her “aha” moment is the realization that her husband is more likely to respond to therapy that’s been tailored to his verbal friskiness and esoteric vocabulary (he accesses obscure words like “spondulicks” but has difficulty summoning its more common synonym, “money”). In order to “keep his language mill churning,”she and the wonderful nurse/amanuensis they hire barrage West with nonstop brain workouts, including conversation, movies, wordplay and writing.

Although intensive, this therapy has little in common with the draconian, unsympathetic regimen Roald Dahl implemented for his wife, actress Patricia Neal, after her 1965 stroke. Emphasizing the playful, Ackerman creates “a sort of madcap Mad Libs” and encourages West to coin new monikers for her — the 100 names of the title, ranging from cute to outlandish, including My Little Spice Owl, My Little Bucket of Hair and Blithe Sickness of Araby.

She also suggests that he write an account of his stroke — by painstaking dictation at first, later in longhand. Published in 2008 as “The Shadow Factory,” this is at once miraculous and heavy going. Miraculous because, as Ackerman reports, five years after his stroke, West’s brain scans lead a doctor to assume he’s “in a vegetative state.” Ackerman is happy to correct him. She writes that although West’s “mental pogo stick was missing some of its springs,” with tenacious work he “has re-loomed vibrant carpets of vocabulary and his speaking continues to improve.” She concludes, “Our life is different, but sweet, often devolving into hilarious charades as he tries to pin a word down. . . . So our days together still include many frustrations, but once again revolve around much laughter and revelry with words.”

“One Hundred Names for Love” marshals thousands of words in a testament to the power of creativity in language, life — and love.

Heller McAlpin reviews regularly for, the Los Angeles Times, Christian Science Monitor and other publications.


A Stroke, A Marriage, and the Language of Healing

By Diane Ackerman

Norton. 322 pp. $26.95