Last Nerve

An ALS diagnosis leads to complex reflections about family, healing, and resilience in this memoir.

In mid-2018,Uhrlaub was struggling with multiple family crises, including her husband Kirk’s second bout with lymphoma, her elder son Ethan’s behavioral problems, and her mother’s struggles with Lou Gehrig’s disease, or ALS. The author’s already difficult role as a helper and healer grew even more complicated when she learned that she’d inherited the C9orf72 mutation that causes ALS. For much of the memoir, Uhrlaub’s diagnosis lurks in the background as she focuses on keeping her family together and as healthy as possible. Ethan attended a wilderness program and a specialized high school to learn how to handle his anger, and Uhrlaub discusses the ups and downs of this process in often searing detail. Kirk had to overcome his stubbornness about going to hospitals, says Uhrlaub, which led to a major fight, and the author reflects on what it means to love and forgive another person. She also tells of how her mother grew sicker, and how, in response, Uhrlaub dove into ALS research studies and into her own childhood. The memoir ties all these themes together by discussing the importance of joining with loved ones to fight against the most frightening problems. As she notes midway through the book, “We all have monsters under our beds, whether they’re anger management, cancer, anxiety, or ALS…If we battle our monsters, we can eventually win.” Readers will likely be inspired by Uhrlaub’s determination to face her own monsters, and by her openness about how difficult it can be to act in a healing role. Sometimes, though, the descriptions of her frustrations feel defensive, particularly in the sections about children, generational wealth, and publishing a first novel. Overall, though, this memoir has a great deal of insight and depth, and readers will be moved.

A complex and thoughtful remembrance about how family members can help one another through the worst of times.