On January 26, 2020, Amy Bloom and her husband, Brian Ameche, boarded a flight from New York to Zurich. They hadn't called on their usual driver to transport them from their home in Connecticut to John F. Kennedy Airport; they didn't want to make small talk about their itinerary. Usually they flew economy, but this time they were in business class.

"In our Swissair pods, Brian and I toast each other, and we say, 'Here's to you,' a little hesitantly, instead of what we usually say, 'Cent'anni' ('May we have a hundred years,' a very Italian toast)," Bloom writes in her 10th book and first memoir, In Love, which Random House will publish on March 8. "There is no 'Cent'anni' for us; we won't make it to our 13th wedding anniversary."

Bloom and Ameche weren't going to Switzerland to enjoy skiing, art or fondue. They were en route to Dignitas, a non-profit organisation in the suburbs of Zurich, where Ameche, 66, would legally, peacefully and painlessly end his own life.

The accomplished architect and former Yale football player had received a diagnosis of Alzheimer's disease in 2019, and he decided that the "long goodbye" was not for him. Bloom recalls him saying, "I'd rather die on my feet than live on my knees."

On a drizzly February afternoon, five days after the second anniversary of Ameche's death, Bloom, 68, sat in her office overlooking the Long Island Sound and spoke calmly about her husband's wishes.

"We were in the kitchen," she recalled. "He had already made his decision and said, 'I don't want to argue. This is what I'm going to do, and I want your help because you're good at this kind of thing.' He was pacing a little bit and he said, 'You have to write about this.' And I was like, 'Oh, honey.' And he was like, 'No, you have to do this for me.'"

The idea of being "good at this kind of thing" makes sense when you're sitting across from Bloom, who exudes capability and reassurance. She was a clinical social worker for 25 years before she turned to writing, and still maintains a small practice. She is the author of four novels, three short story collections, one picture book and one work of nonfiction. Even the titles of Bloom's books seem to telegraph her firmly compassionate gestalt: Come to Me, Love Invents Us, A Blind Man Can See How Much I Love You, Lucky Us.

Amy Bloom: "We had a pretty good 'let the other person be the other person' policy ... [Brian] didn't keep his personality a secret, and neither do I." Photo / Lisa Kereszi, The New York Times

Bloom and Ameche were both in unhappy partnerships when, in 2005, they started taking walks together, then talking at the local Democrats' breakfast club, then chatting in private. They married in 2007. From the start, she said, "We had a pretty good 'let the other person be the other person' policy. It wasn't 'who knows who you'll turn out to be?' He didn't keep his personality a secret, and neither do I. I think it was one of the things that we liked about each other."

Their life together was full of lively conversation, delicious meals, the usual spousal frustrations, Bloom's three grown children from a previous marriage and four adoring granddaughters. (Bloom recalls Ameche saying, "Never had kids and went straight to grandchildren. How lucky am I?")

Then came the excruciating creep of Alzheimer's. Ameche struggled at work; his handwriting and wardrobe changed; he bought off-kilter cards and gifts (including a US$500 sweatshirt); and developed odd habits, like compulsively checking a six-page paper calendar that he carried from room to room.

"You could feel the infrastructure crumbling," Bloom said. "Everything that was 'now' basically fell away. What he talked about was the past, but in particular, football. I think that was one of the happiest times of his life, and that's where he wanted to be."

She went on, "Elaborate and nuanced speech wasn't available to him. It was certainly hard for me. It was very hard for him."

After a neurologist delivered the diagnosis, Bloom writes: "We go out to buy stationery — 'Goodbye, I love you' stationery, so that he can write little notes to my kids and our grandchildren for after he's gone, because he has already made up his mind to end his life."

The couple considered several methods, but each came with its own risks, not to mention legal ramifications. ("Right to die in America is about as meaningful as the right to eat or the right to decent housing," she writes. )

She located Dignitas, "the only place to go," she writes in the book, "if you are an American citizen who wants to die and if you are not certifiably terminally ill with no more than six months to live". Getting approval and corralling paperwork for an "accompanied suicide", as Dignitas calls it, required a herculean mobilisation of resources, including US$10,000 and medical records.

As Bloom went with Ameche from neurologist to psychiatrist to MRI, she kept track of details. "I think better when I write, so I would bring notebooks with me, like my grandmother with her plastic handbag," she said. The couple told very few people why they were going to Switzerland, but Ameche's mother and four siblings were aware.

On January 30, 2020, Bloom and Ameche travelled from Zurich to the suburb of Pfaffikon, where Dignitas has an apartment. There, with an aeroplane pillow around his neck and his hand in Bloom's, Ameche swallowed a lethal dose of sodium pentobarbital.

"I sit, holding his hand for a long time," Bloom writes in the memoir. "I get up and wrap my arms around him and kiss his forehead, as if he is my baby, at last gone to sleep, as if he is my brave boy going on a long journey, miles and miles of nought."

It's a passage that calls to mind the one in The Year of Magical Thinking when Joan Didion describes her decision to save the shoes of her husband, John Gregory Dunne, after he died. As a reader, you know when a writer has ushered you into their innermost sanctum.

Bloom travelled back to New York City with Kay Ariel, a friend of more than 40 years, who had met Bloom and Ameche in Zurich.

"Amy flying back on her own was just not going to happen. This is where friends need to come through," Ariel said in a phone interview, after describing how Bloom was there for her through breast cancer, divorce and her mother's death from Alzheimer's. They held hands on the plane. "It was one of the hardest journeys I've ever taken. There wasn't a lot to be said other than, 'I'm going to miss him for a long time. I love him, and I love you.'"

Bloom had visions of taking to bed upon her return. Her therapist asked if this was a coping strategy she had used before; when she admitted it wasn't, he said, "I don't see that working out for you, but good luck!"

So Bloom got to work. She made a timeline, consulted her notebooks and started writing, per Ameche's instructions. "There were pages I would write about things that made me really angry, which was better than being sad," she said. "And then there were parts that were just so sad to write, always. They're sad for me to read now."

The pandemic arrived "like the snow at the end of The Dead", Bloom said, referring to James Joyce's classic story — a few flakes at first, then blanketing everything. Bloom's daughter, daughter-in-law and granddaughter came from Brooklyn to ride out the storm. Bloom kept writing in the afternoons. She laughed. "My kids tease me, they say, 'You expected to be sitting by the pond, in grey gauze, staring into the distance.'" Instead, she was absorbed by work and the rhythms of family life.

By September 2020, Bloom had a draft to share with her longtime editor, Kate Medina, the executive vice-president, associate publisher and executive editorial director of Random House. Medina had attended Bloom and Ameche's wedding and was at his memorial service; readers see her there in the book, quietly marking up a manuscript before the start of the ceremony.

In a phone interview, Medina said she was accustomed to working with Bloom on novels. She wasn't surprised or daunted by Bloom's decision to tell such a personal story. "If you're a writer and something like this happens, the healthiest thing to do is to write it," Medina said. "You can make up your mind whether you put it in a drawer, but you have enunciated the feelings."

Medina encouraged the braided structure of In Love, which is, as its subtitle promises, a memoir of love and loss, in that order, with chapters alternating between the distant and recent past. "There's that Kierkegaard quote: 'We live our lives forward and understand them backward,'" Medina said. "I think it's breathtaking the way Amy can write about the elephant in the room. Her forthrightness is on the page. So is her humour, and Brian's."

Early reactions from readers have been positive, even rapturous. "Amy Bloom writes with the full bandwidth of her humanity," one Goodreads reviewer effused. A recent widow wrote, also on Goodreads: "I can only say that this book comes from a place of truth. It should be required reading for any grief group."

On the anniversary of Ameche's death, Bloom brought a cup of tea out to the linden tree she planted in his honour. He had a sweet tooth, so she placed chocolates around a plaque engraved with a favourite Rumi quote. It reads: "What is the body? Endurance. What is love? Gratitude. What is hidden in our chests? Laughter. What else? Compassion."

"I definitely feel his presence," Bloom said.

As for how strangers will respond to In Love, she appeared to be at peace. "Brian's strong wish was that nobody would stop him, and he got his wish. And I was glad I could help him."

The New York Times