Beyond the High Blue Air

Book excerpt: A mother reflects on the 5-year aftermath of her son’s traumatic brain injury in this intimate, unflinching portrait of familial love and the profound dilemma posed by modern medicine. “Like The Year of Magical Thinking by Joan Didion . . . a spare, sharp memoir about the speed with which a comfortable existence can be blighted by grief.” —The Sunday Times When Lu Spinney’s 29-year-old son, Miles, flies up on his snowboard, he lands hard on the ice and falls into a coma. Thus begins the erratic loss that unravels over the next 5 years. Spinney, her husband, and 3 other children put their lives on hold to tend to Miles at various hospitals and finally in a care home. They hold out hope that he will be returned to them. A deeply personal memoir, Beyond the High Blue Air also offers universal meaning, presenting an eloquent and piercing description of ambiguous loss: grieving the disappearance of someone who is still there. Three quarters of the way through, however, Spinney’s story takes a turn. The family and, to the degree that he can communicate, Miles himself come to view ending his life as the only possible release from the prison of his body and mind. Spinney, cutting her last thread of hope, wishes for her son to die. And yet, even as she allows this difficult revelation to settle, she learns that this is not her decision to make. Because Miles is diagnosed as being in a “minimally conscious state” rather than a “persistent vegetative state,” there is no legal way to bring about his death, a bewildering paradox that Spinney navigates with compassion and wisdom. This profound book encompasses the lyrical revelations of a memoir like Jean–Dominique Bauby’s The Diving Bell and the Butterfly as well as the crucial medical and moral insights of a book such as Atul Gawande’s Being Mortal.