Summary

Richard has been living in the den at 450 Walnut Street for a week. It is emasculating to return to the house of his failed marriage after leaving had felt like such a triumph. He can enter and exit at will, but all the neighbors know him. He has no privacy because his bedroom door must stay open if he wants to leave without help. It is a relief to have Karina around just in case, but he does not want to ask anything of her. Of his home health aides, only Bill is willing to travel outside his usual territory to help.

He frequently asks himself why him: ALS can be hereditary, or familial, but no one in Richard’s extended family has it. His form is called “sporadic,” and its cause is unknown. He writes a seventh letter to his father, sending...