Retired executive David has Alzheimer’s, but it hasn’t advanced to the stage in which all is lost to him yet. Wanting to avoid that fate, he has opted to leave on his own terms via a Medical Aid in Dying company in Zurich, where such services are legal. Before he goes though, he has two stops planned to wrap up some personal, unfinished business and so, in a jet on loan from his old boss and with his longtime assistant Cody at his side, he leaves the US for one final journey.

First, a stop in London to visit his daughter Rebecca and grandson Rainer, with whom his relationships could charitably be described as strained. There is affection there, but he was always more preoccupied with work than family and so a gulf of personal knowledge looms between them. Then it’s on to France to see childhood friend Tom. But that relationship abruptly ended years ago for reasons that may have left Tom nonplussed about the idea of a reunion. And after that, the end.

As one can imagine this is hardly a lighthearted romp of a book, but it doesn’t spend time wallowing in sadness either. Rather this is a novel of gray areas. While David is certainly a deeply flawed man, he was also quite clever, and some of his quick wit remains intact. The more of him that is revealed to us the more he becomes both sympathetic and unlikable. We can sense that he probably didn’t do much good for the world, but his current experience is too real not to feel some sadness for him.

Cline does an impressive job of conveying the jumbled fog of thoughts that must make up the mind of someone similarly afflicted. Each chapter is composed of small clusters of paragraphs that shift unexpectedly as David’s brain jumps from one notion to another, trying to remember names, places, and events from the distant past through to mere moments earlier, and then trying to hide it from those around him when he fails to do so. I don’t think I’ve encountered such a striking and affecting depiction of the disease since the Anthony Hopkins movie The Father.

I don’t know if I could do what David does, and I hope I never have to make the choice, but his decision, along with much of Switzy leaves readers with plenty to think over. The jumbled nature of his thoughts can make getting into the book a little rough at first but once you do it’s a mesmerizing, memorable, and moving look back at an imperfect life that should leave the reader with a greater appreciation of their own. ★★★★½