• Caleb Kenna
• Emily Shapiro and Alex Belth

Emily Shapiro didn't remember much about Alex Belth from high school. But in a fateful reintroduction as adults years later in New York City, Belth certainly remembered her. How could he not?

"She was one of the hot chicks," Belth, 50, recalled in a 2018 piece for Men's Health. Told against the backdrop of a blizzard in the city, that essay, titled "How Our Relationship Survived When My Partner Got Sick," offered a glimpse of how the couple had navigated their marriage alongside what they call an "uninvited third party" — chronic illness.

When she was 22 and fresh out of college, Shapiro, now 49, developed Crohn's disease. Over the course of nine surgeries in five years and countless other appointments with specialists, surgeons and physicians, the incurable autoimmune disorder eventually "consumed her life," Belth wrote.

In any healthy romantic relationship, partners assume different roles to make it work. But when one partner becomes a "professional patient," as Belth termed it, and the other a caregiver, the challenges deepen well beyond who's going to fold the laundry, whose sex drive is higher or who's more responsible with money.

"When it's your partner that you're caring for, you're not just dealing with an illness," Belth wrote in 2018. "You're dealing with a changed relationship."

This Thursday, February 10, Belth and Shapiro release Here I Are: Anatomy of a Marriage, an audiobook that delves deep into those changes and how they've handled them over 20-plus years together. The book, available as an Audible Original, ostensibly grew out of Belth's 2018 essay. That piece viewed their relationship primarily through his lens as a caregiver, but in Here I Are both Belth and Shapiro present their story the way good partners ideally approach most things: on equal footing.

"I felt really strongly that Emily and I should be partners in this story," Belth told Seven Days in a joint interview with Shapiro. "Because there's value in [what we both] are bringing to it."

Recorded from Belth and Shapiro's home in Bristol, where they've lived since moving from NYC in 2020, the book flows with an easy point-counterpoint rhythm. Though not quite conversational, the narrative structure allows the two not only to tell their parts of the story but also to respond to each other.

For example, when Belth recalls being keenly aware of Shapiro in high school, she offers a rather less flattering half-recollection of her future husband: that he wore a bow tie in his yearbook photo. Especially in lighter moments such as those, the couple's palpable affection for one another is charming and provides a keel for the stormy seas of conflict that inevitably come.

Here I Are takes its title from a phrase Shapiro uses to greet her husband after a good night's sleep. As Belth recalled in his 2018 essay, "Here I are" was her response as a little girl the first time someone asked her "Where are you?" The title reflects those small moments that sweeten every good relationship. It's also a declaration.

Belth, an editor at Esquire, is excitable and eloquent, a classic extrovert. Shapiro, a certified life coach and Reiki practitioner, is an introvert. She's a thoughtful and private person who avoided burdening others with specifics of her illness because she never wanted to be known as "the sick girl," she said.

"So for me," she explained of the audiobook, "this was an opportunity to really come out of my shell and start talking about what's not talked about."

Belth and Shapiro don't shy away from uncomfortable details in their story, particularly when it comes to issues directly and indirectly related to Shapiro's illnesses. In addition to Crohn's, she suffers from chronic migraines and a neurological issue called convergence insufficiency that creates blurred or double vision and can also cause severe headaches.

Their description of the first time they made love, which was also the first time Belth saw Shapiro's ileostomy bag, is both tender and harrowing. Three months into their promising relationship, Belth was getting cold feet due to her illness. Shapiro's ensuing frustration with Belth is gut-wrenching, even though we know they end up together. His confessions of anger born of the helplessness caretakers often feel while watching their partners suffer are heartbreaking and humanizing.

Chronic illness provides Here I Are with a uniquely dramatic framework. But the book is often most compelling in its universal moments, recounted with similarly unvarnished honesty: feeling frustrated when an amorous advance is shot down; stressing over financial problems; finding ways to communicate effectively and give your partner space.

"Yes, illness is a big topic," Shapiro said. "But we're also two humans coming together with all kinds of baggage that has nothing to do with illness."

"It's not just an illness story," Belth concurred. "The core of what we're dealing with is stuff that every couple that's ever existed goes through. What we're hoping [we] can be of service to is [the idea] that an authentic life is an untidy life."