With the End in Mind: Dying, Death and Wisdom in an Age of Denial

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Photograph by Getty Images View image in fullscreen ‘While death may be harrowing, it need not be intolerably painful. No es más que una colección de historias diversas sobre un montón de gente que vivió sus últimos días. In previous centuries, death was familiar and not hidden behind institutional walls: before the 20th century, there would have been scarcely an adult who had not seen their parents, some of their children, and their friends die.

She has written this because, as a palliative care specialist of 30 years, she has seen a lot of people dying. With a tsunami of death coming soon as the baby-boomers die, there really wont be enough staff trained in this particular way.

I was a bit startled by some of the negative reviews for this book which I read when I was half way through. I have referred to that one a number of times when talking to people who were in fear of their death, and I can see how this one would be even more comforting. I truly believe each person should read this book; the stories are heartbreaking but the lessons are forever. When John Keats was dying of TB in Rome, just 25 and far from family and home, he wrote a series of beautifully judged, empathetic letters of farewell that deal lightly (yet never falsely) with his physical suffering and his emotional anguish. It was a chapter about a dying person in Holland who felt he was pushed by his doctor into ending his life with euthanasia.

The final of these inevitable events will happen to every single person on this planet at some point in the future. But ultimately I have to judge With the End in Mind as a book that Mannix has written, separating it from Mannix's personal achievements, and in this context, it fell very short. I must underline that this is not a sad book even though I felt sad and did put the book aside regularly to reflect on what I just read. I shed a few tears but it s not gut wrenching and Mannix weaves the light and dark strands of her experience with finesse.She makes a compelling case for the therapeutic power of approaching death not with trepidation but with openness, clarity and understanding. By turns touching, tragic, at times funny and always wise, they offer us illumination, models for action, and hope. She doesn't fill up the book with pages of medical jargon, but instead talks about many of the patients that she has met during the years and how her job helps them to deal with end of life care.

Unfortunately in our society we seem to have become afraid of dying and being able to talk to people facing death. Again, I would have found this less troubling if Mannix had been upfront about it: instead, she claims that 'many of us in palliative care roles are exasperated by the trenchant, black-and-white opinions of the campaigners for either view [on euthanasia]' but makes her own views pretty clear when she says at the end of the chapter on the Netherlands that 'Once the euthanasia genie is out of the bottle, you must be careful what you wish for', echoing familiar 'slippery slope' arguments. What she is a big advocate of is communication, telling people what is wrong with you, getting them to ask sensitive questions, finding out if people want to be at home for their last moments, or have no real preference.I almost stopped reading With the End in Mind after 'Please Release Me: B Side' where Mannix tells a story about one man's unpleasant experience in the Netherlands that is entirely based on hearsay, and I realised that a number of stories she had been telling in that section had been deliberately engineered to emphasise the benefits of palliative care as opposed to euthanasia. It may also be because I have read quite a number of books with similar themes and scope – including Caitlin Doughty’s two books on death, Caring for the Dying by Henry Fersko-Weiss, Being Mortal by Atul Gawande, and Waiting for the Last Bus by Richard Holloway.

Kathryn Mannix has spent her medical career working with people who have incurable, advanced illnesses. For all ebook purchases, you will be prompted to create an account or login with your existing HarperCollins username and password.They receive their care via England's national health program, so everyone qualifies for the same care. Now Kathryn Mannix joins this distinguished group and her voice, though quiet and calm, is distinctive. My job means I deal with people coping with grief often, and I would dearly love to ease some of this ghastly suffering which comes from being utterly unprepared for death and grief, and having absolutely no language or map to navigate this one certainty in life. If you are wired so that you think there's grandeur, learning, redemption, or whatever other "quality" in suffering except pointless pain, you are going to stand your ground and use this book to reinforce your rationalizations about why the pain (physical suffering) is unavoidable, even necessary part of human experience. Perhaps most of all it is a book which all doctors should read as an example of the healing that can be accomplished simply by a gentle, patient and sensitive conversation.