This book by Seamus O’Mahoney opens with a good introduction as to what the book is about and what the author intends to cover in it. It suggests that, while there is much in this that is medical, it is to be more personal than medical while covering some recent headline medical issues. For me it felt like a remarkably honest account of a number of interactions that this doctor has had with death and dying patients. I already realised before reading this book that the real taboo subject these days is death and this book has simply born out that feeling.
The book is actually remarkably wide ranging covering literature, culture & religion, celebrity deaths, enquiries into medical/hospital issues as well as the philosophy of death more widely. The initial chapter takes a look at how (& where) our lives usually end in current times. That is followed by a chapter looking at the views of 4 modern day (20C) writers on dying under the general heading of “Hidden death”. The current approach of sanitising and hiding death is compared to earlier times when public acceptance was part of life. There is an Irish Catholic background here which influences the book to some degree and so the fact that the book looks into the rituals of death that are now becoming increasing absent such as the Wake is no surprise. The book is peppered with stories about dying including those who are well know as well as those who are quite ordinary people. I certainly found many of these very interesting and often thought provoking.
The book looks at two of the high profile and widely publicised cases of the “Stafford hospital scandal” and the Liverpool Core Pathway. In both cases the author looks at issues that have been well understood in both these cases. However he also looks at aspects that have been less well publicised and understood even. There are critiques of both these issues as well.
Running through this book is an insight into dealing with seriously ill people within the NHS including health workers attitudes to dignity & dying and thoughts on empathy. Hospital and hospice deaths are looked at together, to some degree, with their outcomes. There are some thoughts on the time for syringe drivers, having the “difficult” conversation with patients coupled with the fact that palliative care should be part of most doctors duties. With noting in this that the author states that in his opinion “Our job should be the treatment of illness ” and that dangers await if doctors go beyond that. Unsurprisingly advanced directives are considered as well as assisted dying. However the author makes the point that, whether satisfactory legality of actions can be established or not, such ideas cannot take into account the full range of possibilities that may face someone (& their doctors) towards the end of life.
The book ends with “some proposals” the author noting a caveat that, by the end of the work on this book he is “no wiser, but considerably better informed”. I found his conclusions simple and worth reading personally. Indeed I found the whole book well worth reading. Some chapters did not interest me quite as much as others however those that did I found rewarding in many senses. Certainly I too am better informed now. Obviously this is not a book for everyone – despite that fact that we will all die at some stage. However, for those either within a medical background or those outside with an interest, should find this book a worthwhile read.
After reading this I’m left wondering whether at least some aspects of how are not up to us – there seem to be hints of this in this book. For example there are stories those who “fight” versus those who “accept” when we reach our best before date. That is not to suggest that either approach is right or wrong simply that we need to be as happy as possible in our approach to death.
Note – I received an advance digital copy of this book from the publisher in exchange for a fair review