With the End in Mind by Kathryn Mannix reviewed

With the End in Mind: Dying, Death and Wisdom in an Age of Denial Book Cover With the End in Mind: Dying, Death and Wisdom in an Age of Denial
Kathryn Mannix
Biography & Autobiography
HarperCollins UK
December 28, 2017

In this unprecedented book, palliative medicine pioneer Dr Kathryn Mannix explores the biggest taboo in our society and the only certainty we all share: death.

Told through a series of beautifully crafted stories taken from nearly four decades of clinical practice, her book answers the most intimate questions about the process of dying with touching honesty and humanity. She makes a compelling case for the therapeutic power of approaching death not with trepidation but with openness, clarity and understanding.

With the End in Mind is a book for us all: the grieving and bereaved, ill and healthy. Open these pages and you will find stories about people who are like you, and like people you know and love. You will meet Holly, who danced her last day away; Eric, the retired head teacher who, even with Motor Neurone Disease, gets things done; loving, tender-hearted Nelly and Joe, each living a lonely lie to save their beloved from distress; and Sylvie, 19, dying of leukaemia, sewing a cushion for her mum to hug by the fire after she has died.

These are just four of the book’s thirty-odd stories of normal humans, dying normal human deaths. They show how the dying embrace living not because they are unusual or brave, but because that’s what humans do. By turns touching, tragic, at times funny and always wise, they offer us illumination, models for action, and hope. Read this book and you’ll be better prepared for life as well as death.

With The End in Mind is the story of some of Dr Kathryn Mannix’s patients. She has written this because, as a palliative care specialist of 30 years, she has seen a lot of people dying. She is also aware of the lack of information about the process that is available to patients and their families. This attempts to redress the imbalance. As a by product of this we get to learn quite a bit about the author and her career too.

I have read a few books on the subject of dying over the past few years. They have all been of interest and informed me to some degree whether they illustrate personal stories or look at the bigger picture. The “personal stories” approach ones that I’ve read so far were those of one person’s story. This book contains many personal stories, all different in the same way that we are all different people. One commonality is the misunderstanding of the stages and process of death. The book has a very good introduction to the subject as a whole.

Very early on in the book I realised why palliative care might suit Kathryn Mannix. Concern, empathy and interest are very evident. The writing seems to reflect what I imagine her personality to be – skilled, caring and empathetic. It is also highly readable. The names of her patients have been changed and there is nothing that will give away exactly who is being referred to.

If there are not signs of dampness around the eyes when reading this book I’d be frankly amazed. My eyes were frequently damp and some of the stories had tears rolling down my cheeks. I must emphasise that this was not in a bad way. This book may well not be for everyone however it tackles very difficult subjects with great gentleness. The people in these stories are remarkable people.

The book starts with Sabine’s story and looks particularly at the process of dying and the need for honesty at such a time. I’ll not go through the individual stories – Kathryn writes far better than I do. No two people reading them will react in the same way however I enjoyed (if I can say that about tales of death) them all and some were very special indeed. What I should say is that some are hard stories and “shocking to read” – you have been warned . However the writing is frequently poetic and has a gentle directness that for me made it an excellent read. The phrase a “survival guide to dying ‘ seems apt and is coupled with a gentle caring honesty.

I did find some stories ambush you – for me Mark’s was one of those. It suddenly hit me quite hard. However this book is so well written that it can allow you tears – not of sadness but maybe of understanding and empathy as well as tears of laughter. I hadn’t expected to laugh out loud reading this but I did. One passage even made me both laugh AND cry – not something I expected.

I found this book interesting on more than one level. As well as the stories and the “guide to dying” it is a good insight into palliative care and hospices generally; on what they do or hope to do. Due to the issues involved in one story the book also looks briefly at the legalities and ethics involved in dealing with patients who are approaching the end of life. At the end of each batch of stories there is a “pause for thought” section to allow people to consider their own positions. At the end of the book there is a good resources section.

In many ways it was a privilege to be able to read this book. It managed to be both personal & general and profound & trivial however it was almost always powerful and always deeply human and humane. I really would hope that this book would be widely read and not simply by those directly interested from a medical perspective – as the author tells us we will all die one day.

Note – I received an advance digital copy of this book from the publisher in exchange for a fair review