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

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Even though it is one thing common to all life, it has reached the point where it is seen now as a taboo, something that we deliberately choose to ignore or rarely talk about when pushed. 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. The final of these inevitable events will happen to every single person on this planet at some point in the future. I now feel better educated in just how much these excellent care teams can do to support people and their families at the end of life.

In many cases this involves talking patients and their loved ones through the steps of dying and explaining the patterns – decreased energy, increased time spent asleep, a change in breathing just before the end – as well as being clear about how suffering can be eased. From the shrinking circle of his life, from his frail body drowning in itself, he reached outwards towards the friends he was leaving. She makes the case that we should be neither ashamed nor embarrassed to talk about dying and death but that bringing our fears into the open is a healing process in itself. If one story shows how denial is toxic and the truth needs to be gradually and gently revealed, in another she demonstrates the usefulness of denial; if one describes how precious time can be won for a patient, another is an example of how prolonging life can be cruel and death a necessary kindness.

The 103 third parties who use cookies on this service do so for their purposes of displaying and measuring personalized ads, generating audience insights, and developing and improving products. Mannix's sincere loving care and compassion radiate from the pages of this beautifully written account of her daily life, professional training, clinical practice and most of all, fragile patients. It’s a complicated truth: we all fear dying, and we all fear it in different ways, according to our individual circumstances and life experiences.

At the end of each batch of stories there is a "pause for thought" section to allow people to consider their own positions. I know a lot of NHS staff and they are lovely, but they are also often stressed, irritated by patients and managers, despairing of all they are expected to do in so little time for so little money. I found it incredibly helpful in understanding how my own wee Mum might die in coming days, weeks, months; Parkinson’s, dementia, frailty are all diminishing her quality and quantity of life.

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. I’m a sucker for qualitative snippets of the great transition, and the time before and after, because I am grateful for the privilege of doing death work in my work, and I know no truer teacher than the end of life, so I was a fan of this book. The book is structured around a series of fictionalised case studies drawn from Mannix's own experiences, many of which are deeply affecting. In addition to being an engaging and, dare I say, heartwarming read, it is also richly filled with lessons and advice for current or future use.