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

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Really this is the kind of book I would like to own a copy of and read steadily, just a chapter a week. But this ignores the 'doctor-knows-best' use of medication described above - assisted is apparently OK if the Leader and the author decide to do it. She clearly describes the actual process of death by gradual illness to the people in her care, their families, and the reader. Having qualified as a Cognitive Behaviour Therapist in 1993, she started the UK’s (possibly the world’s) first CBT clinic exclusively for palliative care patients, and devised ‘CBT First Aid’ training to enable palliative care colleagues to add new skills to their repertoire for helping patients. Although it is primarily about death, it is also very much about life – about living your life to the full, by not fearing death when it ultimately comes:.

Clearly, this book isn't about that, but I would have liked the professionals to also have a little more personality too. Even then, death is often held at bay and life prolonged at all costs: the fragile and disintegrating body is plugged into machines, pumped full of oxygen and blood and drugs, its gallant heart restarted and kept going, no matter the pain, no matter the hopelessness of the endeavour, no matter that at a certain point this isn’t living, just a slowed-down, drawn-out, painful and undignified dying.I truly believe each person should read this book; the stories are heartbreaking but the lessons are forever. This was a book to take in slowly, chapter per chapter, intimate and tender story per intimate and beautifully written story.

Mannix’s introductions to each section and chapter, and the Pause for Thought pages at the end of each chapter, mean the book lends itself to being read as a handbook, perhaps in tandem with an ill relative. 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.

This infuriated me because of the damage, pain and suffering the language of 'natural birth' and the doctrine of little medical intervention has caused to women and their babies. It takes an anecdotal story approach to representing a variety of death, dying and grieving situations and conversations that many might find potentially helpful. Her mission is to “reclaim public understanding of dying” and to bring individuality and joy back into our dealings with the dead – and so, in From Here to Eternity, she embarks on a journey of discovery: to the only open pyre in America; to a sky burial in Tibet, where the body breaker slices the corpse into parts, pounds the flesh with a mallet, mixes it with barley flour and yak butter or milk, and leaves it to the shrieking vultures to consume; to burial towers in India; to the people of Tana Toraja in Indonesia, where mummified bodies are cared for in their home (offered food, dressed, even given a bed with the living) over months or years until the family can sacrifice an animal and put the dead to their final rest; to Barcelona’s mass bone pits; Mexico’s Day of the Dead. You can change your choices at any time by visiting Cookie preferences, as described in the Cookie notice. I believe in adding life to my years, not vice versa if that means losing all the basic dignities and quality of human life.

At the end of each batch of stories there is a "pause for thought" section to allow people to consider their own positions. One person’s good death is not another’s – we all need to find our own way to take our bow and leave the stage. She believes that a better public awareness about what happens as we die would reduce fear and enable people to discuss their hopes and plans with the people who matter to them. Most outrageous was the agitated woman given medication to counteract the agitation some other medication had caused.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.

Unfortunately in our society we seem to have become afraid of dying and being able to talk to people facing death. 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. we are privileged to accompany people through moments of enormous meaning and power; moments to be remembered and retold as family legends and, if we get the care right, to reassure and encourage future generations as they face these great events themselves. 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.It’s the great nothing; the everything, which makes us and unmakes us, and to which we all come in the end. About a quarter of deaths are sudden and unexpected, but she usually sees the ones that come slowly, over months or years, and while much of her work is diagnostic and medical, one of her crucial tasks is to help those who are dying and their families find ways of dealing with life’s final, great event. It’s almost impossible to answer, yet people ask as though it’s a calculation of change from a pound. This was not because I wasn’t enjoying it, but because it was a two-week loan and I was conscious of needing to move on to other longlist books.