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

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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. Overall, this book wasn't to my taste, but some readers will engage with the approach to this topic. Mannix shows an incredible devotion and subtility towards human feelings and choices, but in this one chapter she generalizes one case and by doing so makes a faux pas. Finally, Mannix uses the metaphor of 'natural birth' throughout the book to promote her vision of a 'natural death'.

With the End in Mind is my attempt to capture the wisdom of dying and death, distilled into stories that take us to those places we believe are too dark to endure, and yet that are illuminated by human resilience, hope and love. It’s written with such warmth, compassion, and integrity, and it contains just the right amount of humour. 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.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.

That is what many of the conversations with patients are about and the result is usually a very pragmatic response from the patient and gentle but thoroughly honest comments from the doctors, nurses and therapists. 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.I shed a few tears but it s not gut wrenching and Mannix weaves the light and dark strands of her experience with finesse.

Starting in cancer care and changing career to become a pioneer of the new discipline of palliative medicine, she has worked in teams in hospices, hospitals and in patients own homes to deliver palliative care, optimising quality of life even as death is approaching. A last resort decision surrounded by strict laws with the highest regard for the patient's autonomy, family and close ones. It’s offered me some ‘permission’ to say what I see, ask simple and complex questions of her carers, express and ask for what I know she would and wouldn’t want and what I want.

As the hospice leader she's working with on Holly's case describes it to Holly's daughters: 'Have you noticed that she stops breathing from time to time? It also ignores the significant number of individuals who are either rich enough to travel from the UK to Switzerland or not so rich but just as desperate - and so who throw themselves down stairs / try to poison / or suffocate themselves - all alone since they are concerned for their family with the current law.

With the End in Mind, similar to Atul Gawande's recent book Being Mortal, is an outstanding contribution to the topic of end of life care, and as such it is a book that would be of benefit to everyone. I can’t say enough about what a comfort this book was to me - it used knowledge and stories to take the fear away of what may come, and how to face those times with calm and reassurance, grace and finality. Mild, tender and conciliatory, I would like her to be my compassionate, wise doctor when I lie dying. As her children told her when they visited her dying godmother, “you and Dad [a pathologist] have spent a lifetime preparing us for this. There are only two days with fewer than twenty-four hours in each lifetime, sitting like bookends astride our lives: one is celebrated every year, yet it is the other that makes us see living as precious.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. Mannix sketches in the historical background in which (n Western Society) death has been shunted off from the.