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

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By turns touching and tragic, funny and wise, With the End in Mind brings together Kathryn Mannix ’ s lifetime of medical experience to tell powerful stories of life and death. This book is written beautifully by a fellow flawed and compassionate human who happens to be a trained, experienced medical professional - this is the key balance that brings this book life and meaning.

It also helps people to enjoy each day as it arises, instead of fearing a sudden and unexpected onset of dying, because usually, death approaches us gradually.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.

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. Again, I would have found this less troubling if Mannix had been upfront about it: instead, she claims that 'many of us in palliative care roles are exasperated by the trenchant, black-and-white opinions of the campaigners for either view [on euthanasia]' but makes her own views pretty clear when she says at the end of the chapter on the Netherlands that 'Once the euthanasia genie is out of the bottle, you must be careful what you wish for', echoing familiar 'slippery slope' arguments. Sometimes the stories almost moved me to tears, and I was interested to learn many things about dying and how it often follows a very recognisable pattern. We can recognise the progress of life-limiting illness; we can predict, less reliably early on yet with increasing accuracy as death comes closer. If you find Atul Gawande's Being Mortal: Medicine and What Matters in the End a worthy read, you should definitely look this one up.This book is a beautiful collection of stories and reflections about dying, written by a palliative care doctor.

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