With the End in Mind

My parents are both still with us, but they are getting frailer and I'm uncomfortably aware that I'm not well prepared for the day when they will leave us. I also have a friend who works in palliative care, and I'm keen to understand more about what she's dealing with. Come to that, I'm not getting any younger myself and it's just as well to start thinking about the pointy end (though I'm not planning to arrive there for a long time yet).

Considering all this, I'm so glad I borrowed Kathryn Mannix's wonderfully calm and matter-of-fact book about death, With the End in Mind. Mannix has worked as a palliative care doctor in the UK for decades and has been present at thousands of deaths. Perhaps the very first chapter is the most comforting, as she talks a terrified patient (and us) through the typical progress of an ordinary death, through growing tiredness and diminishing energy, through periods of sleepiness and brief unconsciousness, to increased unconsciousness and breathing changes, to the very last breath. Most deaths, she emphasises, are peaceful and painless (though of course there are exceptions).

Each chapter is a case study of a patient Mannix has encountered, and the chapters are grouped in themes, beginning with the physical process of dying and moving through psychological questions to the spiritual aspect of the end of life. Death is a subject that we, as a society, are not good at talking about. I recommend With the End in Mind as way of starting that conversation.