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Knocking on Heaven's Door: The Path to a Better Way of Death

4.11  ·  Rating Details ·  2,194 Ratings  ·  406 Reviews
“A thoroughly researched and compelling mix of personal narrative and hard-nosed reporting that captures just how flawed care at the end of life has become” (Abraham Verghese, The New York Times Book Review).

This bestselling memoir—hailed a “triumph” by The New York Times—ponders the “Good Death” and the forces within medicine that stand in its way.

Award-winning journalist
Paperback, 352 pages
Published June 10th 2014 by Scribner (first published January 1st 2013)
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Mar 29, 2013 Karen rated it it was amazing  ·  review of another edition
Shelves: first-reads
Based on her award winning New York Times Magazine article ‘What Broke My Father’s Heart’ (which still can be found via online search), Katy Butler has written a powerful medical memoir. I have read the pre-release e-version and wish the book could be released sooner than September as I would run out and buy copies to send to my siblings as we are currently facing some medical decisions to be made on behalf of our elderly parents who have major medical problems.

The author concentrates on the fi
Jan Rice
This is combination memoir, investigative journalism, and self-help.

Its main thrust is permission to stand down.

The author's father had already had a stroke and begun his final decline when he got a pacemaker so as to be able to withstand a hernia operation. Then the pacemaker kept him going while he became progressively more demented and dependent, and while caring for him drained her mother and arguably shortened her life. The author explores the economic incentives and legal and emotional is
Monica Wesolowska
If you have parents, you need to read this book. Part memoir, part investigative journalism, Knocking On Heaven's Door by Katy Butler is a gorgeous and essential book. In brief, Butler writes about caring for our parents as they age. The truth is that, as modern medicine enables people to live longer and longer, often with poorer and poorer quality of life, the disproportionate burden of caretaking falls on daughters. This is caretaking for those who have fallen through the cracks, neither so il ...more
Oct 13, 2013 Julie rated it it was amazing  ·  review of another edition
Here is what I think: you should go out right now and pick up a copy of this book.

Go on, I'll wait.

The library, the bookstore, download it from Barnes and Noble or Amazon. Whatever.

I am totally serious.

Fine. Next time you are out and about. Honestly, I found this book to be well-written, well (and quite thoroughly) researched (and footnoted), and unvarnished. Unflinchingly, Butler discusses her parents' declining health and ultimate demise, and dares to search out answers for questions both duri
Dec 22, 2013 Evan rated it it was ok  ·  review of another edition
Having worked in emergency medicine I was interested in learning more about a layman's view of end of life medical care. Family members can have a difficult time letting go. I have been called to homes where the patient was on hospice care and yet a family member panicked and called 911 anyway. EMS has no choice but to respond. I think that the most important point that the author makes is that the family needs to educate itself in order to make the most informed decisions in the best interest o ...more
Patricia Ziegler
Though this book deals with tough issues it is an absolute pleasure to read. This riveting story of the author’s loving journey with her parents through the labyrinth of modern medicine is one of the most courageous and beautifully written books I’ve read in any genre. Butler’s honesty, humility, intelligence and compassion grabbed my heart from page one. Her journalistic skills coupled with her talent as a writer combine to open our eyes and minds to choices we may not know we have until it is ...more
Angel Suhrstedt
Sep 25, 2013 Angel Suhrstedt rated it really liked it  ·  review of another edition
Recommends it for: Anyone taking care of a loved one
Almost six months ago today I said goodbye to my 87-year-old grandfather after what had been a few years of amazingly painful decline in his quality of life. Katy Butler discusses the decline and dying process of her father in this book, and provided some truly eye-opening information on what we as children/grandchildren/medical community/insurance are doing in an effort to keep our loved ones alive, even though the life they are left with is not much life at all.

Making decisions about end-of-li
Paul Pessolano
“Knocking on Heaven’s Door” by Katy Butler, published by Scribner.

Category – Death and Dying Publication Date – September 2013

Death and Dying is certainly not a topic most of us want to read or hear about, however we have been headed that way since our birth and it has been proven to be inescapable “Knocking on Heaven’s Door” is the story of Katy Butler and her parents. Katy explores not only the dying part but what comes before it. Katy’s father, Jeff, in his eighties was given a pacemaker, arg
Apr 21, 2015 Ginger rated it it was amazing  ·  review of another edition
Happened to see this on the shelf at the library after reading Being Mortal. This book is along the same lines, but deals with one woman's personal story of her father's stroke, and the subsequent installation of a pacemaker. His body slowly fell apart, but his heart kept going because pacemaker batteries last a very long time. Definitely a good book to read along with Being Mortal. Can be the start of several conversations for families about what medical decisions should be made regarding quali ...more
Superb treatment of a difficult subject -- part memoir and part investigative journalism, read this book BEFORE you make decisions for your parents and, later, for yourself. I walked beside my mother on the long, rugged road to the end of her life, and I learned things in this book that I still didn't know and wish I had. If I had known them, I would have better negotiated that confusing, isolating, and fearful labyrinth we call a hospital. Highly recommended.
Feb 06, 2016 Maggiemuggins rated it did not like it  ·  review of another edition

I'm getting old myself so I know that what matters most in caring for the elderly is doing what needs to be done before it needs to be done, so, if you're looking for a book that may help in the care of an elderly parent, this one might do – in an entirely negative way.

A more selfish, unhelpful and thoughtless way of caring for an old parent it would be difficult to imagine: – for instance, don't consider buying your aging parent a walker even after he's fallen over several times and managed,
Jul 18, 2014 Marti rated it it was ok  ·  review of another edition
I was expecting much more from this book. Instead of being an expose or an actual investigative report about the state of "the end of life" industries, it was a not-very-perceptive account of the deaths of the author's father and mother. The author comes off really badly, many of her decisions and actions just reflecting a selfishness that isn't flattering. The book itself focuses on her very baby-boomerish preoccupation with her own life choices and totally derails the idea that the book is "ab ...more
Diane Henry
Sep 07, 2013 Diane Henry rated it really liked it  ·  review of another edition
From the NYT: "Butler finds that the health care system — and society — seem quite unprepared for a patient like her father. Had he received a diagnosis of a terminal illness, the family would have been supported by a Medicare-funded hospice team. If he had died, there would have been a funeral, condolences, company. “But there is no public ceremony to commemorate a stroke that blasts your brain utterly, and no common word to describe the ambiguous state of a wife who has lost her husband and be ...more
John Doyle
May 03, 2015 John Doyle rated it it was amazing  ·  review of another edition
Shelves: dying
This "investigative memoir" delves into the experiences of a middle-aged daughter navigating our Kafkaesque healthcare system and her own despair, anger, and ambivalence during her father's six-year decline following a devastating stroke. The central message of the book is that too many of us default ourselves and our loved ones into a medicalized labyrinth of tests, procedures, and futile measures that drain them and us of funds and dignity as we die. Most tragically, we routinely miss the oppo ...more
Jan 02, 2014 Nancy rated it it was ok  ·  review of another edition
I feel this book's reputation is misleading. It isn't, in the main, how to help someone you love have a good death. It is mostly a memoir of the author's difficult years with her dying parents. The part that is common sense helpful doesn't come until the very end. I'd like to see that section offered as a separate guide. I wearied of the author's angst and conflicts, mostly with her mother. The parts about the costs of the current medical system aren't exactly new, at least not anymore. Somewhat ...more
Mel Ziegler
May 20, 2013 Mel Ziegler rated it it was amazing  ·  review of another edition
Every family in America should become an ad hoc book club and start the conversation Katy Butler’s brilliant book provokes. Documenting in heartbreaking detail her father’s descent into a special hell created at the muddled intersection of science and ethics, a hell in which his PaceMaker goes on reliably beating long after virtually every other part of his body shuts down, stripping a proud man of all dignity, a hell that spills over consumes the author and her mother for years, Knocking on Hea ...more
Jacki Leach
May 13, 2013 Jacki Leach rated it it was amazing  ·  review of another edition
This book truly grabbed me, as my family has recently lost an elderly relative to cancer. Death is not a 'family affair' anymore, where the ill are surrounded by those they love, where they may die on their own terms. Author Butler chronicles her own journey during her father's decline into dementia and illness, and when she wrote about how modern medicine prefers to keep elderly people alive instead of letting them go when they are supposed to, it tore apart my heart.

'Knocking on Heaven's Door
May 21, 2013 Jaime rated it it was amazing  ·  review of another edition
Having lost three family members in a year and a half, and witnessing both sudden and protracted death, this book captured each experience excruciatingly accurately. I think Butler has the right amount of clinical and research information in the narrative, and I really like the end part, where she provides a "map" and a reading list. Religion, spirituality, family, medicine - it's all in here. At one point, she writes that though she has been preparing and praying for her father's death for year ...more
Judy Evenson
Sep 14, 2013 Judy Evenson rated it it was ok  ·  review of another edition
Shelves: non-fiction
Not nearly as good as I was hoping it to be. Yes, death and dying is not easy - and yes, sometimes the health care professionals make all the "right calls" and other times... not so much. But geez... lady, did you really have to hang the whole thing on "turn the pacemaker off"? A very complicated topic handled from a very narrow perspective. If she's a whistle blower... seems like she needs a better whistle... disappointed after waiting a long time to actual get the book from the library.
Sep 10, 2014 Mightty rated it it was ok  ·  review of another edition
Not nearly enough science and medicine or discussion over the system of dying in the United States and entirely too much content covering the authors issues with her mother.
Feb 07, 2017 Jenni rated it really liked it  ·  review of another edition
Described as "part memoir, part medical history, part spiritual guide," the book details the author's struggles dealing with her father's stroke and the complex world of medical intervention that kept him alive for another painful seven years after it. From that experience, the author's mother vows to be her own advocate and chooses her own way to face her death, and thus the question of the book arises: how much is too much, and when is it okay to accept death head on?

This book gave me a lot to
Philip Barrison
Jan 29, 2017 Philip Barrison rated it it was amazing  ·  review of another edition
Katy Butler brings to light a matter that we often try to avoid in modern society. Knocking on Heaven's door pairs journalistic investigation with personal experience to deliver a compelling message on the importance of "slow-medicine" and the ethics of dying in a technologically progressive medical world. For a writer to make the reader walk away with such contemplation and reverence as Butler does, is highly commendable. I have walked away with a very fresh perspective of end of life care and ...more
Mar 21, 2013 Grace rated it liked it  ·  review of another edition
Disclosure: I choose to read this book for review because I have an healthy fascination with death rituals which stems from studying anthropology. I also have several friends that are going into the medical field or are already there. While reading this book I was looking a relaxed, informational way of portraying the information and cultural attitudes about death, while also looking at any "how they did it" sort of information.

Knocking on Heaven's Door is a memoir of what Butler and her family
Ghost of the Library
I am sure some of you will think or say - what a weird reading choice for christmas?...believe it or not i got so engrossed in the book i only thought about once it finished.

When is it time to say goodbye (to a loved one who is dying in front of your eyes)?
When the pain becomes too much, when there is nothing to be done, when they say its ok for you to let them go....oh that is a very tricky question to answer, isn't it?
No matter how much you plan it, no matter the preparations you may or may no
Fred Forbes
Jun 25, 2014 Fred Forbes rated it it was amazing  ·  review of another edition
May be one of the most important books you will read, particularly if you have a fear of being trapped in the "medical maw" and being denied the "Good Death" that all of us want. As one of my high school girl friends puts it - "When it is checkout time, please refer me to the express lane." The book serves a welcome need if it spurs you to serious thought and discussions about the issues and the steps necessary to protect yourself and loved ones.

The anecdotes are numerous - the tale of the doct
Mar 23, 2014 Phillip rated it really liked it  ·  review of another edition
I decided to read this book after perusing the NY Times 100 notable books of the year. I have the proclivity to read generally quite depressing fare. One c=Christmas I received "Borrowed Time: An Aids Memoir" by Paul Monette and I actually completed it that day for a rather heartbreaking holiday. I find myself incredibly interested in death, and I have read several other books somewhat related. Before reading this book, I read Katy Butler's article for the New York Times on which it is based. It ...more
Oct 15, 2013 Ci rated it really liked it  ·  review of another edition
Shelves: how-to-books
This review has been hidden because it contains spoilers. To view it, click here.
Mar 06, 2016 Jessica rated it really liked it  ·  review of another edition
Shelves: nonfiction, book-club
Knocking on Heaven's Door is not the easiest book to stick out till the end, but it's very important reading and worth the anger and exhaustion you'll feel reading it. Katy Butler watched the medical care her elderly father received following a stroke keep his body alive while his mind and functions declined to the point where he could barely move or communicate. Her book is both a memoir and a critique of the current state of end-of-life care in America, where our technology can keep our bodies ...more
Nov 12, 2013 Kelly rated it liked it  ·  review of another edition
Unless you have lost a parent, you cannot understand the emotions that surround that loss. Those emotions are magnified when your parent, or parents, have been denied what author (and daughter) Katy Butler describes as the "Good Death": the kind of death that people wish for, a quietly slipping into whatever's next while safe in your bed, all of your faculties and physical abilities still intact. My mother did not get that "Good Death," and perhaps that's why I have been somewhat fascinated with ...more
Sep 23, 2013 Amy rated it it was amazing  ·  review of another edition
Recommends it for: Everyone
I feel like I need to buy this book for myself and everyone I know. Yes, I think its *that* important.

Telling both the story of the medical advances of the modern age and the story of her father’s prolonged and agonized death, this book serves as a wake up call to a nation that has lost its way vis a vis the elderly and the “art” of dying. The age of medical advancement was so fast and furious and so exciting that no one thought of the consequences. The consequences are painfully laid out in the
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Goodreads Librari...: Typo in description 3 15 Apr 11, 2015 08:05PM  
DEATHS DOOR 1 19 Sep 15, 2013 04:29PM  
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“When my father was vigorous and lucid, (my mother) regarded medicine as her wily ally in a lifelong campaign to keep old age, sickness, and death at bay. Now ally and foe exchanged masks. Medicine looked more like the enemy, and death the friend. (p. 184)” 1 likes
“When a fine old carpet is eaten by mice, the colors and patterns of what's left behind do not change,' wrote my neighbor and friend, the poet Jane Hirschfield, after she visited an old friend suffering from Alzheimer's disease in a nursing home. And so it was with my father. His mind did not melt evenly into undistinguishable lumps, like a dissolving sand castle. It was ravaged selectively, like Tintern Abbey, the Cistercian monastery in northern Wales suppressed in 1531 by King Henry VIII in his split with the Church of Rome. Tintern was turned over to a nobleman, its stained-glass windows smashed, its roof tiles taken up and relaid in village houses. Holy artifacts were sold to passing tourists. Religious statues turned up in nearby gardens. At least one interior wall was dismantled to build a pigsty.

I've seen photographs of the remains that inspired Wordsworth: a Gothic skeleton, soaring and roofless, in a green hilly landscape. Grass grows in the transept. The vanished roof lets in light. The delicate stone tracery of its slim, arched quatrefoil windows opens onto green pastures where black-and-white cows graze. Its shape is beautiful, formal, and mysterious. After he developed dementia, my father was no longer useful to anybody. But in the shelter of his broken walls, my mother learned to balance her checkbook, and my heart melted and opened. Never would I wish upon my father the misery of his final years. But he was sacred in his ruin, and I took from it the shards that still sustain me.”
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