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

4.58  ·  Rating details ·  3,222 ratings  ·  456 reviews
Dr. Kathryn Mannix has studied and practiced palliative care for thirty years. In With the End in Mind , she shares beautifully crafted stories from a lifetime of caring for the dying, and makes a case for the therapeutic power of approaching death not with trepidation, but with openness, clarity, and understanding.

Weaving the details of her own experiences as a caregive
Hardcover, 352 pages
Published January 16th 2018 by Little, Brown Spark (first published December 28th 2017)
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Kathryn Mannix Hello, Rene.
My book is about accepting that death will come to us all, and that normal dying is usually far less awful than we fear.
I'm all for medic…more
Hello, Rene.
My book is about accepting that death will come to us all, and that normal dying is usually far less awful than we fear.
I'm all for medical technology helping us to live well and fulfill our potential, but the stories do include a consideration of how we should respond once technology is simply extending dying rather than enhancing living.
Only an individual can answer the quality vs quantity dilemma for herself/himself. Perhaps if we fear dying less, we will be less tempted to string out a low-quality existence using lots of technology simply to remain alive. On the other hand, many people find that they can embrace living a less active life if they have the pleasure of friends, family, music, art or whatever their passion is. It's really hard for anyone to judge someone else's quality of life.
So yes - for some people, extending life until a special event takes place or a particular milestone is reached can be worth it. But extending it simply because of terror of dying? That would be so sad, and it's that dilemma I am trying to address.
Thanks for asking.(less)

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Average rating 4.58  · 
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 ·  3,222 ratings  ·  456 reviews

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Start your review of With the End in Mind: Dying, Death, and Wisdom in an Age of Denial
This is an excellent all-round guide to preparation for death. It’s based around relatable stories of the patients Mannix met in her decades working in the fields of cancer treatment and hospice care. She has a particular interest in combining CBT with palliative care to help the dying approach their remaining time with realism rather than pessimism. In many cases this involves talking patients and their loved ones through the steps of dying and explaining the patterns – decreased energy, increa ...more
Apr 24, 2018 rated it it was amazing  ·  review of another edition
Shelves: books-read-2018
To completely re-write the original quote that Benjamin Franklin made; there are three things that are certain in life; taxes, your computer crashing and death. The final of these inevitable events will happen to every single person on this planet at some point in the future. 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. Death though is something that Dr K ...more
Oct 23, 2017 rated it it was amazing
In brief - Best book of the year without question. A powerful and moving read.

In full
This is the story of some of Dr Kathryn Mannix's patients. She has written this because, as a palliative care specialist of 30 years, she has seen a lot of people dying. She is also aware of the lack of information about the process that is available to patients and their families. This attempts to redress the imbalance. As a by product of this we get to learn quite a bit about the author and her career too.

I ha
Alice Lippart
Oct 12, 2019 rated it really liked it
Surprisingly peaceful and comforting. Well worth reading.
Shirley Revill
I listened to this audiobook and I was very impressed with this book.
The book shares the stories of a palliative care doctor and the people she gets to know who are facing death.
Unfortunately in our society we seem to have become afraid of dying and being able to talk to people facing death.
This is a very well written memoir that will bring a great deal of comfort to so many people.
Well worth reading and very highly recommended.
Bookphenomena (Micky)
2.5 stars

WITH THE END IN MIND is written for the public perspective and not professionals working with the grieving, in my opinion. It takes an anecdotal story approach to representing a variety of death, dying and grieving situations and conversations that many might find potentially helpful.

I tried to read it from a dual perspective, as a professional and academic in this field but also as a person inquisitive about their own death and those of my loved ones. However, I found as a professiona
Mar 01, 2018 rated it did not like it
Kathryn Mannix's With the End in Mind: Dying, Death and Wisdom in an Age of Denial is written from her own experiences as a specialist in palliative care, and this proved, for me, both its strength and its downfall. The book is structured around a series of fictionalised case studies drawn from Mannix's own experiences, many of which are deeply affecting. I was particularly touched by the stories of Sally, a young woman dying from melanoma who refused to accept that her condition was terminal, a ...more
Mrs. Danvers
This is wonderful. It is similar in many respects to Ira Byock's great work Dying Well. 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. Mannix has a touch of rose-colored glasses, but I guess I don't mind in this context.

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.
Feb 10, 2020 rated it really liked it  ·  review of another edition
Shelves: four-star
An emotional journey through one woman’s experience working in palliative medicine that challenges pre conceptions about the field while encouraging thoughts and discussions around our own mortality.

This book tells dozens of stories about people facing the end of their lives, and how best medical and nursing personnel work together to ensure their patient experiences a good death. Meanwhile, the author tells some of her own stories and encourages the reader to think about issues of their own.

Joachim Stoop
Aug 23, 2020 rated it really liked it
The book is as helpfull, wise and sensitive as everybody's been saying and I would've given it 5 stars, but...

It sounds kind of harsh, yet one out of forty chapters made me lower my general score with one star. It was a chapter about a dying person in Holland who felt he was pushed by his doctor into ending his life with euthanasia. Although anecdotal, this was presented by Mannix as the usual method in The Netherlands: doctors brainwashing patients into believing that their lives became too har
May 04, 2019 rated it really liked it
I was a bit startled by some of the negative reviews for this book which I read when I was half way through. I can’t agree with any of them as I thought it a well balanced, kind, considerate and helpful book which raises issues we really should be engaging with now.

They say that the Victorians were happy to talk about death, but not sex, and now we’ve reversed that as no conversation about sex seems too much, and yet we can’t even bring ourselves to use words like died/dead/death, only passed o
Feb 06, 2018 rated it it was ok
There are lots of moving stories in here, extremely well written - and I'm sure that this doctor has done a lot of good things.
But I often felt uncomfortable with what felt like a hierarchical doctor-knows-best approach:
- The idea of the 'Leader' when surely the patient and their family should be leading or at least in parallel with the doctors
- There were lots of peoples problems 'solved' here - rather than empowerment so that individuals and their families could be supported in choosing thei
May 24, 2018 rated it it was amazing
Shelves: 2018
Not a book I really wanted to have a reason for reading, but nonetheless one we all should. Clear-eyed accounts of Dr. Mannix’s career in palliative care and the many lessons learned.
Jul 18, 2020 rated it really liked it
With The End In Mind is Kathryn Mannix’s layman’s guide to death and dying. Mostly a reflection on her years as a palliative care medicine doctor, Mannix shares with readers what the process of death looks like, what is valuable to people at the end, and why honest conversations about the one true inevitable event in our lives yields so much less fear and such richer endings. I’m a sucker for qualitative snippets of the great transition, and the time before and after, because I am grateful for t ...more
Bon Tom
Dec 28, 2018 rated it it was amazing
I believe this is that kind of book which is only going to affirm you in your belief, whatever it is. Which, probably, in this case and with most people, is of bipolar nature.

If you are wired so that you think there's grandeur, learning, redemption, or whatever other "quality" in suffering except pointless pain, you are going to stand your ground and use this book to reinforce your rationalizations about why the pain (physical suffering) is unavoidable, even necessary part of human experience.

Feb 09, 2018 rated it it was amazing
This outstanding book, which was shortlisted for this year's Wellcome Book Prize and was written by a palliative care physician in the UK, describes several remarkable people she cared for at the end of their lives, their families and other loved ones, and her experiences and lessons learned during her four decades in clinical practice. Dr Mannix demystifies and humanizes the experience of death for her patients, their families, and especially her readers, as people who have or very likely will ...more
Rod MacLeod
Dec 16, 2018 rated it it was amazing
Brilliant, insightful, compassionate and wise. Kathryn has skilfully negotiated a territory that few have tried and she has done it with skill.
It should be required reading for everyone who cares for those who are dying in whatever role they have.
Thank you so much for your honesty and for taking what was possibly a great deal of time and effort in doing so.
Jan 01, 2019 rated it it was amazing
Warning - do not read this book in public!! (Unless you like crying in public) However I would add this aside we should all read it!
An accessible and moving account of death and what to expect and what we all need to consider. It’s not morbid, but it is sad and moving but also hopeful and considerate. Can not recommend this highly enough!
Feb 02, 2018 rated it it was amazing  ·  review of another edition
The primary thought on reading this book is that if you enjoyed Being Mortal by Atul Gawande then this very much feels like a companion read. One that I think that everyone should read and share with their loved ones.

Dr Kathryn Mannix is a palliative care Consultant and in this book she writes about her experiences of working with dying patients. She looks at the pattern of dying and what most people will experience as they die. Her insights into the support of the patient and the care of their
"I realise that it is a rare privilege to be present and to serve those who are approaching their unmaking. I was discovering that I was not afraid of death; rather, I was in awe of it, and of its impact on our lives."

Perfect for fans of When Breath Becomes Air, With the End in Mind is a collection of case studies about dying from Dr. Kathryn Mannix, a specialist in palliative care. Far from being melancholy (though I'll admit I shed a tear or two), this collection is a hopeful and comfortin
Leigh Kramer
Oct 20, 2017 rated it really liked it
Why do we struggle to talk about death and dying?

This is a question I’ve often asked myself in the past 15 or so years. Because my maternal grandparents were both one of thirteen children, I grew up in a large extended family and, as such, I grew up going to funerals. I learned how to mourn from my relatives and how to have hard conversations. It was a sad part of life. But it was part of life.

When I started my first fieldwork placement at hospice as a social work intern, it quickly became clear
Tiffany Cheung
Dec 30, 2019 rated it it was amazing
This is a book that should be read by everyone. Death is generally accompanied by fear of pain, disappointment and end. Dr Mannix intricately weaves stories and conversations to make you breathe out and know that death is perhaps something that can be understood with compassion and respect.
Jack Gibson
Jan 27, 2020 rated it it was amazing  ·  review of another edition
Recommends it for: Everyone!
Much exists in today's world about how to (perhaps) live a life well and get the best out of it. Yet, in a world which puts increasing emphasis on knowing and facing truths, why should the topic of death often be overlooked and kept behind closed doors of discussion, if indeed the topic comes up at all...

Dr Kathryn Mannix, to take her direction, urges that we should take the narrative of this book like any other necessary prescription: in good faith, aware of side effects and at the right time.
Debra Forsythe
Aug 01, 2020 rated it really liked it
Tough but good read, beware the emotional triggers
Jason Pettus
This is a great idea for a book, especially in these times, a look at what kinds of advice we can glean about aging from the words and actions of the advanced elderly as they approach the ends of their lives. Unfortunately, though, the actual execution of the idea is deeply flawed; the "lesson" part of each story takes up only one paragraph, often devolving into the kind of hokey and cliched advice you can get from an Ann Landers column or a Pluggers comic, while it's impossible to describe the ...more
Gavin Whyte
May 03, 2020 rated it it was amazing  ·  review of another edition
Thoroughly enjoyed it. It’s written with such warmth, compassion, and integrity, and it contains just the right amount of humour. The narrative isn’t intrusive; it knows what’s important.

Yes, the book’s full of sad stories, and occasionally I swallowed a lump, but it’s a book about death and dying, and how people cope in/with their final moments, so it never was gonna be much of a hoot.

Many of us won’t read a book like this because we don’t want to look at death, think about death, speak about
Oct 03, 2017 rated it it was amazing
Best book I've read in ages.

This is an incredible book that will truly affect you. I found myself on the train running the full gamut of emotions: from being close to tears to laughing at an anecdote to genuinely feeling unsettled. And all because Kathryn Mannix forces you to look death up close and personal. But this isn’t just a collection of her stories as a palliative carer. It’s also a meditation on death and everything that comes with it. She groups her stories into themes such as Patterns
This book has meant a lot to me.

It has helped me to understand death better. It has also gave me peace of mind for when I seen my dad pass away last year and was left with a lot of unanswered questions.

There was also some assurance for me when it comes to my ill health. A patient mentioned in this book had the same illness as me (Cystic Fibrosis) And this was really interesting to me.

Death is always on my mind, due to ill health and especially in the last 12 months after watching my dad pass a
H.A. Leuschel
Dec 23, 2019 rated it it was amazing  ·  review of another edition
This was a book to take in slowly, chapter per chapter, intimate and tender story per intimate and beautifully written story. I shed tears as much as I felt wonder and awe for the people who accompany the dying. I must underline that this is not a sad book even though I felt sad and did put the book aside regularly to reflect on what I just read. Dying is made special in this book because it is given back its precious highly emotionally charged as well as matter of fact place in life.

Highly, hi
Melanie Baker
Dec 02, 2020 rated it it was amazing
Required reading, along with Being Mortal. Not an easy read, by any means, and you will cry. There is a good chance you will read heartbreaking sections and react only with quiet thoughtfulness. And then you will be gut-punched by some random, seemingly innocuous sentence. But you will think, and continue to, which is the good doctor’s first goal, I believe.
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Kathryn Mannix has spent her medical career working with people who have incurable, advanced illnesses. 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. Having qualified as a Cogni ...more

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“There are only two days with fewer than twenty-four hours in each lifetime, sitting like bookmarks astride our lives; one is celebrated every year, yet it is the other that makes us see living as precious.” 7 likes
“I was discovering that I was not afraid of death; rather, I was in awe of it, and of its impact on our lives. What would happen if we ever ‘found a cure’ for death? Immortality seems in many ways an uninviting option. It is the fact that every day counts us down that makes each one such a gift. 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.” 4 likes
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