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

"Living is precious, and is perhaps best appreciated when we live with the end in mind. It’s time to talk about dying."  

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

Author: Kathryn Mannix

I'd put this book in the 'must read' category. It is not an easy or completely enjoyable read, it evokes sad (but also happy) feelings and it left a bit of dread in the bottom of my stomach and a lot of 'I really should...'. Still, I'll encourage family and friends to read it and allow us to be on the same page when approaching the nowadays perceived taboo subject of death.

"It’s a truth rarely acknowledged that as we live longer thanks to modern medicine, it is our years of old age that are extended, not our years of youth and vigour."

The book is a series of stories told by Mannix based on her experience throughout her medical career. She has written the book to enable people to become familiar with the process of dying, of not feeling fear but instead prepare for the inevitable. Most of us will not experience dying, or even talk about it until we experience it with a close relative. Reading the stories it felt like having lots of relatives factually and compassionately telling you about what death is like. 

"Watching dying is like watching birth: in both, there are recognisable stages in a progression of changes towards the anticipated outcome."

The first we notice is that people are more tired, they sleep more to boost their energy levels. The period of being awake slowly gets shorter and shorter, until sleep gets really deep and turns into a coma where the patient is unconscious without even being aware of it. Knowing this pattern of death families can be much more relaxed and provide the support needed at the final stages. 

"People are not limited so much by their illness as by their attitude to it. The illness may present physical challenges, but the emotional challenge is often far more important."

A few of the questions posed by Mannix include;

• What balance do you see between the length of time you live, and the quality of life you are living?
• Would you choose to accept or to forgo treatments that extend your life if they do not restore quality?
• Would you prefer to live for as long as possible, or to focus on comfort instead of prolonging life?

I recommend that you read this book (or something similar) and discuss end of life with your family and close friends, so you all know what kind of care and interventions (if any) you would like when death approaches.