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 caregiver through stories of her patients, their families, and their distinctive lives, Dr. Mannix discusses the universal, but deeply personal, process of dying. With meditations on life, death, and the space between them, With the End in Mind describes the possibility of meeting death gently, with forethought and preparation, and shows the unexpected beauty, dignity, and profound humanity of life coming to an end.

    It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.Like so many of us, award-winning writer Katy Butler always assumed her aging parents would experience healthy, active retire­ments before dying peacefully at home. Then her father suffered a stroke that left him incapable of easily finishing a sentence or showering without assistance. Her mother was thrust into full-time caregiving, and Katy became one of the 24 mil­lion Americans who help care for aging parents. In an effort to correct a minor and non–life threatening heart arrhythmia, doctors outfitted her father with a pacemaker. The device kept his heart beating but did nothing to prevent his slide into dementia, incontinence, near-muteness, and misery. After several years, he asked his wife for help, telling her, "I am living too long." Mother and daughter faced a series of wrench­ing moral questions: When does death cease being a curse and become a blessing? Where is the line between saving life and prolonging a dying? When is the right time to say to a doctor, "Let my loved one go"? When doctors refused to disable the pace­maker, sentencing her father to a protracted and agonizing death, Katy set out to understand why. Her quest had barely begun when her mother faced her own illness, rebelled against her doctors, refused open-heart surgery, and instead met death head-on. Knocking on Heaven's Door, a revolution­ary blend of memoir and investigative reporting, is the fruit of the Butler family's journey. With a reporter's skill, a poet's eye, and a daughter's love, Butler explores what happens when our terror of death collides with the tech­nological imperatives of modern medicine. Her provocative thesis is that advanced medicine, in its single-minded pursuit of maximum longevity, often creates more suffering than it prevents. Butler lays bare the tangled web of technology, medicine, and commerce that modern dying has become and chronicles the rise of Slow Medicine - a growing movement that promotes care over cure. Knocking on Heaven's Door is a visionary map through the labyrinth of a broken and morally adrift medical system. It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.

    I have loved and been loved. I have been given much and I have given something in return. Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.” —Oliver SacksNo writer has succeeded in capturing the medical and human drama of illness as honestly and as eloquently as Oliver Sacks. During the last few months of his life, he wrote a set of essays in which he movingly explored his feelings about completing a life and coming to terms with his own death. “It is the fate of every human being,” Sacks writes, “to be a unique individual, to find his own path, to live his own life, to die his own death.”Together, these four essays form an ode to the uniqueness of each human being and to gratitude for the gift of life.

    At nine he started working on an original theory in astrophysics that experts believe may someday put him in line for a Nobel Prize, and at age twelve he became a paid researcher in quantum physics. But the story of Kristine’s journey with Jake is all the more remarkable because his extraordinary mind was almost lost to autism. At age two, when Jake was diagnosed, Kristine was told he might never be able to tie his own shoes. The Spark is a remarkable memoir of mother and son. Surrounded by “experts” at home and in special ed who tried to focus on Jake’s most basic skills and curtail his distracting interests—moving shadows on the wall, stars, plaid patterns on sofa fabric—Jake made no progress, withdrew more and more into his own world, and eventually stopped talking completely. Kristine knew in her heart that she had to make a change. Against the advice of her husband, Michael, and the developmental specialists, Kristine followed her instincts, pulled Jake out of special ed, and began preparing him for mainstream kindergarten on her own. Relying on the insights she developed at the daycare center she runs out of the garage in her home, Kristine resolved to follow Jacob’s “spark”—his passionate interests. Why concentrate on what he couldn’t do? Why not focus on what he could? This basic philosophy, along with her belief in the power of ordinary childhood experiences (softball, picnics, s’mores around the campfire) and the importance of play, helped Kristine overcome huge odds. The Barnetts were not wealthy people, and in addition to financial hardship, Kristine herself faced serious health issues. But through hard work and determination on behalf of Jake and his two younger brothers, as well as an undying faith in their community, friends, and family, Kristine and Michael prevailed. The results were beyond anything anyone could have imagined. Dramatic, inspiring, and transformative, The Spark is about the power of love and courage in the face of overwhelming obstacles, and the dazzling possibilities that can occur when we learn how to tap the true potential that lies within every child, and in all of us.

    She lost thirty pounds, chugged antacid, and visited doctors for three months before she was finally diagnosed with Stage IV colon cancer.As she navigates the aftermath of her diagnosis, Kate pulls the reader deeply into her life, which is populated with a colorful, often hilarious collection of friends, pastors, parents, and doctors, and shares her laser-sharp reflections on faith, friendship, love, and death. She wonders why suffering makes her feel like a loser and explores the burden of positivity. Trying to relish the time she still has with her son and husband, she realizes she must change her habit of skipping to the end and planning the next move. A historian of the "American prosperity gospel"--the creed of the mega-churches that promises believers a cure for tragedy, if they just want it badly enough--Bowler finds that, in the wake of her diagnosis, she craves these same "outrageous certainties." She wants to know why it's so hard to surrender control over that which you have no control. She contends with the terrifying fact that, even for her husband and child, she is not the lynchpin of existence, and that even without her, life will go on.On the page, Kate Bowler is warm, witty, and ruthless, and, like Paul Kalanithi, one of the talented, courageous few who can articulate the grief she feels as she contemplates her own mortality.

    Thrown into a profession of gallows humor and vivid characters (both living and very dead), Caitlin learned to navigate the secretive culture of those who care for the deceased.Smoke Gets in Your Eyes tells an unusual coming-of-age story full of bizarre encounters and unforgettable scenes. Caring for dead bodies of every color, shape, and affliction, Caitlin soon becomes an intrepid explorer in the world of the dead. She describes how she swept ashes from the machines (and sometimes onto her clothes) and reveals the strange history of cremation and undertaking, marveling at bizarre and wonderful funeral practices from different cultures.Her eye-opening, candid, and often hilarious story is like going on a journey with your bravest friend to the cemetery at midnight. She demystifies death, leading us behind the black curtain of her unique profession. And she answers questions you didn’t know you had: Can you catch a disease from a corpse? How many dead bodies can you fit in a Dodge van? What exactly does a flaming skull look like?Honest and heartfelt, self-deprecating and ironic, Caitlin's engaging style makes this otherwise taboo topic both approachable and engrossing. Now a licensed mortician with an alternative funeral practice, Caitlin argues that our fear of dying warps our culture and society, and she calls for better ways of dealing with death (and our dead).

    What began as the chronicle of an imminent and early death became something much more--a powerful exhortation to the living.That Julie Yip-Williams survived infancy was a miracle. Born blind in Vietnam, she narrowly escaped euthanasia at the hands of her grandmother, only to flee with her family the political upheaval of her country in the late 1970s. Loaded into a rickety boat with three hundred other refugees, Julie made it to Hong Kong and, ultimately, America, where a surgeon at UCLA gave her partial sight. She would go on to become a Harvard-educated lawyer, with a husband, a family, and a life she had once assumed would be impossible. Then, at age thirty-seven, with two little girls at home, Julie was diagnosed with terminal metastatic colon cancer, and a different journey began.The Unwinding of the Miracle is the story of a vigorous life refracted through the prism of imminent death. When she was first diagnosed, Julie Yip-Williams sought clarity and guidance through the experience and, finding none, began to write her way through it--a chronicle that grew beyond her imagining. Motherhood, marriage, the immigrant experience, ambition, love, wanderlust, tennis, fortune-tellers, grief, reincarnation, jealousy, comfort, pain, the marvel of the body in full rebellion--this book is as sprawling and majestic as the life it records. It is inspiring and instructive, delightful and shattering. It is a book of indelible moments, seared deep--an incomparable guide to living vividly by facing hard truths consciously.With humor, bracing honesty, and the cleansing power of well-deployed anger, Julie Yip-Williams set the stage for her lasting legacy and one final miracle: the story of her life.

    One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi's transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir. Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. "I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything," he wrote. "Seven words from Samuel Beckett began to repeat in my head: 'I can't go on. I'll go on.'" When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.

    She was forty-four years old, with a devoted husband and three young children, and she had only one year of health remaining.Susan decided to live that year with joy.She quit her job as a journalist and spent time with her family. She built an outdoor meeting space for friends in her backyard. And she took seven trips with the seven most important people in her life. As her health declined, Susan journeyed to the Yukon, Hungary, the Bahamas, and Cyprus. She took her sons to swim with dolphins, and her teenage daughter, Marina, to Kleinfeld's bridal shop in New York City to see her for the first and last time in a wedding dress.She also wrote this book. No longer able to walk or even to lift her arms, she tapped it out letter by letter on her iPhone using only her right thumb, the last finger still working.However, Until I Say Good-Bye is not angry or bitter. It is sad in parts--how could it not be?--but it is filled with Susan's optimism, joie de vivre, and sense of humor. It is a book about life, not death. One that, like Susan, will make everyone smile.From the Burger King parking lot where she cried after her diagnosis to a snowy hot spring near the Arctic Circle, from a hilarious family Christmas disaster to the decrepit monastery in eastern Cyprus where she rediscovered her heritage, Until I Say Good-Bye is not only Susan Spencer-Wendel's unforgettable gift to her loved ones--a heartfelt record of their final experiences together--but an offering to all of us: a reminder that "every day is better when it is lived with joy."

    They are promises. They are the only way to walk from one night to the other."Nina Riggs was just thirty-seven years old when initially diagnosed with breast cancer--one small spot. Within a year, the mother of two sons, ages seven and nine, and married sixteen years to her best friend, received the devastating news that her cancer was terminal.How does one live each day, "unattached to outcome"? How does one approach the moments, big and small, with both love and honesty?Exploring motherhood, marriage, friendship, and memory, even as she wrestles with the legacy of her great-great-great grandfather, Ralph Waldo Emerson, Nina Riggs's breathtaking memoir continues the urgent conversation that Paul Kalanithi began in his gorgeous When Breath Becomes Air. She asks, what makes a meaningful life when one has limited time?Brilliantly written, disarmingly funny, and deeply moving, The Bright Hour is about how to love all the days, even the bad ones, and it's about the way literature, especially Emerson, and Nina's other muse, Montaigne, can be a balm and a form of prayer. It's a book about looking death squarely in the face and saying "this is what will be."Especially poignant in these uncertain times, The Bright Hour urges us to live well and not lose sight of what makes us human: love, art, music, words.

    But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.

    Today, it is the most common form of officially classified mental illness. Scott Stossel gracefully guides us across the terrain of an affliction that is pervasive yet too often misunderstood. Drawing on his own long-standing battle with anxiety, Stossel presents an astonishing history, at once intimate and authoritative, of the efforts to understand the condition from medical, cultural, philosophical, and experiential perspectives. He ranges from the earliest medical reports of Galen and Hippocrates, through later observations by Robert Burton and Søren Kierkegaard, to the investigations by great nineteenth-century scientists, such as Charles Darwin, William James, and Sigmund Freud, as they began to explore its sources and causes, to the latest research by neuroscientists and geneticists. Stossel reports on famous individuals who struggled with anxiety, as well as on the afflicted generations of his own family. His portrait of anxiety reveals not only the emotion’s myriad manifestations and the anguish anxiety produces but also the countless psychotherapies, medications, and other (often outlandish) treatments that have been developed to counteract it. Stossel vividly depicts anxiety’s human toll—its crippling impact, its devastating power to paralyze—while at the same time exploring how those who suffer from it find ways to manage and control it. My Age of Anxiety is learned and empathetic, humorous and inspirational, offering the reader great insight into the biological, cultural, and environmental factors that contribute to the affliction.

    If you have ever wondered, How am I supposed to survive this? This is How.

    Instead, she discovered she’d been granted an invaluable chance to witness firsthand what she calls the “spiritual work of dying”—the work of finding or making meaning of one’s life, the experiences it’s contained and the people who have touched it, the betrayals, wounds, unfinished business, and unrealized dreams. Instead of talking, she mainly listened: to stories of hope and regret, shame and pride, mystery and revelation and secrets held too long. Most of all, though, she listened as her patients talked about love—love for their children and partners and friends; love they didn’t know how to offer; love they gave unconditionally; love they, sometimes belatedly, learned to grant themselves. This isn’t a book about dying—it’s a book about living. And Egan isn’t just passively bearing witness to these stories. An emergency procedure during the birth of her first child left her physically whole but emotionally and spiritually adrift. Her work as a hospice chaplain healed her, from a brokenness she came to see we all share. Each of her patients taught her something—how to find courage in the face of fear or the strength to make amends; how to be profoundly compassionate and fiercely empathetic; how to see the world in grays instead of black and white. In this poignant, moving, and beautiful book, she passes along all their precious and necessary gifts.

    Illuminating, completely engaging—it's essential reading for all since we all know someone whose life, family or friends are touched by the disease that directly afflicts a fifth of Canadians. In her early twenties, while outwardly thriving in her dream job and enjoying warm familial support and a strong social network, award-winning journalist Anna Mehler Paperny found herself trapped by feelings of failure and despair. Her first suicide attempt—ingesting a deadly mix of sleeping pills and antifreeze—landed her in the ICU, followed by weeks of enforced detention that ran the gamut of horrifying, boring, hilarious, and absurd. This was Anna's entry into the labyrinthine psychiatric care system responsible for providing care to millions of Canadians.As she struggled to survive the psych ward and as an outpatient—enduring the "survivor's" shame of facing concerned family, friends, and co-workers; finding (or not) the right therapist, the right meds; staying healthy, insured, and employed—Anna could not help but turn her demanding journalist's eye on her condition and on the system in which she found herself. She set off on a quest to "know her enemy," interviewing leading practitioners in the field across Canada and the US—from psychiatrists to neurological experts, brain-mapping pioneers to heroic family practitioners, and others dabbling in novel hypotheses. She reveals in courageously frank detail her own experiences with the pharmacological pitfalls and side effects of long-term treatment, and offers moving case studies of conversations with others, opening wide a window into how we treat (and fail to treat) the disease that accounts for more years swallowed up by disability than any other in the world.