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.

    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.

    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.

    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.

    What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine’s most profound paradox, that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality, and struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure.From her first dissection of a cadaver in gross anatomy to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flatlining in the emergency room to the first time she pronounces a patient dead, Chen is struck by her own mortal fears: there was a dying friend she could not call; a young patient’s tortured death she could not forget; even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two. Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen’s transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live.Moving and provocative, motored equally by clinical expertise and extraordinary personal grace, this is a piercing and compassionate journey into the heart of a world that is hidden and yet touches all of our lives. A superb addition to the best medical literature of our time.

    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.

    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.

    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.

    These periods of dislocation can be lonely and unexpected. For May, her husband fell ill, her son stopped attending school, and her own medical issues led her to leave a demanding job. Wintering explores how she not only endured this painful time, but embraced the singular opportunities it offered.A moving personal narrative shot through with lessons from literature, mythology, and the natural world, May’s story offers instruction on the transformative power of rest and retreat. Illumination emerges from many sources: solstice celebrations and dormice hibernation, C.S. Lewis and Sylvia Plath, swimming in icy waters and sailing arctic seas.Ultimately Wintering invites us to change how we relate to our own fallow times. May models an active acceptance of sadness and finds nourishment in deep retreat, joy in the hushed beauty of winter, and encouragement in understanding life as cyclical, not linear. A secular mystic, May forms a guiding philosophy for transforming the hardships that arise before the ushering in of a new season.

    Rana Awdish never imagined that an emergency trip to the hospital would result in hemorrhaging nearly all of her blood volume and losing her unborn first child. But after her first visit, Dr. Awdish spent months fighting for her life, enduring consecutive major surgeries and experiencing multiple overlapping organ failures. At each step of the recovery process, Awdish was faced with something even more unexpected: repeated cavalier behavior from her fellow physicians—indifference following human loss, disregard for anguish and suffering, and an exacting emotional distance.Hauntingly perceptive and beautifully written, In Shock allows the reader to transform alongside Awidsh and watch what she discovers in our carefully-cultivated, yet often misguided, standard of care. Awdish comes to understand the fatal flaws in her profession and in her own past actions as a physician while achieving, through unflinching presence, a crystalline vision of a new and better possibility for us all.As Dr. Awdish finds herself up against the same self-protective partitions she was trained to construct as a medical student and physician, she artfully illuminates the dysfunction of disconnection. Shatteringly personal, and yet wholly universal, she offers a brave road map for anyone navigating illness while presenting physicians with a new paradigm and rationale for embracing the emotional bond between doctor and patient.

    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.

    In the span of twelve hours, lives can be lost, life-altering medical treatment decisions made, and dreams fulfilled or irrevocably stolen. In Brown’s skilled hands--as both a dedicated nurse and an insightful chronicler of events--we are given an unprecedented view into the individual struggles as well as the larger truths about medicine in this country, and by shift’s end, we have witnessed something profound about hope and healing and humanity. Every day, Theresa Brown holds patients' lives in her hands. On this day there are four. There is Mr. Hampton, a patient with lymphoma to whom Brown is charged with administering a powerful drug that could cure him--or kill him; Sheila, who may have been dangerously misdiagnosed; Candace, a returning patient who arrives (perhaps advisedly) with her own disinfectant wipes, cleansing rituals, and demands; and Dorothy, who after six weeks in the hospital may finally go home. Prioritizing and ministering to their needs takes the kind of skill, sensitivity, and, yes, humor that enable a nurse to be a patient’s most ardent advocate in a medical system marked by heartbreaking dysfunction as well as miraculous success.

    From miraculous pregnancies to dirty protests, and from violent attacks on prisoners to heartbreaking acts of self-harm, she has witnessed it all. In this memoir, Amanda reveals the stories, the patients and the cases that have shaped a career helping those most of us would rather forget.

    Brought up in Washington, DC, in an abusive family, she went to Harvard, where she met her husband. They stayed together through medical school until two months before she was scheduled to join the staff of a hospital in central Philadelphia, when he told her he couldn't move with her. Her marriage at an end, Harper began her new life in a new city, in a new job, as a newly single woman.In the ensuing years, as Harper learned to become an effective ER physician, bringing insight and empathy to every patient encounter, she came to understand that each of us is broken—physically, emotionally, psychically. How we recognize those breaks, how we try to mend them, and where we go from there are all crucial parts of the healing process.The Beauty in Breaking is the poignant true story of Harper's journey toward self-healing. Each of the patients Harper writes about taught her something important about recuperation and recovery. How to let go of fear even when the future is murky. How to tell the truth when it's simpler to overlook it. How to understand that compassion isn't the same as justice. As she shines a light on the systemic disenfranchisement of the patients she treats as they struggle to maintain their health and dignity, Harper comes to understand the importance of allowing ourselves to make peace with the past as we draw support from the present. In this hopeful, moving, and beautiful book, she passes along the precious, necessary lessons that she has learned as a daughter, a woman, and a physician.

    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.