In the third act of Richard III, Sir William Catesby tells Lord Hastings: “’Tis a vile thing to die, my gracious lord, when men are unprepared and look not for it.” Although written around 1592, Catesby’s words still ring true today. Many of us are not prepared for our own deaths. In fact, death remains a topic that makes most of us so anxious and unsettled that we spend much of our lives avoiding the subject entirely. Complicating matters even further is that we live in a culture that shields us from death with the use of euphemisms, such as he “passed away” or she “lost” her husband, rather than the word died.
British palliative-care physician Kathryn Mannix has spent more than thirty years working with the terminally ill. She wants us to regain “the familiarity we once had” with dying because “death itself has become increasingly taboo.” Often separated from loved ones and familiar surroundings, we “now die in ambulances and emergency rooms and intensive care units, our loved ones separated from us by the machinery of life preservation.” Yet all of us will eventually die. So, Mannix decided: “It’s time to talk about dying.” She does just that and much more in her powerful testament to dying well, With the End in Mind: Dying, Death, and Wisdom in an Age of Denial.
Mannix draws us into the world of the dying through stories of her patients. Heart-wrenching and heartwarming at the same time, these poignant tales carry us directly into the core of that mysterious territory we try so hard to avoid. Her stories are not for the faint. Mannix spares no details of the physical and emotional toll the dying process takes on both patients and their support systems. Yet she does so in such an eloquent and tender manner that we do not object to being transported into the private worlds of the terminally ill. Instead, we are inspired and uplifted by these ordinary people and how they deal with the extraordinary pressure of trying to live while they know they are dying. Questions about suffering, meaning, fear, and transcendence emerge on every page. By the end of the book we have learned that while the dying process itself is generally predictable and comfortable, we can make certain choices to increase the likelihood that our life journeys will finish well.