This blog post is a little different to anything I have done before and quite rightly so as I have never learnt from, related to or reflected on a book as much as I have from this one.
With the End in Mind: How to Live and Die Well by Kathryn Mannix openly discusses the topic we, as a society, have made almost a taboo subject – dying. Deaths that would once have happened at home surrounded by loved ones have been replaced as treatments, medications and knowledge has advanced. More and more people are dying in the care of healthcare professionals which isn’t a bad thing, but it does mean that many people have never seen someone die creating a feeling of anxiety about what to expect.
Dr Kathryn Mannix uses a series of real events that she encountered during her career, starting from when she was still completing her training and continuing into her role as a palliative care consultant. This book explains the patterns of dying and recognising the stages, explaining this process to the person themselves and their loved ones, how to converse with people/their loved ones who are in denial, who are trying to stay in control, who are anxious, who want to stop a treatment that is prolonging life but not improving their quality of life, who are scared of ‘suffering’, who are comforted by death, who have clear plans of the care they would like as death approaches, who want to leave something behind in the world, who are withholding the truth from their loved ones out of love and protection and how to talk about death with children.
This book also highlights the importance of naming death. Coincidently, I was talking to one of my patients this week and they told me that they “lost their dog last year.” I misunderstood this by thinking that the dog had run away and felt embarrassed when my patient had to explain that the dog did in fact die last year. This is a perfect example of how terms such as ‘lost’, ‘passed’, or ‘passed away’ can cause misunderstanding. We need to become familiar again with using the terms ‘died’ or ‘dying’ to reduce the chance of misunderstanding and to ensure that what we are saying does not get lost in translation.
Another aspect of this book I love is the comparison made between birth and death. Both events happen in a sequence and progress in stages. We often hear birth stories and have an understanding about the stages of labour and yet we aren’t as comfortable discussing the stages of dying and sharing our experiences. It’s time to be more open.
I recommend this book to everyone. As the cover says, this is “essential reading for anyone who will encounter death, and that means all of us.” As a healthcare professional, this book has developed my understanding and confidence in having these types of conversations with my patients and their loved ones and I could also relate many of my own encounters with death to the scenarios in this book. For those that have lost a loved one and for those who may facing death themselves or death of a loved one currently, although it may be difficult to read, I believe this book could help you to understand the dying process, process your thoughts and feelings and relieve your concerns.
I truly hope you take the time to read this book and then apply what you learn to your future practice as I will be doing. Thank you to the palliative care nurse who recommended this book to me.
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