Ever since I read, When Breath becomes Air, I have been fascinated by medical professionals conversations an situations with death, this book too fell in that category. I wasn't sure what exactly to look for in the book, but it was none the less a good read. I got the book for NetGalley and it was well written and moved at a decent pace. While I think the stories felt disjointed, as a whole the book was a wonderful way to learn about how to talk about death.

Kathryn Mannix does an excellent job in presenting this often avoided and difficult topic: how do we deal with our own mortality and our grief when we lose those we love. As a clinician in palliative care and CBT, she has been .involved intimately with these topics both personally and professionally. The takeaway: grief is not something to run from. She presents a graceful and palatable approach to processing fears about our own mortality and the grief that accompanies all forms of loss.

This is not only a timely book, it is also an important one. As a former hospice volunteer, I have seen not only the negative aspects of the dying process (pain, grief, loss of body integrity-incontinence etc) but also some incredibly positive aspects (resolution of painful family dynamics, peacefulness, positive spiritual beliefs,gratitude etc). Too often we are afraid of this last, great unknown step and so seek to avoid the topic altogether. This book is a compassionate work with a large educational component. The case stories, although sometimes heartbreaking, are also valuable learning opportunities. On top of all this, the author has an accessible writing style. Well-written and researched. Highly recommended.
My thanks to NetGalley for providing me with an eARC in exchange for my honest review.

Case studies of a physician who specializes in palliative care and CBM (cognitive behavior therapy). The author effectively mixes educating the reader about these topics and sharing the stories of patients who illustrate their application. Of particular value both to healthcare professionals who treat dying patients as well as those patients themselves and their families and friends.

Having read the Tibetan Book of Living and Dying years ago I was interested to see what Mannix had to say on it in the modern world. Her perspective and experiences are intriguing, complex yet there is warmth that you don't see in the eastern religions. Mannix raises some questions and ethical issues that will keep your mind spinning long after putting this one down.

Why do we struggle to talk about death and dying?

This is a question I’ve often asked myself in the past 15 or so years. Because my maternal grandparents were both one of thirteen children, I grew up in a large extended family and, as such, I grew up going to funerals. I learned how to mourn from my relatives and how to have hard conversations. It was a sad part of life. But it was part of life.

When I started my first fieldwork placement at hospice as a social work intern, it quickly became clear I had an unusual upbringing compared to many of my patients and their families. Many were not as well-versed in talking through these issues. From the fieldwork placement, I went on to be a hospice social worker and child and teen bereavement specialist.

My mantra became “hope for today, plan for the future.” Yes, we can hope that this decline will reverse but we can make things easier on ourselves and our loved ones by discussing advanced directives and funeral plans now.

Kathryn Mannix and I have a lot in common in this regard. Mannix is a palliative care and hospice doctor in the UK. I was particularly fascinated that she founded the UK’s first palliative care cognitive behavior therapy (CBT) clinic. I love the idea of using CBT in this context!

Mannix’s goal with this book is both to promote conversation about dying and to show that those who are dying are still living. This often surprised people when I still worked for hospice, that there was so much light and laughter in my days. Yes, there were sad, hard, and frustrating days- how could there not be?- but more often than not, my days were filled with life.

Mannix shares stories to illustrate what happens when people are dying and at various stages, as well as people’s reactions to their or their loved one’s decline. She shares stories from early on in her career when she was a student on up to the present. She doesn’t always get it right and I appreciate how she owned up to her mistakes and learned from them. This helps us learn too. She also shares how her colleagues helped her improve her practice.

This could simply be a collection of stories but Mannix also includes questions at the end of each section. These are questions to think through and then to discuss with family. You’re able to follow the process modeled by Mannix and her team.

French Resistance included one of the best, most compassionate descriptions of the dying process I’ve ever encountered. Mannix observes her trainer walking a patient through it at the new hospice. “Few have seen a death. Most imagine dying to be agonizing and undignified. We can help them to know that we do not see that, and that they need not fear that their families will see something terrible.” p. 30

Talking About The Unmentionable is about how to talk to children about death and dying, whether it’s due to pets or relatives. It helps normalize the idea of death and shows the importance of our need to grieve our loved ones, plus details about what children understand at various ages.

Last Waltz was about death of Mannix’s 99 yo grandmother. I especially appreciated her insights on how waiting is not a passive experience when it comes to our loved ones who are declining. She notes how this loss made her a “better servant” to patients’ families and more patient with repeated requests for her to make sure their loves weren’t in discomfort or distress.

There are two chapters that puzzled me. Wrecking Ball may need a trigger warning. The description of the death might shock or be disturbing to some and the caution does not come until the end of the chapter. While it’s a good example of an unanticipated death, proceed with caution.

Please Release Me - B side, is an odd chapter loosely about euthanasia. The patient was originally from the Netherlands where it’s legal but he came to England instead where he went on hospice. Euthanasia is a complex issue and I felt she did it a disservice with her commentary. We don’t know whether hospice exists there, what the cultural understanding of death is, or whether the patient's account was biased. Don’t take this to mean I’m advocating for euthanasia. But it requires more nuance than we were given in this chapter.

Overall, this is a solid resource on end of life issues, whether you’re a family member facing the loss of a loved one or someone who has worked in hospice for years. The stories are often heartwarming and beautiful and even the hard ones illustrate some aspect of death and life we need to better understand.

This is a very compassionate book about a taboo subject to many of us: death. We all know it will come as part as the cycle of life, but it is not something we discuss. The stories in this book are heart-breaking and very sad. But, they still are able to teach us a lesson. I applaud the author for this book, it is written with much respect but it also teaches us things that may help us when we are facing the end journey of our own life or the life of a loved one. Thanks to NetGalley, the author and the publisher for the ARC of this book in return for my honest review.