After the End was such an emotional roller coaster, and super-fast read. What if parents could provide more than one future for their child, giving them everything they want and the parents want for the child? As a parent myself, this book put me through a lot of emotions and made me rethink all that I had done for my daughter when she was growing up. A great read!

The problem with this book is that it wants to be everything and while it ends up being a little bit of everything, that means it is mostly a whole lot of nothing. In the attempt to provide a novel that's both heartbreaking and uplifting, After the End runs the gamut. It's a medical mystery/thriller, it's a story about family it's a story about losing the one you love and finding love again. It's about loss and renewal. This novel wants you to cry, both in sorrow and in joy.

It's too much to do and there just isn't enough there to hit all the emotional notes that After the End wants to hit. I like Clare Mackintosh and her work a lot but this book is a big departure and a big mess

Max and Pip have to make the hardest decision of their life. Their son has brain cancer and is fighting for his life. They must chose to let him go or proceed with advanced treatment. The couple each want something different for their son. Halfway through the book the story is split into Pip’s perspective and her choice and then in Max’s perspectives and his choice.

I wasn’t a huge fan of this one because I didn’t like how the book was split up in the end and there was no definite outcome. You don’t get to see what actually happened in the whole situation and I felt like there was no good conclusion to the story. However, I did like the medical aspect of the book and it made me feel like I was reading a Jodi Picoult book and I really like her books. Overall, I wasn’t satisfied with the ending and was disappointed.

After The End is a powerful book about the incredibly difficult decisions that need to be made and the inability to know what would happen if you chose differently.

Pip and Max are given the news that after months of treatment and surgery - their son won’t be getting better. His brain tumor is growing back and they recommend hospice care. Max finds an experimental treatment that could extend his life for months or years. When the doctors disagree and the couple is split about what they want to do - they end up in court.

From there, we get to see both paths and learn what would happen either way. This is a challenging read - there are no right choices, there aren’t good guys and bad guys - everyone is trying to do what they believe is best.

I really enjoyed the concepts and most of this book. Some parts felt a little slow for me. And there is one part right near the ending - last paragraph of the second to last chapter - that has really confused me.

However, those parts aside - I do still think this is a really powerful read and even more after reading the author’s note about how personal this is to her own experiences.

Thank you to the publisher and Netgalley for the opportunity to read an advance copy in exchange for my honest review.

I adore Clare Mackintosh’s writing. All of her thrillers are unputdownable (I Let you Go is my favorite). Her new book is unlike her others, but equally good. This one is inspired by a tragic choice she and her husband were forced to face when their child was terminally ill. In the novel, Pip and Max are faced with the unimaginable. Their two year old son, Dylan, is dying of a brain tumor. After exhausting almost all treatments, they are advised to let him go. Pip wants to end Dylan’s suffering while Max wants to keep fighting no matter what. Forced to face off in court, the storylines split midway into the book. What if Pip wins and their son is allowed to die peacefully? What if Max gets his way and takes Dylan to Houston for alternative treatments? The reader gets to see the story play out both ways, each path equal parts emotional, believable and heartbreaking.

Content warning: this story does deal with terminally-ill children, so if this is a subject you are sensitive to, read with care. I enjoyed this book a lot more than I initially thought I was going to. We meet Pip and Max, whose toddler is diagnosed with a terminal illness. The first half of the book is them fighting for their son's life, but each has a different hope for what the future looks like for him. The second half of the book looks more at the aftermath. (This is not a spoiler. You know early on the child is going to die, but don't know when or under what circumstances.) What happens to a family who has lost a child? What happens to their marriage? The author takes you on a very intimate journey of this couple's pain and some of the things that come up in this type of circumstance that can break your heart, like what to do with your child's clothes after they are gone, how to do holidays like Christmas. After finishing this book, I learned that the Mackintosh actually did suffer this loss and was able to write this pain in the first person. I appreciated the rawness of the novel. The only downside for me was the way in which this book was told. The second part, after, bounced back and forth between dates and made it slightly difficult to keep track of what was happening and what part of their lives we were in. I understand that telling the story this way was necessary to fully encapsulate the emotion between this couple, but it did take some intentional effort to find your place in time. *Advance copy provided by the publisher in exchange for my honest review.

I'm astounded to have not heard more buzz about this book—hands down one of my favorite reads of the year. The story begins in the midst of a couple's worst nightmare, when they have to make an impossible decision about the fate of their terminally ill toddler. The opening chapters were difficult to read for this reason, but I'm so glad I stayed with them. It's a choice they'll both spend the rest of their lives second guessing, and that's where the true magic of the story begins. Mackintosh gifts her readers with what we can never have in real life: A chance to see how both outcomes play out. In parallel universes, we watch a husband and wife fall apart and put themselves together again. We see how two divergent paths can still lead to redemption and grace, in very different forms. The result is far more than a Sliding Doors-style Choose Your Own Adventure tale: After the End is a moving, enlightening, and memorable portrait of the triumph of the human spirit.

a beautiful, emotionally charged story of how the love of a child not only brings families together, it can tear them apart. Clare Mackintosh has written a story that you will think and talk about long after you've finished reading. The characters are so will defined you'll feel their heartbreak and cry along with them. The back story flows smoothly leaving an impact that really can't be described, it has to be felt. Lovely, if sad, story that you'll love through your tears.

After the End is a heartbreaking story of a couple coming to grips with treatment of their terminally ill son. As a parent, I can't imagine losing a child. Clare Mackintosh had me enthralled with the "what if's" in this story. A must read!

When their young son is diagnosed with a terminal brain tumor, Max and Pip must make an impossible choice: seek further treatment that might extend his life or let him go. As they become further at odds with each other, and the world begins to tune in to their story, a decision is made, but what happens after the end is just the beginning of another journey for this young couple.

As a parent, especially that of young children, this book made me cry. I had to stop several times during the first half because reading through tears is impossible. The love that Max and Pip have for their son is overwhelming, but perfectly understandable, especially as their toddler is quickly losing a battle. It hurt my heart to read, but the strength Max and Pip showed together and separately made me keep reading.

The first half was heartbreakingly beautiful. It encompasses everything that happens before "the end." Max and Pip are seen caring for their son while he's in the hospital and then grappling with the decision the hospital is forcing on them about what to do about his future care. We're given the story from Max's and Pip's points of view as well as their son's doctor, Leila. It was a bit of a slow going as the only major events were Max and Pip in the hospital with their son and the trial to determine how care should proceed for their son. There wasn't much action or movement; it felt more like a gradual buildup to what comes after "the end."

The second half moved much quicker. It follows the events after the trial, detailing whether Max had won or if Pip had won, and told from their respective points of view. At first, it was a little confusing to follow with the alternating narratives and different timelines, but it became easier to follow, though I sometimes still had to remind myself of which person went where, and stopping in the middle of a chapter was a no-no for me because I then couldn't remember whose narrative I was reading. There was a lot of overlap between the two stories, but they eventually took separate journeys that became easier to follow. It was intriguing to see how two different decisions could have so many similar features, like the introduction of the same people despite different trial outcomes, and still end differently. I suppose two choices from the same starting point with the same people will lead them on different journeys but still have enough similarities because it involves the same start point and same involved parties.

I really loved that this book never gave a definitive answer of what the court chose. Instead, it gave both Max and Pip the room to explore what their lives would be like if one or the other had won and still leaves the reader satisfied. This is great for any reader who ever wondered if a character's different choice would have taken the story in a different direction. As strange as it was to read sometimes, it was oddly satisfying and I feel as though I don't need to know what the real decision was, because I still got both stories and can decide for myself which path I favored and believe the court went with. It's like Schrodinger's cat: both beliefs that the cat is alive or dead are true until the chamber the cat is in is opened to reveal the truth. Unless we're given the real decision, both paths could, and are, true.

What I didn't like as much were how Leila and Max were characterized and how rushed the ending to Pip's story was. Leila was portrayed as the professional, caring doctor, but she made key mistakes that she should not have. As someone who has worked in healthcare-related positions, I know patient privacy is of utmost importance, so Leila's mistakes really bothered me. Max was also troublesome for me as he's an American who moved to the U.K. for Pip. It's explained that he's been there so long that he's become more British than American. I get that, but, when he returned to the States, he still felt overwhelmingly British, even after he'd been there for a long stretch of time. It was a little tough to get past and I would have appreciated seeing him return to his roots a little more. Lastly, Max's story wrapped up really well, but Pip's seemed to jump a bit and, while it mostly makes sense and there were hints, it feels like it was smacked in my face and I was left reeling a bit.

Overall, I really enjoyed this book. A few things bothered me, but the story of a couple with a huge love for their son and each other was beautifully done. It's both the story of a family struggling to remain intact and the story of two people traveling two different paths.

Thank you so much to NetGalley and the publisher for a free copy. All opinions are my own.

Blog: The Lily Cafe
Blog link: thelilycafe.wordpress.com
Publication on blog: 6/21/19
Link to review: https://thelilycafe.wordpress.com/2019/06/21/book-review-after-the-end-by-clare-mackintosh/

A difficult decision for this husband and wife over prolonging the life of their sick child kept me reading this story. I enjoyed the before section. The after part was very confusing, particularly why she remarried her husband. A book for book club discussion.

This was a difficult read. Not because it wasn’t good, but because I kept imagining myself in the situation. At first I didn’t love the alternating structure but it grew on me. Definitely a tear jerker.

Amazing! Read this moving story in an afternoon while traveling.

Mackintosh continues to get better and better with each story she writes.

This heartfelt story will suck you in and keep you wanting more.

Max and Pip are the type of couple that everyone envies - strong and in love. That marriage is tested when their 3 year old son Dylan is diagnosed with a brain tumor. When he is taken off of a ventilator, the doctor tells them the cancer has spread. They have to come together and make the impossible decision to continue treatment or discontinue it to end his suffering and let him go. Pip wants end treatment and end Dylan's pain, but Max wants to continue to give him and chance and hold out hope. This causes Max and Pip's one road to split into two opposite path's as they both fight for what they think is right.
We get to see this story from both the mother and father's POV, and as an added bonus we also get the doctor's POV. I could relate to all 3! I felt all the emotions reading this book, all the way into my soul. I loved the book regardless, but then reading the afterword regarding the author's personal story relating to the book I loved it even more!!!
Thanks to Clare Mackintosh, Penguin Group Putnam and NetGalley for the ARC of this wonderful book!

After the End is one of those books you cannot read on the bus or on your lunch break. It must be read in privacy where you are free to cry your heart out. It is the story of Pip and Max, a couple deeply in love with each other and their young son, Dylan. It opens with a trial, the judge preparing to decide whether than son will be allowed to die or whether further heroic measures will be attempted to prolong his life. Unlike the infamous cases in the news, this is not a case of the parents versus insurance of the National Health Service, but parents against each other.

The story begins being told in alternate chapters by Pip, Max, and their doctor Leila. Their son Dylan has a brain tumor that was partially removed and treated with radiation. They are waiting weeks for him to wake from his coma and to be able to breathe on his own. Pip spends her days in the hospital. Max travels for work but is present as much as possible. When they learn that his tumor is growing, Leila and the NHS recommend letting him rest until he dies but Max researches proton treatment in the U.S. It’s very up to the moment with the Go-Fund-Me campaign and the viciousness of social media. Pip and Max do not agree on what to do next…so what happens next?



I have only myself to blame for the aching, tired eyes that came from crying. After all, anyone reading the book description knows they are in for a tearjerker. I did not, however, expect to care so very deeply for Pip and Max. Mackintosh does an excellent job of making them real people whose motivations are ones we can understand and identify with. She makes an excellent case for giving up and for heroic measures – making clear how terribly difficult this is.

Believe me, even if you’re not a tearful person, this book is going to reach deep and squeeze them out.

I received an e-galley of After the End from the publisher through NetGalley.

After the End at G. P. Putnam’s Sons | Penguin Random House
Clare Mackintosh author site
I Let You Go by Clare Mackintosh

This book had me feeling all the feels. Being a mother to a young son myself this book just pulled at my heart. I couldn’t imagine having to go through that in life. Wonderful book!

This story was so sad and heartbreaking, even sadder when I read the author's afterword. At first I admit I was confused by the divergent POVs's but it was so brilliantly written that I flew through this story in one sitting.

I simply had problems getting involved in this novel.
I suspect it is a problem of mine, rather than the author, anything that surrounds a child and family with this level of despair is problematic for me.

A child with severe problems and the agony of the parents is sadly something that happens. Many couples don’t survive the pressure, especially when the disagree with how it should be handled.
This explores the depth of love and the ability of a couple to get past tragedy.

I know many book clubs will have rich discussions about how this should have been handled.

Thank you Netgalley.

I have read a few other of Clare Mackintosh's books. This one is starkly different from the others I have read, which are primarily mystery. Overall, I enjoyed the majority of the book which was more of a family drama than mystery. After the End tells the story of Pip and Max as they deal with their son Dylan's terminal illness. They're both at odds about what to do - go for a new therapy that could prolong his life (though he may deal with being handicapped) or end his suffering. The book is told is two parts: Before and After. I really enjoyed the Before part but the After part was actually a little confusing as it alternated perspectives between Pip and Max and jumped between years (the Before part also alternates between Pip and Max's perspectives - as well as the perspective of the Doctor treating Dylan). I felt like even in the Before parts they skipped time and it wasn't clear in some parts how much time had passed.

This book became that much more emotional for me after I read the author's note and found out that although this is fiction the idea behind the family dealing with a child with a terminal illness had been born from the author's personal story of dealing with a terminally ill child.

Be sure to grab some Kleenex as you tackle this book!

In this remarkable story, Clare Mackintosh shares the story of Pip and Max, parents of nearly three years old Dylan and seemingly the most solid, stable, connected couple anyone knows even when challenged by a horrific diagnosis for their son. It took three tries for me to become absolutely enthralled with this wonderfully well-wrought, heart wrenching story. It could have veered into sentimental and predictable and issues-driven, but it never did. Always, always, the story is centered on love, on intelligence and doing the best that we can possibly do under high pressure and no easy solutions. The story felt so real, the moments so wrenching and powerful that I could not believe it was entirely fiction -- and when I read the back matter, learned that Ms. Mackintosh knows Pediatric intensive care units intimately. Somehow, she has taken her own experience and distilled it into a powerful story that resonates for the reader, causing us to question who we are, what love means, what choices we might make under the same circumstances. I read the book in one day and am so very glad that I did.