4.5/5 rounded down

"Why palliative care? Because I didn't want anyone else to hurt the way I did when I was a kid"

This is the book that has made me need to take a break from reading medical non-fictions for a while. To call me an emotive reader would be an understatement. I work in healthcare myself but there is a reason I do not specialise in paediatrics, nevermind paediatric palliative care.

Doctor, father, priest: Macauley tells all in this memoir about working as a paediatric palliative care doctor. Equal parts harrowing and compelling, the author takes the reader through his career, through the pitfalls and hardship whilst shining light on the hope and positive aspects of palliative medicine.

The author weaves together aspects of his own childhood and childhood trauma, being raw and vulnerable with the reader, whilst not taking away from the true message of this book. The subject matter is intense and sometimes disturbing - as is the nature of the field of medicine - but the author treats it with the care and reverence it deserves.

Thank you to NetGalley and Mindbuck Media for providing me with an ARC copy in exchange for an honest review. All opinions are my own.

This is one of the most special and profound books I've ever read. This author (who is a doctor, priest,& father) is the most compassionate, self-reflective, empathetic person and perfectly suited for palliative care, especially with children. It was beautiful to hear him describe the inner thoughts of a doctor, yet also the inner thoughts of a priest while navigating a child's death. It never even occurred to me that children's palliative care even existed. But unfortunately it does, and those who live through this nightmare need people with huge hearts and sensitivity.

I am changed for having read this book. The author is not only a super smart doctor, but also an excellent writer.

Dr. Macauley’s book provides the reader with a real sense of what it’s like to be a paediatric palliative care physician. He presents detailed but accessible studies of several children with a range diseases—from genetic and neuromuscular conditions to cancer. Alongside the stories of his patients and their parents, he tells his own story, which is an unusual one: he’s trained as both an Episcopalian priest and a physician and has served as a clinical ethicist in a hospital setting. He feels he was drawn to paediatrics because of the abuse he endured in childhood.

This is a heartfelt, brave, and vulnerable work. However, it’s my view that less would have been a great deal more. I believe significant revision, editing, and a general tightening up of the prose could have made this book a much finer one. Mine was an advanced reader copy, and it seemed very much a rough draft. This is particularly true of the sections that concern the author’s own story and the conclusion, where the language is often fuzzy and rambling. The skills of a first-rate editor could have made a huge difference.

Rating: 2.5 rounded up

This is an incredible book on many levels. Robert Macauley shares a unique point of view as a father who became a pediatric palliative care specialist, a clinical ethicist, and an Episcopalian priest. He depicts many moving situations with his patients and their families, as well as with his mentors and some professionals who opposed his views. While the subject matter is very intense and sometimes disturbing--how can it not when this book involves the deaths of children--the author never trivializes these experiences, and he gives them the reverence they deserve. He also bravely reveals his own traumatic background, but he doesn't make it the focus of the book. Instead, Macauley artfully weaves his early childhood trauma and how it shaped him throughout the work. The writing is outstanding and it makes for compelling reading. I was so glad I chose to read "Because I Knew You" for it has given me a little more empathy for the tragedies people suffer, and it reveals that sometimes miracles happen even during a heartbreaking time.