“It’s time to talk about dying” says Kathryn Mannix, a doctor who has spent a majority of her career working in palliative care. Her book, With the End in Mind, seeks to open up a conversation around death – a subject that people typically find uncomfortable and want to avoid at all costs.

Mannix argues that the idea of death has become increasingly taboo over time as we have lost our familiarity with it and are not as frequently exposed to it as people were in the past. In her book, she tackles the subject head on by shedding light on the realities of death and clearing up misconceptions around the process of dying.

Throughout the book, Mannix shares stories about a wide variety of patients she has encountered across her career, grouped into themes. For instance, one chapter looks at some of the different coping strategies she has witnessed in people who are dying. This includes the heartbreaking story of a young woman with cancer whose denial around the seriousness of her condition is so unwavering that her family go along with it until the end of her life in hospice care.

Another chapter focuses on communication, or perhaps more accurately, the absence of communication. We hear about the sons of a man who regret dismissing his attempts to talk about death when they are unsure of his resuscitation wishes. In this chapter, Mannix also tells us of an encounter with a married couple who are both aware that the wife has cancer, but they each wrongly believe that their spouse doesn’t know and needs to be protected from the truth.

The importance of communication is a strong theme throughout Mannix’s book. She advocates for open and honest conversations around death, and even includes a letter template at the back of the book designed to facilitate these conversations. 

At several points in the book, Mannix compares her role to that of a midwife, equating the processes of guiding patients (and their family members) through birth and through death. She describes her job as ‘a privilege’ and it’s difficult not to finish the book with an even greater appreciation for anybody involved in end of life care. It’s both a moving and enlightening read, with learning points to help us all lead better lives by living ‘With the End in Mind’.

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