Book review – With the End in Mind, by Dr Kathryn Mannix

Community Co-Ordinator Becky reviews the ground-breaking book by a palliative care specialist

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Becky’s latest recommended read – accompanied by recommended cup of tea!

During 2018, I talked about dying a lot. In October 2017, Freeman Brothers Funeral Directors recruited me to the new role of Community Co-Ordinator, with the remit to support local organisations, and encourage the public to discuss their funeral wishes.  Discussing death at work was one thing, and suddenly I noticed more stories appearing in the press, as well as how death, and the potential imminence of it, impacted my own life: in addition to various family members experiencing health issues which required hospital treatment, my Grandad died in April, and I went through my own health diagnosis, swiftly followed by surgery.

By virtue of living as a human being, death affects us all, even if only through our own ultimately personal experience.  It is, however, unlikely that the only death we will know is our own, as few of us exist as lone individuals.  And, although some of us deal with death via our professional lives, experiencing it in our personal lives is a different matter.  Via her book, “With the End in Mind”, Dr Kathryn Mannix takes the same approach: Dr Mannix is a specialist in palliative care, and states that she is, “on a mission to reclaim public understanding of dying.”

In the book, the author shares the stories of many patients and their loved ones, as well as several anecdotes relating to the deaths of members of her own family, death through the eyes of her children (in fact, the stories of the goldfish and the cat are two of my favourite – fear not, neither died at the claws of the other), and supporting friends through death.  Each of the stories is told with a softness and warmth which alludes to Kathryn’s decades of experience within a clinical setting, but also to her experiences as a human being – many of us visit doctors or other healthcare professionals and forget what their inner dialogue might be, as there is a hierarchy due to the professional/patient dynamic – whereby she shares her inner thoughts at some of these critical moments.  Some of these moments came when she was a trainee, at a time when palliative care didn’t even exist as a discipline; other accounts are of more recent experiences, such as observing the practice of a doctor Kathryn herself was involved in training, or supervising a unit she is in charge of.

It did not surprise me that each experience is unique – this is something which is mirrored in our own work where, contrary to popular belief, no two funerals are the same.  However, the similarity is conveyed again by the human experience: when the patients and families in these stories are encouraged to open up about their situation, whether it is simply actively recognising that death is imminent, or taking steps to prepare for it, all of them are better for it.  They are more comfortable, more at ease, reassured that they are not alone, or that things will be well in their absence.

At the end of the book, there is an additional gift: Kathryn has supplied a glossary of terms used, a list of resources (such as information on Dying Matters and Samaritans), and a template for a letter to your loved ones, outlining potential closing thoughts that you would like to convey.

Perhaps my favourite part – better even than the story of the goldfish – is that the author raises the subject of “Naming Death”; we live in a rather euphemistic culture and, upon observing this, Kathryn reaches a point which we see consistently in our work at Freeman Brothers – that families and friends of those who have died want to provide the funeral the Deceased would have wanted for themselves, but don’t know what this looks like.  Having a simple discussion around an individual’s wishes is something that the author encourages, and an idea that we too would support.

The positivity of Dr Mannix’s book is something that I applaud, and the softness of tone encourages the reader to sink peacefully into the pages, finding it a comforting and accessible read, rather than a painful and heart-wrenching one.  I’d recommend this book to anyone who would like to gain an insight into palliative care – and would urge those within the healthcare industry to read it too!  I’d also recommend it to anyone who hasn’t experienced death – whether young or old – or those who have experienced death in a traumatic way, as the book is a clear demonstration of this not having to be the case, though it is sometimes unavoidable.  Readers will find a new perspective on the concerns of patients and their loved ones, and hopefully appreciate that it’s better to have conversations around death and dying sooner rather than later, and that being open and honest about these topics can also be achieved in a kind and supportive way.

Following Becky’s profound enjoyment of this book, and her assertion that it should be read by as many people as possible, Freeman Brothers will be donating four paperback copies to local libraries – Horsham, Crawley, Billingshurst and Hurstpierpoint – when it is released on 7 February 2019.  This review has also featured on the Horsham District Year of Culture Reading Challenge website; Freeman Brothers is a proud sponsor of another Horsham District Year of Culture event – Sussex Comedian of the Year 2019.

We’d love to hear if you benefit from our donated copies – let us know in the comments, or share your thoughts with us on Twitter, using #BigDealSmallTalk.


Written by Becky Hughes

Community Co-Ordinator

February 4, 2019

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