We are presented with case histories of patients facing the end of their life, how they cope (or don't), and what help Mannix and her team (and others) are able to provide via palliative care. Mannix's sincere loving care and compassion radiate from the pages of this beautifully written account of her daily life, professional training, clinical practice and most of all, fragile patients. It’s clear she feels she’s been honored to work with the dying, and she’s helped to propagate a healthy approach to death.

But so often, dying people and their families remain unprepared because our fear about death has become a fear about even mentioning dying. It’s offered me some ‘permission’ to say what I see, ask simple and complex questions of her carers, express and ask for what I know she would and wouldn’t want and what I want. That is what many of the conversations with patients are about and the result is usually a very pragmatic response from the patient and gentle but thoroughly honest comments from the doctors, nurses and therapists. With the End in Mind is my attempt to capture the wisdom of dying and death, distilled into stories that take us to those places we believe are too dark to endure, and yet that are illuminated by human resilience, hope and love.She is also aware of the lack of information about the process that is available to patients and their families.

What she is a big advocate of is communication, telling people what is wrong with you, getting them to ask sensitive questions, finding out if people want to be at home for their last moments, or have no real preference. It is heartbreaking and sad but also life affirming and full of wonderful, interesting, inspiring people the author has encountered and cared for. Now Kathryn Mannix joins this distinguished group and her voice, though quiet and calm, is distinctive. It is a real insight into what happens in end-of-life care in hospices across the world and indeed in East Kent.They have all been of interest and informed me to some degree whether they illustrate personal stories or look at the bigger picture. Mainly though, to feel at as much ease as is possible as she comes to the end and what that end will likely look like - which I can share with her too.

Open these pages and you will find stories about people who are like you, and like people you know and love. If you are wired so that you think there's grandeur, learning, redemption, or whatever other "quality" in suffering except pointless pain, you are going to stand your ground and use this book to reinforce your rationalizations about why the pain (physical suffering) is unavoidable, even necessary part of human experience.I think that the practical elements, particularly the reflection points, would make good conversation starters, even with yourself, if death looms large in your consciousness for any reason. Meanwhile, the author tells some of her own stories and encourages the reader to think about issues of their own.

As the hospice leader she's working with on Holly's case describes it to Holly's daughters: 'Have you noticed that she stops breathing from time to time? Kathryn Mannix's With the End in Mind: Dying, Death and Wisdom in an Age of Denial is written from her own experiences as a specialist in palliative care, and this proved, for me, both its strength and its downfall. She has a particular interest in combining CBT with palliative care to help the dying approach their remaining time with realism rather than pessimism. The book is structured around a series of fictionalised case studies drawn from Mannix's own experiences, many of which are deeply affecting. This book is not going to be for everyone given the subject matter, but it is a step in the right direction to seeing death as an intrinsic part of life and coping with it in the best way for you.Having qualified as a Cognitive Behaviour Therapist in 1993, she started the UK’s (possibly the world’s) first CBT clinic exclusively for palliative care patients, and devised ‘CBT First Aid’ training to enable palliative care colleagues to add new skills to their repertoire for helping patients. Many of us won’t read a book like this because we don’t want to look at death, think about death, speak about death, let alone read about Mr Grim and his rusty scythe. I have referred to that one a number of times when talking to people who were in fear of their death, and I can see how this one would be even more comforting.