After the End is a devastating, beautifully written novel about an impossible choice. Clare Mackintosh is known for thrillers. This is very different territory. It’s heartbreaking territory, but absolutely worth it.
Max and Pip are the strongest couple you know. They’re best friends, lovers—unshakable. But then their son is diagnosed with a brain tumour and the doctors put the question of his survival into their hands. Medical advice is that Dylan’s condition is terminal, and if prolonged his quality of life will be diminished. The heartbroken parents are advised to accept palliative care for Dylan. However, it’s their choice. For the first time, Max and Pip can’t agree. They each want a different future for their son. Max is desperate to keep Dylan alive. Pip wants her son to be spared of further pain.
The first part of the book alternates between Max, Pip and Dylan’s doctor as we journey with them through the terrain of Dylan’s illness, how their life has changed and then the realisation that a decision needs to bemade about Dylan’s treatment. When Max and Pip are unable to agree, Dr Khalili informs them that the Children and Family Court Advisory and Support Service will allocate a guardian for Dylan and appoint a barrister. The case will be heard in court.
There are similarities here with the Charlie Gard case in London in 2017, where Charlie’s parents wanted to try an experimental treatment in the USA, however the British courts supported the Great Ormond Street Hospital decision to not allow that and instead begin palliative care. However, the inspiration behind the story is more personal. In 2006, Clare Mackintosh and her husband had to make the devastating decision to turn off their son’s life support. Her familiarity with children’s hospitals and heartbreak is evident, but there is more than that on the pages of this book – there is survival and hope.
From the day of judgement in court, the book changes gears and in alternating chapters we see how life would proceed for the family under both outcomes – where the judge decides to proceed with palliative care, and where the judge orders an experimental treatment. Mackintosh weaves these different realities skilfully together, and we realise that sometimes different choices will ultimately lead in similar directions.
A gripping and propulsive exploration of love, marriage, parenthood, and the road not taken, After the End brings one unforgettable family from unimaginable loss to a surprising, satisfying, and redemptive ending and the life they are fated to find. With the emotional power of Jodi Picoult’s My Sister’s Keeper, Mackintosh helps us to see that sometimes the end is just another beginning.
After the End destroyed me, but somehow, by the end, it put me back together again. Despite the pain, there is hope. There is love. And every single aspect of that is so beautifully told. I loved this book. I could not put it down.
This is a brilliant book club pick. It’s simply a brilliant book.
With over 2 million copies of her books sold worldwide, number one bestseller Clare Mackintosh is the multi-award-winning author of I Let You Go, which was a Sunday Timesbestseller and the fastest-selling title by a new crime writer in 2015. It also won the Theakston Old Peculier Crime Novel of the Year in 2016. Both Clare’s second and third novels, I See You and Let Me Lie, were number one Sunday Times bestsellers. All three of her books were selected for the Richard & Judy Book Club, and together have been translated into over thirty-five languages.
Clare is patron of the Silver Star Society, a charity based at the John Radcliffe hospital in Oxford, which supports parents experiencing high-risk or difficult pregnancies. She lives in North Wales with her husband and their three children.