Let’s just start with the most important statement that this review will contain. READ THIS BOOK! This book was a fast read that was thought provoking and addressed contemporary issues without hitting you over the head with a clear opinion.
After the End tells the story of Max and Pip, a couple living in England. Their only child, Dylan, will soon turn three years old — hopefully. Dylan is currently in the Pediatric ICU as a result of complications from a brain tumor. After multiple surgeries and chemotherapy, the doctors have discovered that the remaining portion of the tumor is growing. Sadly, they do not recommend further treatment and ask Max and Pip to make an impossible decision. Do they continue to seek treatment that might prolong Dylan’s life for a short while or do they simply offer palliative care and allow the child to die? The doctors have made it clear that should Dylan continue to live, he will have very little function, if any. He will not walk or feed himself. It is doubtful that he will ever clearly communicate his wishes or pains. He will not regain control of his bladder or bowels. Faced with the question that has no obvious answer, Max and Pip find themselves on opposite sides — unable to agree on the best course of action to take for young Dylan. As a result, the case will be taken before family court.
In a startling turn at the novel’s mid-point, Mackintosh produces two subsequent chapters that have the opposite decisions handed down by the court. For the remainder of the story, the author masterfully explores what *might* happen to Dylan and his parents in both scenarios. When I first encountered these chapters in the novel, I was confused and uncertain of how this was going to play out. Soon it became clear that Mackintosh was showing the reader alternate endings to the story. Through this unusual storytelling device, After the End points out that mistakes, suffering, and joy result along both paths and that it is absolutely impossible to truly know what the best choice is in every situation. One simply must consider the facts as presented at the moment, listen to your heart and gut-instinct, and follow a path. Then, we simply must travel the chosen path and not torment ourselves by constantly looking back and second-guessing our choices.
At the conclusion of the novel, Mackintosh shares some insight in her author’s note that I think readers need to know before beginning the journey. While the novel is completely a work of fiction, Mackintosh and her husband faced a similar situation in their own lives when their child became gravely ill; the Mackintoshes were forced to face a decision similar to that of Max and Pip. While Candace and her husband were in total agreement about their decision, I personally believe that her experience allowed her to write the story of Pip and Max with an unmatched level of truthfulness, compassion, and empathy for all characters in her novel while carefully navigating the waters of the quality of life versus quantity of life debate.
If you are ready to ask yourself repeatedly how you would handle such a challenging and unimaginably difficult situation, journey with Pip and Max through the pages of After the End. Once you reach the end of the novel, these characters will stay with you long after the final page and continue to give you much to think about and consider.
Reading for Me 