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The Art of Dying Well: A Practical Guide to a Good End of Life Hardcover – February 19, 2019
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“A common sense path to define what a ‘good’ death looks like” (USA TODAY), The Art of Dying Well is about living as well as possible for as long as possible and adapting successfully to change. Packed with extraordinarily helpful insights and inspiring true stories, award-winning journalist Katy Butler shows how to thrive in later life (even when coping with a chronic medical condition), how to get the best from our health system, and how to make your own “good death” more likely. Butler explains how to successfully age in place, why to pick a younger doctor and how to have an honest conversation with them, when not to call 911, and how to make your death a sacred rite of passage rather than a medical event. This handbook of preparations—practical, communal, physical, and spiritual—will help you make the most of your remaining time, be it decades, years, or months.
Based on Butler’s experience caring for aging parents, and hundreds of interviews with people who have successfully navigated our fragmented health system and helped their loved ones have good deaths, The Art of Dying Well also draws on the expertise of national leaders in family medicine, palliative care, geriatrics, oncology, and hospice. This “empowering guide clearly outlines the steps necessary to prepare for a beautiful death without fear” (Shelf Awareness).
- Print length288 pages
- LanguageEnglish
- PublisherScribner
- Publication dateFebruary 19, 2019
- Dimensions8.66 x 5.91 x 0.98 inches
- ISBN-101501135317
- ISBN-13978-1501135316
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Editorial Reviews
Review
—The Washington Post
“A better roadmap to the end… combines medical, practical, and spiritual guidance.”
—Kate Tuttle, The Boston Globe
"A commonsense path to define what a 'good' death looks like."
—USA Today
“An empowering guide that clearly outlines the steps necessary to avoid a chaotic end in an emergency room and to prepare for a beautiful death without fear.”
—Shelf Awareness
“Straightforward, well-organized, nondepressing… Free of platitudes, Butler’s voice makes the most intimidating of processes—that of dying—come across as approachable. Her reasonable, down-to-earth tone makes for an effective preparatory guide.”
—Publishers Weekly
“This book is filled with deep knowledge and many interesting experiences. It is a guide for staying as healthy and happy as possible while aging, and also shows how important it is to be medically informed and know our rights in the communities where we live, in order to stay in charge of our lives and therefore less afraid of the future. Katy Butler has written a very honest book. I just wish I had read it ten years ago. You can do it now!”
—Margareta Magnusson, author of The Gentle Art of Swedish Death Cleaning
“The Art of Dying Well is a guide to just that: how to face the inevitable in an artful way. Katy Butler has clear eyes and speaks plainly about complicated decisions. This book is chock-full of good ideas.”
—Sallie Tisdale, author of Advice for Future Corpses
“In plain English and with plenty of true stories to illustrate her advice, Katy Butler provides a brilliant map for living well through old age and getting from the health system what you want and need, while avoiding what you don't. Armed with this superb book, you can take back control of how you live before you die.”
—Diane E. Meier, MD, Director, Center to Advance Palliative Care
“No, you won’t survive your death, but you can live until the very last moment without the pain and humiliation that inevitably accompany an over-medicalized dying process. Katy Butler shows how, and I am profoundly grateful to her for doing so.”
—Barbara Ehrenreich, author of Natural Causes
“This is a book to devour, discuss, dog-ear, and then revisit as the years pass. Covering matters medical, practical, financial and spiritual – and, beautifully, their intersection – Katy Butler gives wise counsel for the final decades of our ‘wild and precious’ lives. A crucial addition to the bookshelves of those seeking agency, comfort and meaning, The Art of Dying Well is not only about dying. It’s about living intentionally and in community.”
—Lucy Kalanithi, MD, FACP, Clinical Assistant Professor of Medicine, Stanford School of Medicine
“The Art of Dying Well is the best guidebook I know of for navigating the later stages of life. Katy Butler’s counsel is simple and practical, but the impact of this book is profound. A remarkable feat.”
—Ira Byock, MD, author of Dying Well and The Best Care Possible, Active Emeritus Professor of Medicine, the Geisel School of Medicine at Dartmouth
Praise for Katy Butler and Knocking on Heaven's Door
“This is a book so honest, so insightful and so achingly beautiful that its poetic essence transcends even the anguished story that it tells. Katy Butler’s perceptive intellect has probed deeply, and seen into the many troubling aspects of our nation’s inability to deal with the reality of dying in the 21st century: emotional, spiritual, medical, financial, social, historical and even political. And yet, though such valuable insights are presented with a journalist’s clear eye, they are so skillfully woven into the narrative of her beloved parents’ deaths that every sentence seems to come from the very wellspring of the human spirit that is in her." -- Dr. Sherwin B. Nuland, author of How We Die: Reflections of Life’s Final Chapter
“Knocking on Heaven’s Door is a thoroughly researched and compelling mix of personal narrative and hard-nosed reporting that captures just how flawed care at the end of life has become." -- Abraham Verghese ― New York Times Book Review
“This is some of the most important material I have read in years, and so beautifully written. It is riveting, and even with parents long gone, I found it very hard to put down. ... I am deeply grateful for its truth, wisdom, and gorgeous stories—some heartbreaking, some life-giving, some both at the same time. Butler is an amazing and generous writer. This book will change you, and, I hope, our society." -- Anne Lamott ― author of Help, Thanks, Wow
"Shimmer[s] with grace, lucid intelligence, and solace." -- Lindsey Crittenden ― Spirituality and Health Magazine
"[A] deeply felt book...[Butler] is both thoughtful and passionate about the hard questions she raises — questions that most of us will at some point have to consider. Given our rapidly aging population, the timing of this tough and important book could not be better." -- Laurie Hertzel ― Minneapolis Star Tribune
"This braid of a book...examines the battle between death and the imperatives of modern medicine. Impeccably reported, Knocking on Heaven's Door grapples with how we need to protect our loved ones and ourselves." ― More Magazine
"A forthright memoir on illness and investigation of how to improve end-of-life scenarios. With candidness and reverence, Butler examines one of the most challenging questions a child may face: how to let a parent die with dignity and integrity. Honest and compassionate..." ― Kirkus Reviews
“Katy Butler’s science background and her gift for metaphor make her a wonderfully engaging storyteller, even as she depicts one of our saddest but most common experiences: that of a slow death in an American hospital. Knocking on Heaven’s Door is a terrible, beautiful book that offers the information we need to navigate the complicated world of procedure and technology-driven health care.” -- Mary Pipher ― author of Reviving Ophelia and Seeking Peace: Chronicles of the Worst Buddhist in the World
"Katy Butler's new book—brave, frank, poignant, and loving—will encourage the conversation we, as a society, desperately need to have about better ways of dying. From her own closely-examined personal experience, she fearlessly poses the difficult questions that sooner or later will face us all.” -- Adam Hochschild ― author of King Leopold’s Ghost and To End All Wars
"This is the most important book you and I can read. It is not just about dying, it is about life, our political and medical system, and how to face and address the profound ethical and personal issues that we encounter as we care for those facing dying and death. [This book's] tenderness, beauty, and heart-breaking honesty matches the stunning data on dying in the West. A splendid and compassionate endeavor." -- Joan Halifax, PhD, Founding Abbot, Upaya Institute/Zen Center and Director, Project on Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death
"This beautifully written and well researched book will take you deep into the unexplored heart of aging and medical care in America today. With courage, unrelenting honesty, and deepest compassion, ... Knocking on Heaven’s Door makes it clear that until care of the soul, families, and communities become central to our medical approaches, true quality of care for elders will not be achieved." -- Dennis McCullough ― author of My Mother, Your Mother: Embracing "Slow Medicine,'" the Compassionate Approach to Cari
"Butler’s advice is neither formulaic nor derived from pamphlets...[it] is useful, and her challenge of our culture of denial about death necessary...Knocking on Heaven’s Door [is] a book those caring for dying parents will want to read and reread. [It] will help those many of us who have tended or will tend dying parents to accept the beauty of our imperfect caregiving." -- Suzanne Koven ― Boston Globe
"Knocking on Heaven's Door is more than just a guide to dying, or a personal story of a difficult death: It is a lyrical meditation on death written with extraordinary beauty and sensitivity." ― San Francisco Chronicle
"[Knocking on Heaven's Door is] a triumph, distinguished by the beauty of Ms. Butler's prose and her saber-sharp indictment of certain medical habits. [Butler offers an] articulate challenge to the medical profession: to reconsider its reflexive postponement of death long after lifesaving acts cease to be anything but pure brutality." -- Abigail Zuger, MD ― New York Times
About the Author
Excerpt. © Reprinted by permission. All rights reserved.
The River Grows Wider
Some old people are oppressed by the fear of death.… The best way to overcome it is to make your interests gradually wider and more impersonal, until bit by bit the walls of the ego recede, and your life becomes increasingly merged in the universal life. An individual human existence should be like a river: small at first, narrowly contained within its banks, and rushing passionately past rocks and over waterfalls. Gradually the river grows wider, the banks recede, the waters flow more quietly, and in the end, without any visible break, they become merged in the sea, and painlessly lose their individual being. [Those] who can see life in this way will not suffer from the fear of death, since the things [they care] for will continue.
—BERTRAND RUSSELL
Product details
- Publisher : Scribner (February 19, 2019)
- Language : English
- Hardcover : 288 pages
- ISBN-10 : 1501135317
- ISBN-13 : 978-1501135316
- Item Weight : 1.05 pounds
- Dimensions : 8.66 x 5.91 x 0.98 inches
- Best Sellers Rank: #73,128 in Books (See Top 100 in Books)
- #90 in Green Housecleaning
- #262 in Love & Loss
- #2,484 in Memoirs (Books)
- Customer Reviews:
About the author
Biography
Katy Butler is a public speaker, journalist-author, and teacher of memoir writing at Esalen Institute. She is best known for books about medicine's changing approach to the end of life. A graduate of Wesleyan University, she is the author of a critically acclaimed investigative memoir, "Knocking on Heaven’s Door: The Path to a Better Way of Death" (2013); and a nonfiction handbook for the last third of life called "The Art of Dying Well: A Practical Guide to a Good End of Life" (2019.)
Her main areas of interest are: health; aging; death; bioethics; aging parents; family caregiving; the structure and shortcomings of American medicine; domestic and sexual violence; neuroscience; human behavior; addiction; psychotherapy; meditation; and religious and spiritual life.
Her writing has appeared in many publications including The New York Times, the Wall Street Journal, JAMA-Internal Medicine, The New Yorker, Atlantic, and Scientific American. It has earned the Science in Society Prize from the National Association of Science Writers; a Books for a Better Life "best first book" award; fellowships and residencies at Yaddo, Blue Mountain Center, Hedgebrook, and Mesa Refuge; and inclusion in Best American Essays, Best American Science Writing, and Best Buddhist Writing. She is a past finalist for a National Magazine Award and the Dayton Literary Peace Prize.
Her books have been praised by many leading medical, spiritual, and literary figures, including Ira Byock MD, Barbara Ehrenreich, Anne Lamott, Adam Hochschild, Jack Kornfield, Joan Halifax, Sherwin Nuland, MD, Mary Pipher, and Abraham Verghese, MD.
"Knocking on Heaven’s Door," a New York Times bestseller, was named one of the ten best memoirs of the year by Publishers Weekly and was named an “Editors’ Choice," a "Best Book," or a "Notable Book of the Year" by the NYT, The SF Chronicle, the Boston Globe and other publications.
The book weaves a memoir of caring for her father during a long, difficult decline with an investigative history of medical innovation and a critical exploration of why medicine now focuses on warding off death rather than preparing people for peaceful ones. It was based on a groundbreaking NYT magazine article, "What Broke My Father's Heart: How a Pacemaker Wrecked a Family's Life," a "most emailed" NYT story for more than a month.
She is one of relatively few non-physicians to give “Grand Rounds” and endowed lectures at leading medical centers, including Harvard Medical School, Mt. Sinai, Cedars-Sinai, UCSF, the VA Medical Center in Minneapolis, and Kaiser-Permanente northern California. She has appeared on scores of public television and radio programs, such as Melissa Harris Perry's former program on MSNBC and on the Diane Rehm show. She has given keynotes before more than 100 community and professional groups and at leading bookstores across the country.
Her literary agent is Amanda (Binky) Urban of ICM Partners in Manhattan. Scribner, a division of Simon & Schuster, published her first two books.
Katy was born in Grahamstown, South Africa, was raised in Oxford, England. She came to the US as a child, settling with her family in the Boston area. (Her father Jeffrey was a Wesleyan University college professor and World War II veteran who lost his left arm in combat in Italy; her mother was a gifted amateur artist and homemaker.) She attended Sarah Lawrence college and obtained her BA from Wesleyan University in Middletown, Conn. Earlier in life, she lived in a mud hut in the Venezuelan rain forest and in two Buddhist monasteries and worked as a pizza waitress, a reporter for the San Francisco Chronicle (winning awards for her coverage, with Randy Shilts, of the AIDS crisis) an investigative reporter for an alternative newspaper, and a school crossing guard. For ten years, she wrote and edited for Psychotherapy Networker, contributing many 10,000-word articles of cultural criticism and therapeutic analysis to issues that won several National Magazine Awards and nominations.
Her writing has also appeared in Vogue, Salon, Utne Reader, Yoga Journal, MORE, Tricycle: the Buddhist Quarterly, and The Whole Earth Review and Catalog. A practicing Buddhist, she lives in the San Francisco Bay Area with her husband, professional musician Brian Donohue, who performs widely in local nursing homes, dementia units, and assisted living residences.
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Highly recommended.
HOWEVER: The book and description indicate that a pdf accompaniues the audio download. NOT TRUE and no idea how to resolve. If you haven't got the hard copy, the pdf is critical to value because there are many references to resources etc which (are contained within the pdf provided with your download"
A peaceful passing is not accomplished only by arranging for hospice and pain management in the last two or three days of life. Ms. Butler says the preparation starts years before. Of course, the obvious practical steps are important, like completing a “Living Will” and “Durable Power of Attorney for Healthcare.” I say “obvious,” but precious few people actually take the small number of minutes needed to complete these documents. So, perhaps, not so obvious, therefore, it needs to be said again, and again. Butler takes this preparation for dying well to a whole new level, way beyond pieces of paper.
The book is organized in seven chapters, each covering a phase from our healthy years to our final days. The chapters are: 1. “Resilience”; 2. “Slowing Down”; 3. “Adaptation”; 4. ”Awareness of Mortality”; 5. “House of Cards”; 6. “Preparing for a Good Death”; and 7. “Active Dying”. Each chapter starts by helping the reader identify whether he or she is in this phase… “You may find this chapter useful if…” and there is a list of signs marking that particular phase. For example, if “You can’t walk a half a mile unaided, unscrew a jar, or pick up a dining room chair” you may benefit with the information in chapter 5 “House of Cards.”
A recurring section in all but the last chapter is “Finding Allies in…”. These are healthcare professionals in every field from preventive medicine, physical therapy, house call programs, to hospice. Nurture your “tribe” too. While you are healthy, take care of your friends, neighbors (especially your younger ones), people in your faith community and family members—you may need to call on them someday.
Omitting “Finding Allies” from the “Active Dying” (the last hours or days of life) chapter says to me, if you haven’t been developing these relationships by your last days, it may be too late. Family and friends are really needed in this last phase. Could you ask your next-door neighbor to pick up some meds at the pharmacy if you have never met them? Build your tribe long before you need them.
If one waits until just a few days before dying to start preparations to have a peaceful death, it may be too late. A HUGE problem hospices face is last-minute admissions. It is a problem because it can take a several days to get all the necessary medical equipment into a patient’s home and find the best way to get pain under control. We are back to my “dying peacefully takes a lot of planning and preparation.”
Not to be overlooked in preparing for a peaceful end is the spiritual side of life. This may or may not be religious in nature. Butler points the reader toward many spiritual traditions with examples of prayers and rituals. Those who do not consider themselves to be religious will find resources here. The chaplain in me really appreciates this aspect being included in a book called “A Practical Guide”. Saying goodbye at the end of life IS a spiritual journey.
In the end, Butler turns to a healthcare system which makes dying well so much harder. The way our system works in the United States is doctors and hospitals are paid for doing stuff. The more aggressive the treatments… the more machines used… the more tests ordered and more needle sticks… the more providers are paid. We (through Congress and Medicare/Medicaid) have no problem spending $7,000 a day on a dying elderly patient in an ICU but cannot find the money for more physical therapy to help another old person live independently. A doctor can order pills for a frail patient that cost hundreds of dollars but can’t help them get food. Katy Butler, appropriately, encourages all of us to become activists in changing the way we care for, not just the dying, but those living with frail health throughout our declining years.
Get the book. Read it now. Read it again every time you find yourself moving from one of Butler’s phases to the next.
Hank Dunn, author of "Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures, and the Patient with a Serious Illness"
Like most books I've read on this topic, Katy Butler's "Art of Dying Well: A practical Guide to a Good End of Life" is sort of mixed up between talking to caregivers and the person who will be doing the dying. Some messages are easier to read when you imagine yourself as the caregiver, of course, but anything you learn in the course of being a caregiver you can pivot to use for yourself when the need arises.
Talking about death starts out stilted and hard, but quickly becomes sacred. It's like imagining a childbirth, all gross with blood and feces and unattractive uses of sexual parts. When you're distant from the occasion it's unseemly to give TMI. But when it's YOU having a baby, or your spouse, well: we want to know ALL the tricks for avoiding tears on the perineum, how to roll the nipples, what sort of car seat you want to have installed in advance.
Reading about death is much the same. In fact, one quote that stuck with me was "I didn't choose to be born, and I don't choose to die." It's a contemplation of the limits of our powers. Sometimes we're just swept along with these great forces and control is an illusion. You can meditate on that for yourself if you wish, it leads to useful places.
This entire book leads to useful places, in my opinion. Knowing when to post a MOLST on the fridge, knowing when NOT to call 911 (and what to do instead): this is useful information for most of us. It gives you some language to help interpret what doctors are trying to tell you, which I found helpful. She does this at various stages. When they say you're ill, asking what the progression of the disease will look like is more helpful, in some ways, than their estimate of how long you'll live. (The doctors routinely over-estimate how long you'll live, by the way. They may be thinking 3 to 6 months and tell you 6 months because they want you to have hope. But it can screw up planning!)
I'm a financial planner and this book isn't a clear win for the financial piece of it. That's Harry Margolis' "Get Your Ducks In a Row". But I liked this book better than the trollishly named "Advice for Future Corpses". Recommended.