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Book review
At the end of life: true stories about how we die
  1. Neil Vickers
  1. Correspondence to Dr Neil Vickers, Department of English Language and Literature, King's College London, Strand, London WC2R 2LS, UK; neil.vickers{at}

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Edited by Lee Gutkind. Published by Underland Press, 2012, paperback, 288 pages. ISBN 9781937163044, £10.99.

This book is a collection of essays about dying. The essays were all first published in 2011 by a different publisher, the Southern Methodist University Press, under a different title, Twelve Breaths a Minute: End of Life Essays. They are reissued under the new title as part of ‘a series of narrative books on science and medicine supported by the Jewish Healthcare Foundation’.

The phrase ‘How We Die’ in the new title is no doubt intended to recall Sherwin B Nuland's book, How We Die: Reflections on Life's Last Chapters (1994) which was a New York Times bestseller, and won the National Book Award for Nonfiction. The message of that book is that most of us will die in hospital, from a heart attack, stroke or cancer, or some combination of the above. We will probably die in our old age, by which time our bodies will no longer be able to cope with some of the treatments intended to keep us alive. For Nuland, dying is ‘a messy business’, ‘a series of destructive events that involve by their very nature the disintegration of the dying person's humanity. I have not seen much dignity in the process by which we die.’ ‘Dying badly,’ he goes on to say, is not ‘a judgment upon the many that are fated to die badly, simply the nature of the thing that kills them’. How We Die, explained to the lay reader in biological terms, the dehumanising work of the most common terminal illnesses; but it also used real-life examples to show how hi-tech medicine often made the moment of death less dignified.

Nuland was, of course, writing in the shadow of another classic book, whose shade also hovers over the present volume: Elisabeth Kübler-Ross's On Death and Dying (1969). A psychiatrist by training, …

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  • Provenance and peer review Commissioned; internally peer reviewed.