I read After the End by Clare Mackintosh in one day on holiday, it is compulsive reading. It begins in a courtroom as everyone awaits the verdict of the judge. Leila, and at this point we do not know what role she plays in this story, watches two parents hold hands as they await the verdict on their son’s fate.
This is a book of two halves. The first is compelling, telling the story of how Max and Pip Adams find themselves in the courtroom described in the Prologue. Their two and a half year old son Dylan has a terminal brain tumour, surgery has removed only part of the tumour. Max and Pip are a strong couple, committed to each other and to Dylan. So far, they have coped. That is, until the hospital says it recommends no further treatment as Dylan has no quality of life. The reactions of Max and Pip to this advice are different and traumatic. Should Dylan be allowed to die peacefully without further painful, disruptive medical intervention? Or should he be taken to America for cutting edge medical treatment which his NHS consultants warn is not suitable for him? As the court case approaches, trust is broken, a pro-life group gets involved, secrets are told to the media, and Pip and Max are on all the front pages.
Part two centres on what happens after the court case and this, for me, is the weaker half. In a kind of ‘Sliding Doors’ approach, Mackintosh alternates chapters for two different outcomes of the court case. For me the technique was confusing, perhaps better signposting in chapter headings might have helped. I realise she is making a comment about the randomness of life but the ‘after’ story would be emotionally stronger if one option was told.
The community of Dylan’s PICU unit was so well drawn it felt real. Reading the Author’s Note afterwards, it becomes clear that Mackintosh experienced her own real life tragedy. The small details make it oh so believable. The specialist nurses, the parents of other patients, and doctor Leila Khalili are so well drawn. In a novel so emotional and at times polarised, I think it was important to include the viewpoint of Leila. Mackintosh is so good at showing the emotions of people on the edge, living in an abnormal world centred on the four walls of a hospital room, separate from the outside world operating as normal.
Understandably this book has been a word-of-mouth hit but it comes with an advance warning for anyone suffering grief at the illness or loss of a child. At times it is difficult to read, but its bare honesty is refreshing.
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