Desert Isle Keeper
After the End
I always get a little nervous when authors who write a particular type of book very well decide to try something new. Sometimes, it ends up working out well, but there are also those times when it turns out to be a flop. Fortunately, After the End, the latest novel from renowned thriller writer Clare Mackintosh is an example of a departure done extraordinarily well.
Everyone who knows Max and Pip considers them to be strongest couple they know. Not only are they husband and wife, but they’re also best friends. Together with their three-year-old son Dylan, they embody the perfect family, until tragedy tears them apart.
Dylan has been battling an aggressive form of brain cancer for quite some time before the story opens, and when we first meet Max and Pip, they’re spending long stretches of time in the Pediatric Intensive Care unit of a local hospital. Dylan has not been breathing on his own for several weeks, but his doctors are cautiously optimistic they’ll be able to take him off the respirator soon.
Unfortunately, things don’t end up going as well as Dylan’s medical team expects, and further testing shows that Dylan’s tumor has continued to grow in spite of the treatment he’s been undergoing. To make matters worse, the tumor itself plus the surgery necessary to remove a part of it has left Dylan with irreversible brain damage. Now, Dylan’s medical team puts a terrible question to Max and Pip. Do they want to stop treating Dylan’s cancer, allowing him to die with dignity, or do they wish to continue pursuing forms of treatment that might extend his life?
For the first time since they got married, Pip and Max find it impossible to agree on what comes next for their son. Max is desperate to extend Dylan’s life for as long as possible, even if that means leaving the UK and seeking treatment in the US. Pip, on the other hand, isn’t sure that’s the right thing to do. Although she hates the thought of losing her son, she’s not convinced that exposing him to more treatment that has little chance of getting rid of the cancer is really in his best interest. And so, the courts get involved, propelling Pip, Max, and their tragic fight into the public eye.
If you’ve ever read one of Ms. Mackintosh’s thrillers, you know she has a definite way with words. Her writing is incredibly vivid and evocative, making me feel as though I was experiencing this crushing sadness right along with Pip and Max. There is a stark beauty in her descriptions of days spent on an ICU ward that choked me up on more than a few occasions.
About midway through the story, Ms. Mackintosh throws in a twist that will completely blow your mind if you’re not expecting it. Rather than exploring the actual outcome of the legal proceedings, she begins writing two different time lines, each of which examines what the lives of the characters might look like if the judge decides in their favor. So in Pip’s timeline, Dylan does not undergo further treatment, while in Max’s chapters, he and Pip move to Texas in order to obtain a specialized radiation treatment for Dylan’s cancer. This might be difficult to get your head around at first, but if you just surrender to Ms. Mackintosh’s moving prose, all will eventually become clear.
Pip and Max aren’t our only narrators. We also see events from the perspective of Leila, one of the doctors looking after Dylan. I enjoyed spending time in Leila’s head, because not only is she a fascinating character in her own right, but she allows the reader to see how difficult cases can forever change a medical professional’s outlook on what it means to actually lead a meaningful life.
This is not a happy book. In fact, it’s honestly one of the saddest stories I’ve picked up in quite some time, but it’s also one of the most beautiful. It touches on difficult issues with so much sensitivity, and I found myself fully empathizing with everyone involved in making a decision about Dylan’s future.
I’ll always be a fan of Ms. Mackintosh’s psychological thrillers, but I’d also like to see her write something else that packs the same type of emotional punch as After the End. It’s a masterful story that is sure to touch the hearts of readers everywhere, and I’m so glad to have read it.