Knocking on Heaven's Door


In this visionary memoir, based on a groundbreaking New York Times Magazine story, award-winning journalist Katy Butler ponders her parents’ desires for “Good Deaths” and the forces within medicine that stood in the way.

Katy Butler was living thousands of miles from her vigorous and self-reliant parents when the call came: a crippling stroke had left her proud seventy-nine-year-old father unable to fasten a belt or complete a sentence. Tragedy at first drew the family closer: her mother devoted herself to caregiving, and Butler joined the twenty-four million Americans helping shepherd parents through their final declines.

Then doctors outfitted her father with a pacemaker, keeping his heart going but doing nothing to prevent his six-year slide into dementia, near-blindness, and misery. When he told his exhausted wife, “I’m living too long,” mother and daughter were forced to confront a series of wrenching moral questions. When does death stop being a curse and become a blessing? Where is the line between saving a life and prolonging a dying? When do you say to a doctor, “Let my loved one go?”

When doctors refused to disable the pacemaker, condemning her father to a prolonged and agonizing death, Butler set out to understand why. Her quest had barely begun when her mother took another path. Faced with her own grave illness, she rebelled against her doctors, refused open-heart surgery, and met death head-on.

With a reporter’s skill and a daughter’s love, Butler explores what happens when our terror of death collides with the technological imperatives of medicine. Her provocative thesis is that modern medicine, in its pursuit of maximum longevity, often creates more suffering than it prevents.

This revolutionary blend of memoir and investigative reporting lays bare the tangled web of technology, medicine, and commerce that dying has become. And it chronicles the rise of Slow Medicine, a new movement trying to reclaim the “Good Deaths” our ancestors prized.

Knocking on Heaven’s Door is a map through the labyrinth of a broken medical system. It will inspire the difficult conversations we need to have with loved ones as it illuminates the path to a better way of death.


This extremely heart felt and poignant book takes a look at one of the hardest decisions a person can ever face.  When is medical care too much?

Having worked in a hospital, I have seen too many times where the families and physicians keep patients hooked up to all sorts of life sustaining machines.  This isn't usually done for the patient's benefit.  Most of them at that point are already brain dead and their souls have already gone on.  This is more because the families are unable to let go and allow the bodies to die gracefully.

When I was a teenager in high school, my dad was diagnosed with cancer.  We went the chemotherapy route.  Back then, chemotherapy was sheer torture in which the patient was hospitalized for weeks on end receiving painful and sickening doses.  My dad went from a strong roofer to a mere skeleton in a very short period of time. 

Finally, he just didn't and couldn't take anymore.  So we allowed him dignity and brought him home to die in peace.  It was a struggle for us, but we were able to allow him to have a "Good Death" surrounded by those who loved him. 

Unfortunately, this choices can often times tear families apart.  I know this first hand.  When my grandma was dying from cancer, she couldn't go on anymore.  She wanted to die peacefully.  One son didn't want to give up the fight (even though she was 74 years old).  The other 2 sons and 1 daughter wanted to follow her wishes.  Because of this, there was a horrible rift in the family that didn't get healed until my dad was on his death bed.  So many years were wasted. 

It is a difficult decision.  This book helps to open up the channels of communication so you can discuss the issues before it becomes too late.  It also allows people to see it from another perspective. 

Disclaimer: I received this book free from NetGalley in exchange for an honest review. I did not receive any form of compensation.

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