Pip and Max are faced with every parents worst nightmare, when their three year old son Dylan is diagnosed with pneumonitis, an illness for which there is no cure. Pip wants to follow the doctor’s and hospital's recommendation of allowing Dylan to die with dignity. But Max has done research on Dylan's condition and knows of a clinic in the U.S. that can provide proton beam therapy, which has been known to have some level of success. Faced with an impossible choice, Max and Pip's world together implodes.
Twelve years prior to writing After The End Mackintosh’s son became critically ill. She and her husband were asked to make a decision that would change all of their lives forever. It was this traumatic experience that was the impetus for what Max and Pip go through here ... Since this is a Clare Mackintosh novel, readers should be prepared for anything ... It is a novel turned inside out and with a narrative twisted up with it. After The End will not be easy to forget. Thankfully, Mackintosh has done through fiction writing what real life could not provide her --- the opportunity to see both choices and get the chance to live through each of them to their own ends.
After the End is a heavy, but expertly told tale that focuses upon how illness and helplessness can strain and ultimately damage a family, sometimes beyond repair. Still, there is a ray of hope at the end. Human beings can move on from loss, though the journey is long and riddled with pain.
This is grim material, and in other hands, the story easily could have turned mawkish. But Mackintosh, a British author of mystery-thrillers ...gets a lot of things right. She’s a natural writer, and her powers of observation are keen ... Everything, at least in the first half of the novel, feels true ... The book is also briskly plotted, an unlikely page-turner .. The book falters in the overlong second half. The author imagines dual outcomes to her story, which seems gimmicky—things get complicated (and sometimes confusing) as well as repetitive. Plus, Max’s downward trajectory doesn’t seem entirely credible; neither do some of his personal choices. But the ending, if not exactly happy, is authentically hopeful. While occasionally overwrought, this is a perceptive, skillfully told story about a profoundly painful subject.