'A Beginner's Guide to the End': A Book Review


When we think of death and dying, it's usually in the context of someone else's death — not our own. We are inquisitive and ask about how they died, whether it was painful, and if they suffered in their last moments. If they’re especially close to us, we may even ask if there was a will in place.

Fortunately, a thoughtful and insightful book, A Beginner's Guide to the End: Practical Advice for Living Life and Facing Death, by Dr. BJ Miller and Shoshana Berger, provides guidance on how to prepare, plan for, and usher death in as it comes knocking at your door. 

Jump ahead to these sections:

Death is always something that happens to someone else, somewhere else, at some other time. Rarely do we consider our own mortality, and very few of us take the time to learn about what to expect as we approach the end of life. As such, we tend to avoid thinking too much about it and leave it to others to deal with for us when the time comes. 

Nothing quite prepares you for hearing the news that your loved one has died, especially when it's you that has to figure out what to do next. 

Dr. BJ Miller is a palliative care doctor who came close to death as a result of a life-altering event when he was still a young medical student. Shoshana Berger is the editorial director of the global design firm IDEO.

Together they joined forces to bring you a straight-forward and matter-of-fact guide to preparing for death.

» MORE: Honor a loved one with an online memorial. Create one for free with Cake.

A Comprehensive Book on End-of-Life Planning

Authors Miller and Berger penned a guide for anyone wanting to know what the business of death is like and what to expect at each stage. The practical book includes details for each step you may face, the roles people play in your care along the way, and the necessary paperwork that needs to be in place to make things easier. 

They outline just about everything you need to know for a successful death. The information is not only aimed at making things easier for yourself while you're living but for your loved ones after you die. 

It isn't simply an end-of-life manual to guide you as you approach death, but a guidebook that you can start with as soon as you turn eighteen. In essence, this book is for anyone who wants to understand and manage the dying process as best as possible.

Accepting death and living life

Through their experiences, Miller and Berger capture how fragile life can be any age. To drive home the point that life-altering things can happen without warning and at any time, they talk about the traumatic events that happened in their lives at different ends of the age spectrum.

The book isn't only about our lives ending when we're old, sick, and frail — it's about being prepared for death in the event it comes today.

For example, Berger's father was a highly respected university professor for all his adult life. When he developed dementia, it changed him in unexpected ways. Berger was not prepared for the many life challenges that followed.

Even with the age of the internet and all the wide resources available to her, she wasn't able to find much of the information she hoped for. Her journey in caring for her father became a series of learn-as-you-go experiments.

» MORE: Need help with funeral costs? Create a free online memorial to gather donations.

The bureaucracy of dying

Miller's experience was completely the opposite. He was faced early on with not only his mother's medical incapacities but to an even greater extent — his own.

As a young medical student, Miller suffered an unfortunate event that cost him most of his limbs. In the book, he talks about his emotional, psychological, medical, and physical struggles. All the things he was struggling through that ultimately made him the man he is today. 

The point that he drives home is not that he has these physical incapacities, or how he overcame challenges as he recovered. It's about how our healthcare system is full of red tape that requires us to thoughtfully plan and prepare for anything that is thrown our way.

He gives us invaluable strategies that we can start implementing right now in case we need to put our plan in motion earlier rather than later.

Planning For Your Death: 5 Key Takeaways

One thing the book stresses for everyone is to not take for granted that human life ends for all of us. None of us go on to live forever in these human bodies, regardless of what your spiritual or religious beliefs are. So even if you aren't planning on dying, you should prepare for it regardless. But the juxtaposition here is that even though life is fleeting, it can also be a long one if lived right and with meaning. 

Berger and Miller open up a dialogue about life, death, and dying that few people have done before them. They stress that in our society, we still fail to talk about death, we're not prepared for it, and we treat it as if it's something that isn't ever going to happen to us. Their book helps you move toward these conversations in very detailed and explicit ways. 

They don't leave much unanswered about the paperwork that you should put in place right away. The book also provides needed context on what you should expect from healthcare professionals, what their roles are in your care plan, what happens when you die, and what your loved ones should do afterward.

1. Entering into a relationship with death

Having a relationship with death is not as morbid as it sounds. It means getting used to the idea that you are going to die, living your life fully in awareness of our mortality, and preparing for it as you would any other one of life's great events.

Many people in our society choose to ignore death as if it doesn't exist. This can leave you filled with fear and anxiety of the unknown. It can also make it more difficult to process your emotions when someone close to you dies. Developing a healthy relationship with death better prepares you for it.

2. Don’t leave a mess — plan ahead

One of the last things your loved ones will want to do is sort out the legal, medical, and financial mess that comes with dying unprepared. Most of the time you're able to avoid these types of messes by having certain end-of-life planning documents and legal instruments in place.

This book brings to light everything you need to know about putting a plan together to make this transition easier for those you leave behind. It walks you through the types of insurance available to you, what documents you need in place to hand over to someone else certain powers to make decisions on your behalf in case you're unable to, and how to legally leave behind your estate to your heirs.

3. Dealing with illness — feeding your soul

The chapters on how to handle your healthcare not only makes things easier for your caregiver and loved ones, it's also full of practical advice for yourself. The authors lay out advice on how to gain control of choosing the best healthcare plan for yourself, how to talk to your medical and healthcare professionals, and what options are available to you.

One particular sticking point is that there are many things that you have an absolute right to decide for yourself. Ultimately, you learn how to ensure that your wishes are followed, and even how to make provisions for your loved ones in making those decisions to honor their wishes about your end of life care. 

4. Your relationships

It seems that hardly anyone talks about how to work out your relationships with your loved ones as you face the end of your life. Everything is discussed here from holding on to intimacy with your partner to being careful not to hurt your children's feelings when notifying the family of your condition.

For many of us, these are sticky situations that can easily lead to anxiety, hurt feelings, and resentment. The authors give real-life scenarios and solutions on how to best handle these delicate matters.

5. Healthcare help

In case you didn't know, there is an entire (huge) team of medical and healthcare professionals that take charge of your end-of-life care and treatment. The book details all the roles these people play in caring for your needs, what to say to them, what questions to ask, and when you should ask them to revisit your end of life planning you might have set in place ahead of time.

After reading this book, the authors hope to instill confidence and peace of mind to talk to your healthcare team, not as a mere player in the game, but the coach that's ultimately in charge of all major decisions.

Where Are You in This Stage?

Taking a close look at where you are in your death planning and taking stock of your life has just become easier with the help of this book. Here are some questions to consider as you move forward with your end-of-life planning:

  • How in control are you of what happens to you at the end of life?
  • Do you have your paperwork in order?
  • Have you planned out how to pay for your end of life healthcare?
  • Have you prepaid for your funeral or other final disposition?
  • Will you tell your employer, friends, and co-workers if you are diagnosed with a terminal illness?
  • Have you talked to your children about your last wishes and who will inherit your estate?

The How-To Guide for Dealing with Death

This book does not mince words when it comes to planning and preparing for your own death. Both Miller and Berger share their pain in recounting their experiences with death and dying, but not without hope that readers can feel calm about encountering another one of life’s large events.

There’s a lot of paperwork, emotions, and legal documents that come into play when doing end-of-life planning. A Beginner’s Guide to the End deals with the nitty-gritty but also provides some emotional support when everything can feel like…well, the end is near.

If you're looking for more book recommendations read our guides on books about death and books about grief.

Icons sourced from FlatIcon.