Max and Pip are parents to nearly 3 year old Dylan, a terminally ill child in the pediatric intensive care unit of St. Elizabeth's Hospital. In the first half of the book, we are told the story through narratives of Max, Pip and Dylan's doctor, Laila. Dylan's parents ultimately disagree on his future care and end up in Court, on opposing sides, to decide his best treatment going forward.

After the End is a book so completely different to anything Clare Mackintosh has written before, that if you had told me Jodi Picoult had written it I would have believed it, such is the storyline and the style of writing itself.

The first half of this book is very good. The emotions and toll of life with a terminally ill child on Dylan's parents, his grandparents and even his doctor are portrayed touchingly and heartbreakingly. This is an extremely painful subject written with empathy, tenderness and sensitivity.

However, part 2 of this book deals with the "what ifs" following the outcome of the Court case in both Max and Pip's lives and while it was interesting to see what happened in both scenarios of the outcome, I found it very confusing as to whose narrative I was reading, and the years in which the chapters were set.

After the End by Clare Mackintosh is a touching and controversial book that is extremely well written. Max and Pippa face an extreme emotionally heart wrenching time, that the author tackles with such passion and care. I wasn’t sure if I wanted to continue reading this book, in places as it was upsetting and I was expecting a psychological thriller, which it isn’t, but I’m really glad that I finished the book. I found it a insightful, compassionate and thought provoking.

If you're expecting more of the same from Ms Mackintosh with respect to the psychological thriller genre, be warned that this book is not that. It's the story of two people torn apart from the tragedy of a sick child and the decision they have to make regarding his ongoing care. It's all the emotions and then some and fraught with all the things that go hand in hand with dealing with a life that is out of their control.
Max and Pip have a very strong relationship. Their family is complete when Dylan is born but then their world is torn apart when he starts to get sick. He deteriorates quite quickly and it soon becomes obvious that decisions regarding his ongoing care have to be made. To stop the treatment and let him go or to carry on regardless of what quality of life he may have afterwards. You already know from the start of the book how things develop there but, as we find out, that's just the start of things to come...
As with one of her earlier books, this book is a book of two halves. The second half leading nicely on from what happens and told alternately by Max and Pip. It's hard to say much more about it as you will find out yourself when you get to that point but I will say that it really gave me food for thought about the whole thing and both voices tugged on my heartstrings.
I remember the recent story about Ashya King, a young boy, and his family going through a similar thing near to me. How his parents defied the hospital and took him abroad for treatment. This case was front and centre in my local paper for quite a while. The story in this book does not follow this case so it's no spoiler but I am mentioning it as it speaks to an understanding and appreciation of what the author is writing about here and gives a lot of credence to what I read. I also understand that the story in this book has personal connections for the author and the parts that are not autobiographical have obviously been very well researched.
Gosh, it all sounds a bit dark doesn't it. Well, yes it is a bit along the way, but the author has managed to inject lighter moments within the book so it never gets too depressing. A tricky balance to maintain but also an important one and here her skill as an author really shines through.
It's a book about a journey, one taken by a loving couple who differ on one important outcome. It's also about that outcome and how the aftermath shapes the rest of their lives. The way the book progresses really makes it an incredible read but I can't go into that here for reasons which will become evident. It's a book that I feel privileged to have read and one that will stay with me for a while yet. My thanks go to the Publisher and Netgalley for the chance to read this book.

Wow, this book was such an emotional read. I don't think I have ever read anything that was this emotional and powerful. So cleverly written. Had me hooked from the first page. I sympathised with both Max and Pip and I honestly don't know what I would do if I had to face a decision like theirs. There is no wrong or right answer. Each decision is made out of the love for their child. I was so emotionally wrapped up in this book I did not want this to end. I have read all of Clare Macintosh's books and they each in their own way are the best books I have ever read. This book will live on in my soul forever and has taught me never to take life for granted. Thank you Clare for the amazing opportunity to have the wonderful opportunity of an advance reading of this new book.

Any book that has the ability to make me cry is, weirdly, a hit with me and this one made me cry more than once. Such a heartbreaking story that sadly is all too familiar for many families and while I can't imagine the pain of these poor families, this book manages to capture some of that heartbreak and gives a glimse into the feelings and story's of those involved both during and after such tragedies. Definitely a 5 star from me.

Thanks to netgalley for an early copy in return for an honest review
Usually love her books this was really not my cup of tea it's not a bad book just not for me

Pip and Max Adams have a little boy, Dylan, who is rising three. He is dying from cancer. Devoted parents, they are spending all the time that they can at his hospital bedside tending to him and talking to him month after month whilst he remains unresponsive. Eventually their doctor, Leila Khalili, informs them that prolonging Dylan’s life is not in his best interest. They disagree and so begins their battle with the hospital – at least that’s where Clare Mackintosh appears to be heading. However, after visiting a mother who has been caring for her severely disabled daughter for many years, Pip decides that keeping Dylan alive is selfish; he has suffered more than enough in his short life. Meanwhile, her husband, determined that his son should live for as long as possible, has been researching new treatments in the US. The couple end up battling for their preferred outcomes in court.
The first half of the novel, with the focus on life at the hospital contrasted with memories of their energetic toddler at home, feels really authentic, perhaps because, very sadly, Clare Mackintosh has first-hand knowledge of life in a NICU which she writes about in her Afterward. The experience is every parent’s nightmare and the events are written about very movingly, without sensationalism or sentimentality, but with a profound sense of suffering and a deep understanding of how all parents react differently to such tragedies.
In the second half of ‘After the End’, the author explores how life changes for the family because of their child’s terminal illness. Using the poem ‘The Road Not Taken’ by Robert Frost as inspiration, Mackintosh takes the concept of lives moving forward because of a decision taken at a certain moment and gives the reader different possible scenarios for the once happily married Pip and Max. Most of these feel entirely plausible; life can never again be pain free even though they will become more able to bear their suffering as time passes. However, the ‘final version’ – Chapter 52, set in 2019 – reminds me of one of those happy-ever-after chapters demanded by Victorian readers (think Dickens’ ‘Great Expectations’) which does not fit with the overall tone of the novel. Better to have left it out!
My thanks to NetGalley and Sphere for a copy of this novel in exchange for a fair review.

If you’re a fan of Clare Mackintosh’s previous books this may not be what you are expecting. However, this was a gripping and thought-provoking book which had me gripped from the start. I’m sure this will be as successful as her previous books but it also takes the author beyond the psychological thriller genre and into the upper echelons of contemporary authors.

Having read Clare Mackintosh’s books before I was fully expecting a psychological thriller, especially as I read the first chapter. (I hadn’t actually read the synopsis, just dived straight in!) Of course I then realised it wasn’t a thriller, but an extremely sad but well written and clever book. You wonder how authors sometimes write such books, and after I read the authors notes it made the whole book even more emotional and thought provoking.

Having read Clare Mackintosh previous novels, I was aware that this was not her usual psychological thriller, and wondered if I would enjoy this as much. However, this is another of her books which is well-deserved of 5 stars! This novel is highly emotional at times, exploring the tragic issue no parent ever wants to be faced with; being given the devastating news that your child has terminal cancer. The book is based around our two main characters, Pip and Max, the parents of young Dylan, who has a cancerous brain tumour. When they are told the news this is terminal, they are faced with some life changing decisions, which they will continue to reflect and continually dwell upon over the passing years. Through the unfolding of events, Mackintosh explores the options that these parents have, which they tragically cannot agree on, resulting in an impasse that the courts are finally left to decide. Whilst the book presents some extremely emotional events at times, you find yourself as a reader considering the same difficult plight and what you yourself feel should be the best outcome. Mackintosh cleverly deals with the expression in life we may find ourselves at times asking of various situations ‘what if…???’ She presents almost a ‘Sliding doors’ offer of events, where one decision can change the whole course of history. As the events evolve, it keeps you continually wondering about the decisions and questions the parents are faced with, but also keeps you gripped wanting to know more and how the novel will finally end – and in true Mackintosh style, doesn’t finish without a slight twist! As Mackintosh acknowledges in the Afterward, this is something that is very personal to her and so enables her to write from the heart in a powerful and creative way, but with such sensitivity and emotion. My thanks go to netgalley and Little Brown Books for the opportunity to read and review an ARC of this.

After The End is unlike anything I have read before and the story of Pip and Max and their baby Dylan is a complete departure from the Psychological Thrillers that I have read by Clare Mackintosh. After the End was brilliantly written (I wouldn’t expect anything less from Clare Mackintosh) and is a very special, sensitive book that was sometimes hard to read and tugged at my heart strings. Dylan’s story will stay with me for a long time. I give this book 5 stars. A big thank you to the publishers and to NetGalley for letting me read this for an honest review, I can’t wait for the publication date so that I can recommend After The End to friends and family.

This is a book that will stay with me for a long while. I wasn’t sure what to expect. I am a fan of Clare MacIntosh and I have enjoyed her thrillers. This is a departure. A story of love and loss, and I am very impressed.
The illness and potential death of a child is such a hard subject matter, but one that is tackled with sensitivity and understanding by the author. I was engrossed and felt so privileged to share the story of Dylan, his parents, and his doctor.
The book is very well written. To manage the time differences in part 2 could not have been easy and it was done really well. I was never lost or confused (sometimes I do struggle to keep up when a book has a ‘sliding door’ type concept.). I don’t want to give any spoilers, but the way the book is structured is very clever and works beautifully.
The main characters are believable, flawed, and so very human. I wanted to be their friend and to give them a massive hug. I found it so emotional - It is probably not a book for public transport.
I highly recommend this book and do not hesitate to give it 5 stars. I can’t wait to see what Clare MacIntosh writes next.

Thanks Netgalley and the Publisher. This is certainly a different style of writing from this author and I personally found this really emotional and hit home in a couple of parts

This book was so moving. At the centre is one poorly little boy surrounded by love but what happens when parents don’t agree on a way forward. You follow the parents through there turmoil where there is no right or wrong path. This book grabs you and holds you till you turn the last page.

Max and Pip are a happy couple facing their two year old son, Dylan's, terminal illness. When Max finds out about a new life-prolonging treatment available abroad, he starts fundraising to get his son to an American hospital for the most advanced care. Pip, however, is unsure that this is the right path for Dylan. Their little boy is reliant on pain relief and endless medications and therapies to get through each day, and she begins to wonder if the kindest thing would be to let Dylan go. Max and Pip cannot agree on what is best for Dylan, and what follows is an incredibly honest and painful story in which no one can be a winner.

In recent years there have been numerous reports in the news of parents fighting in court for further treatment of their children when the medical teams have concluded that this would not be in the child's best interests. Mackintosh has created a story in which Max and Pip are completely believable characters, with separate chapters written from both of their points of view. The views of Dylan's doctor adds weight to the story, showing the often impossible decisions healthcare professionals have to make on behalf of their patients. The far reaching impact of Dylan's illness on his grandparents, Pip's 'mum friends' with similarly aged children, Max's colleagues and strangers reading about Dylan online and in newspapers is explored giving the book even more depth.

At times heartbreaking, After The End is a frank look at the pain of parenting a child with a terminal illness, and being asked to make impossible decisions about their care. It shows the difficulty of navigating work, family, social situations and strangers when the worst thing in the world is happening to you, and the different ways in which we might start to heal and recover.

I have previously loved all the books I have read by Clare Mackintosh and I never knew what to expect from After the end due to the book being a lot more different to her normal writing style. But please don't let put you off this is one of those diamond in the rough books that really starts to sparkle the more you read on. It really makes you appreciate the things in life knowing people go through these struggles every day.

And knowing the Author went through a similar experience of her own really makes you appreciate the book so much more and how difficult this may have been to put pen to paper. But I am so glad she did.

It was a wonderful read to see two sides of each story and each of there lives might have been different depending on each outcome, it reminded me a lot of a film called Sliding doors.

This book is highly recommended and a must read for any fans of Clare Mackintosh, and I am so glad I got to see another part of the Author and all I can say this book has really touched me in a way that I shall give my kids an extra squeeze before bed!

Thankyou

Max and Pip have a strong marriage, but their son Dylan is sick and the doctors recommends that no further treatment be offered, only palliative care. Max finds other treatment options but they disagree and both want different futures for their son. They go to court for the judge to decide what is best for their son. The question becomes right to life verses quality of life.
After the court decision the novel goes into two directions. One is from Pips point of view from what she wanted for her son, and the others is Max if the result went in his favour.

I couldn’t stop reading this novel, it is totally different from what the Author usually writes. I connected with all the characters and were with them all the way, feeling their pain with them. The second half of the book, showing the alternative lives was different and very well written.
Many thanks to Netgalley for an advanced copy of this book in exchange for for my honest review.

Have you ever heard about Charlie Gard? I thought so much about that poor baby during reading this book. Couldn't help thinking Mackintosh was inspired by that real life event but I have learned sadly Claire Mackintosh herself lost a child so really felt for her during reading this book and how brave of her to write about this difficult subjects.. Turning her own experience into an eye opening read is definitely worth congratulations.

I am really in between 3 or 4 stars on this one but settled on 3.
I loved the first part of the book. It's a difficult subject, a dilemma, a decision you should never judge unless you're making it yourself. There is the painful reality of losing a child without being able to do anything. The emotions of Pip and Max were so brilliantly portrayed.

As much as I enjoyed "before" I didn't really like "after". Part of my problem with this book was Doctor Leila- I did expect her story to continue in the "after" section- but it really didn't. I thought she was thrown in to make a point- and I respect that- but her sudden fall from the story -despite the special appearance later- wasn't something I enjoyed. I also found the alternate scenarios a bit confusing to read - as there were different point of views- and they really started to drag at one point around 75% also again I didn't get why there were two alternates (I see it's the weight of that decision and what-if's but especially when the story transformed into dating adventures of the parents I questioned that)

Overall this was a good read but I think if the aftermath of the event was a bit shorter I'd have enjoyed this more.

Max and Pip are the strongest couple you know. They’re best friends, lovers, unshakable. But then their son gets sick and the doctors put the question of his survival into their hands. For the first time, Max and Pip can’t agree. They each want a different future for their son.

What if they could have both?

How would you know if the decision you made was the right decision? Would you second guess yourself, would you always wonder 'what if? We get to see the impact that each decision would have on the family here, and follow both potential timelines. This was a really interesting way to write the story, and it had me hooked. The subject matter was difficult to read at times, and certainly caused a fair few tears through the book. Well worth a read.

You just know that whenever you pick up a book written by Clare Mackintosh as a reader you are not going to be disappointed l
Clare has written about such a difficult subject with sensitivity and pure beauty.
It is through yet gentle- raw and honest.
Recommend you to read it with a box of tissues at the ready.
Thank you to both NetGalley and Littlebrownbookgroupuk for my eARC in exchange for my honest unbiased review