Knocking on Heaven's Door

The Path to a Better Way of Death

By: Katy Butler

Narrated by: Katy Butler

Length: 10 hrs and 28 mins

Publisher's Summary

Like so many of us, award-winning writer Katy Butler always assumed her aging parents would experience healthy, active retirements before dying peacefully at home. Then her father suffered a stroke that left him incapable of easily finishing a sentence or showering without assistance. Her mother was thrust into full-time caregiving, and Katy became one of the 24 million Americans who help care for aging parents. In an effort to correct a minor and non - life threatening heart arrhythmia, doctors outfitted her father with a pacemaker. The device kept his heart beating but did nothing to prevent his slide into dementia, incontinence, near-muteness, and misery. After several years, he asked his wife for help, telling her, "I am living too long."

Mother and daughter faced a series of wrenching moral questions: When does death cease being a curse and become a blessing? Where is the line between saving life and prolonging a dying? When is the right time to say to a doctor, "Let my loved one go?"

When doctors refused to disable the pace-maker, sentencing her father to a protracted and agonizing death, Katy set out to understand why. Her quest had barely begun when her mother faced her own illness, rebelled against her doctors, refused open-heart surgery, and instead met death head-on. Knocking on Heaven's Door, a revolutionary blend of memoir and investigative reporting, is the fruit of the Butler family's journey.

With a reporter's skill, a poet's eye, and a daughter's love, Butler explores what happens when our terror of death collides with the technological imperatives of modern medicine. Her provocative thesis is that advanced medicine, in its single-minded pursuit of maximum longevity, often creates more suffering than it prevents. Butler lays bare the tangled web of technology, medicine, and commerce that modern dying has become and chronicles the rise of Slow Medicine - a growing movement that promotes care over cure.

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

Download the accompanying reference guide.

©2013 Katy Butler (P)2013 Simon and Schuster

A better way to narrate a book about death?

What would have made Knocking on Heaven's Door better?

The narrator droned on and on--much like a dirge.

Would you recommend Knocking on Heaven's Door to your friends? Why or why not?

Perhaps--although I would suggest he or she try reading the book--and avoid the audible format.

Who would you have cast as narrator instead of Katy Butler?

Not sure--John Lee?

What character would you cut from Knocking on Heaven's Door?

This question does not pertain to this book.

Any additional comments?

The author's thesis has merit, but her atheism was a huge obstacle to my finding it applicable to my life. I would periodically nod to myself agreeing, "She has a point here." But then her super depressing voice and "story" with no twinge of joy or hope would overwhelm my ability to relate.

I too lost my father recently so have been thinking more about death and agree that our society could benefit from discussing its inevitability. I still miss my father and talk with my mother and siblings about him and the feelings of emptiness brought on by his death --but then I recall his deep faith and how much he looked forward to Heaven. When my father took his last breath, my younger sister rushed to open the windows and doors so that the angels could enter. And later when all 8 of us lovingly zipped up the bag containing his body, and walked alongside staff from the funeral home as they wheeled the gurney to the hearse, we knew he had already gone to Heaven. It was such a comfort and a beautiful memory. In conclusion, I felt sorry for the author quite often—she was without God, faith or community, sisters or any children of her own, left alone with all that grief.

Very relevant story that could be executed better

What would have made Knocking on Heaven's Door better?

Taking the product out of the author's hands more. Narration would have benefited from another person's interpretation. A stronger editor could have narrowed the story more and prevented Ms. Butler's frequent repeats and overuse of forced metaphors.

What was the most interesting aspect of this story? The least interesting?

The story is very personal, yet universal. This is Ms. Butler's strength, however, much time is spent on working out her own personal issues with her family, with childhood issues repeated a number of times. This slows down the story, lessens the impact, and at times is tiresome.

Would you be willing to try another one of Katy Butler’s performances?

No.

Difficult to review due to morality issues

Would you recommend this book to a friend? Why or why not?

I would not.

Would you ever listen to anything by Katy Butler again?

No

If this book were a movie would you go see it?

No

Any additional comments?

I will be 100% honest. This is probably the most difficult and confusing review I believe I have written thus far, therfore, I chose a middle of the road rating.

There were many parts of this book, such as statistics and other information on aging and the dying process that I found fascinating, but on the other hand, I am a christian and hold strong views as to we should wait until God takes us to die. I realize that in some instances, pulling the plug is the less painful option, but it is my belief that God is not finished with us until He calls us home and not a second before.

I was absolutely horrified at how her father was portrayed in some cases and the author's thoughts, actions and feelings about her father and his dying process. She just wanted him to die and move on. At every corner it seemed that she was running from helping her mother and when she did decide to stop her life and help, her trips were always cut short because her and her mother were at odds. She states that at the end stages of her fathers life, they did not give him food or water and supposedly doctors said that was not a painful way to die. I'm not sure if you've ever gone days or weeks without drinking water or eating, but after several hours I feel as if I'm about to die.

I came into this book with no expectations except that I was hoping to get more insight into this author's thoughts and views. She did bring forth strong emotions, I will give her that and at the end of the book, I was in tears, not necessarily for the story that she told, but for a similar situation that I am going through with my own grandfather. Just a few short months ago, I sat in the hospital with him day and night not sure if he was going to pull through and then I continued my journey with him day and night through his month long stay at a long term accute care facility where I was thoroughly unimpressed with the general doctors bedside manner nor was I impressed with how he treated my grandfather, but thats another story for another day. My point there is that I did not feel as if they were taking extreme actions to prolong my grandfather's life without thinking of his quality of life, if anything, I felt it was the opposite. I felt that if I hadn't been there as an advocate and pressed them for answers and tests they would have just written everything off as "old age" and moved on. Luckily, he was released from the hospital after 1 month in the long term accute care facility and was able to return home while receiving home health for approximately 1 month. I wouldn't go on to say that he is back to 100%, but for 85, I would say that he is doing very well. I definitely felt for the author as she was speaking about who difficult and heart breaking it is to see someone you love become someone that is a stranger to you as I am in the same boat. Seeing someone that has been so strong and resilient all their life become fragile and weak is tragic and nothing I would wish on my worst enemy.

One thing I did enjoy learning more about was palliative care, it is a topic I was fairly unversed with and now feel as though I have more knowledge for the future and options that are available for me and my family if that time ever comes.

Another issue I had with the book was how the author seemed to struggle with religion. She would quote scriptures from the bible, chants from buddhists and poems and such, but she didn't seem like she ever completely stuck with one nor did it seem to help her as much as Buddhism seemed to help her mother.

All in all, I'm glad I listened to this book and surprisingly the author was a fairly decent narrator, but it is not one that I would recommend to everyone, nor is it one I would read again.

The most important book I've read in recent memory

There aren't enough stars for this incredibly timely book. THANKFULLY this journey, as it relates to my parents, is in my rear view mirror. But as it relates to me - we Americans have work to do. I'm going to shout this book's message from the rooftops. We need to re-think our "modern medicine's" approach to the last years/months/weeks/days of our lives, and this book lays out a difficult, but important intellectual game change in how we approach dying. A thousand stars to Katy Butler, for living through her parents deaths, and for so eloquently discussing how we can change OUR experiences moving forward.

A must for caregivers!

If you could sum up Knocking on Heaven's Door in three words, what would they be?

Beautiful, tragic, and motivating.

What did you like best about this story?

The fine details of the characters, nature, the body, the brain and our healthcare system.

What does Katy Butler bring to the story that you wouldn’t experience if you just read the book?

Her voice conveys real emotion: calm, frustration, sadness, guilt, desperation, love, respect, and peace. Also, she made the many medical terms and descriptions easy to understand and visualize. (I would have glossed over them if reading.)

Was this a book you wanted to listen to all in one sitting?

Yes, after a seven hour drive I wanted to sit in the car just to hear more.

Unpleasant but important

What did you love best about Knocking on Heaven's Door?

The end of the book has strategies and questions to ponder and ask yourself or your parent. I will review them and give them more thought.

What other book might you compare Knocking on Heaven's Door to and why?

Being Mortal had similarities because of dealing with end of life issues involving parents. Being Moral was not just about the author's parents, but their story was interwoven into examples of other people.

What does Katy Butler bring to the story that you wouldn’t experience if you just read the book?

Because she was the daughter of the parents involved, I enjoyed hearing her story from her personally as the reader. I could relate to her because I am going through some similar issues as she experienced and I felt more connected knowing she was not a professional speaker brought in for the project.

Any additional comments?

Reading about the slow agonizing death of one's parents is not uplifting but the message of how to have a better death experience is worthy. I found the information to be timely and pertinent to my own situation. If you have aging parents and want to be more aware of the pitfalls of prolonging life to beyond the point that either the parent or the caregivers can endure without lasting negative effects and undue suffering, read this book.

Put on your must read list.

This book will help you and your family look realistically at end of life issues...or at least to begin the conversation.

Beautiful

This was fantastic, so well written. I appreciate the candor as well as vulnerability shared by Katy.

So grateful

Thank you, Katy Butler, for this timely help! Having been a fairly passive bystander to my father and brother's deaths in hospice care, I am the primary caregiver to my 88 year old mother and your book will be my guide. As a Buddhist, I love the way those philosophies are interwoven into your story. As a recovering alcoholic, I appreciated your inclusion of that wisdom, too. I am so grateful for you.

Really misleading

I thought it would be about preparing for a parents Departure. Instead it went on & on & on about her boring relationship /issues with her Mom. REFUND PLEASE

Thought provoking, heart rending and encouraging

I found this book was wonderful and painful to listen to. I do live in England, with the wonderful NHS still in place - just, I’m guessing - but here too, I have experienced fast and slow medicine being applied with elderly, dying family members. It makes a tremendous, lasting difference to those left behind, I think, if we feel we have stood up for those who once had our back when they need us because they are disabled and/or dying (even if they weren’t very good at having our back, it matters).