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?

My thoughts:
After the end was such an emotional read and I know I went threw a lot of tissues especially in the first half of the book. I really enjoyed reading the different perspectives of Max, Pip and the Dr.

If you need a good cry I'd definitely recommend this book!

Many thanks to the publisher and Edelweiss for a copy of the book in exchange for an honest review.

For fans of Jody Picoult and the like. Max and Pip have a seriously ill (terminal) young son. When the doctor tells them there is no hope and recommends end of life care, their lives fall apart.

Told in alternating chapters (Max, Pip, and Leila the doctor) and switching back and forth in time over the course of about 10 years, the narrative is sometimes (often!) confusing. While the details give the reader a very close look at what each of the characters is thinking and feeling, and the emotions are raw, I just didn't really get it. (see below for more detail) Oh, I understand the issues and the emotions attached, but sometimes it was unclear what was actually happening. This could have been so much better.


SPOILER -- The leadup to the judge's decision (which is setup in the first chapter) is compelling and suspenseful. Then what!!?? Some chapters are written as if the child dies peacefully in London, some as if he is taken to the US for treatment and lives a few years. Some chapters are written as if Max & Pip live together in an uneasy relationship, some they are divorced. Some chapters have Max fired & living with his mother, others he is still working as a consultant. I just didn't get it. Alternate universes? Exploring the possibilities? Sorry, but to me it was just weird. This is the sort of story my mother-in-law loves to read, but I guarantee she would be thoroughly confused.

Emotionally I'm destroyed after this book. Of course I put myself in the shoes of Dylan's parents and I couldn't even imagine the pain of choosing pretty much life or death for your child. The novel is thought-provoking but very triggering. I feel completely wrecked and I finished several days ago. The first half was perfection, but I didn't know what to make of the alternate paths in the second half and I didn't find it as compelling. I've read the author's mystery/thriller books before and I think she did an excellent job of switching genres. Overall 4.5/5 stars.

This book is definitely not for the faint of heart since it centers around two parents grieving their young son's terminal cancer diagnosis. The first half of the book was heartbreaking but still totally engaging. Then, Mackintosh made a strange choice that made me dislike the entire rest of the book. She created two timelines and two perspectives of what happens to the parents moving forward. I found this extremely off-putting and confusing. I couldn't remember what was happening in each timeline and I just couldn't seem to care about what the characters were going through (since I didn't know which one was 'real.') It almost seemed like Mackintosh just couldn't make a decision about where she wanted the plot to go, so she wrote both. It just didn't work for me. Additionally, the ending seemed sort of trite and contrived, so I didn't leave this book feeling impressed or satisfied at all.

I can see that some of her other titles get great Goodreads reviews (especially the ones that are more in the thriller genre). So, I might check out her work in the future even though this was a definite miss for me.

This book was a tough read. As a parent of two young children, it was just incredibly heartbreaking. That said, the first half was so much better than the "after" half. I just didn't love how that part was done. Overall, it was worth the read.

This novel hit very close to home. I think this is why I waited to read. In an earlier chapter of my own life, I taught seriously ill children, some wer healing maybe after an accident or needed surgery while others had cancer and in some situations terminal. Having raised my own four who have had at times serious health crisis, the writing was real and very relatable. This story is not only read with your heart but your gut. The biggest takeaway— which we should try to not treat as a cliche- is live in this very, present moment. Reach for all the joy you can find in it.

Good book. The writing was quick paced and easy to follow along with. I’d definitely recommend this to a friend.

I did not know what to expect going into this one, and was honestly expecting a thriller based on her prior books. That is definitely not what this is. Instead, it is a heartbreaking story about how a relationship survives (or not) after a child has a devastating illness. Max and Pip are about as strong as a couple could be, until their son gets sick and they have differing views on his survival and how it should be handled. How they each choose to handle it and the toll it takes on each other and their relationship is curious but you do not doubt they are each coming from a place of deep love for their son.

This is by no means an uplifting book, but it is very well written and extremely thought provoking, asking the 'what if' and 'if only' questions that any parent would. Told from both Max and Pip's POV, as well as the Doctor's POV that treated their son, I was blown away at this story. You should be warned at the heavy subjects in this book, and might need to be in the right mindset for this one, but it was so moving and so well done.

Thank you to NetGalley and Sphere for the egalley to review.

I fell in love with Clare Mackintosh through her strong thrillers. Her sleight-of-hand twists never cease to amaze me. Except, After the End is not one of her thrillers. Instead, it is a deeply personal and heartrending story of parents forced to make an unthinkable choice and their lives after making that choice.

One sign that we left a typical Mackintosh far behind is how she tells her story. Told through the eyes of each parent, After the End has a bit of a choose your own adventure feel to it. Not only do we see the story through both Pip's and Max's eyes, but we also follow each of the two paths from the choice Pip and Max must make. Both versions are equally brutal in the constant emotional battering that occurs. It truly is a case of being damned if you do and damned if you don't, and Ms. Mackintosh shows all of it without mercy.

Personally, I found nothing redemptive about either path. My heart broke over and over again as Pip and Max each weather their new normals, if only because I kept dwelling on what could have been had one thing been different. Because of this, either ending upset me because I could not accept them. I still want a third path, one which would be just as emotional and upsetting but which, to me, remains true to Pip and Max as a couple. Call me a romantic or someone seeking some form of happiness in this story that has little.

Intense in a completely different way, After the End is still an excellent read, if only because it makes you cherish what you have and improves your empathy skills for those for whom the story is their reality. Just don't look for it to make you feel good or help escape reality. Ms. Mackintosh is a bit too good at what she does for that.

This book is great! Would definitely recommend. Thanks so much to NetGalley and the publisher for the ARC.

As a parent with a son, it's hard to read about someone's child dying. Perhaps if I had chosen to read this at a different time (not during a pandemic while working in healthcare) I would have been able to handle the heartbreaking subject. But apart from feeling quite depressed as I was reading this, the split possible endings just didn't do it for me.

This heartbreaking story is going to stay with me for a long time. I haven’t had a book hangover this bad in awhile!

As a mother of 4, it is my biggest fear having one of my children become terminally ill. When Max and Pip had to make big decisions regarding the future of Dylan’s life, I just couldn’t even imagine having to do something like that myself. The strength of these parents! Even though my heart was breaking, Mackintosh writes with quick chapters, relatable and developed characters, and hope woven throughout the story.

When a book breaks your heart, makes you mad, makes you cry, and has you contemplate life and all things introspective, I’m not sure how you can rate that experience!

Absolutely amazing read. I enjoy her books very much and this was no exception. It was not what i was expecting and wound up being so much more. I have already recommended to two of my coworkers!

Pip and Max Adams life is turned upside down when their young child is diagnosed with cancer. Their days are marked by countless hours at the pediatric unit where Dylan receives his chemotherapy.

They see other children come and go and when a child is released healthy and happy they imagine that one day that will be their child but those dreams are shattered when Dr. Leila Khalili comes back with a grim diagnosis.

After thinking things through Pip and Max reach a conclusion on what to do next however they are not on the same page and now the courts must intervene to determine what is best for Dylan. The couple who thought their love would get them through this tragedy is now faced with being on opposite sides. Both fighting for their son and both still very much in love but how will they face this challenge?

At this part of the narrative the author decides to take the reader through two different story lines to imagine what happens depending on which choice the parents will have to take. I really liked this and thought it was an interesting way to show that regardless of the path, this family was going to go through the most difficult time of their lives. This was a sad and moving story and despite the subject matter it was a page-turner because I was invested in what happened to the characters.

Aaaaand I’m crying. I cried through so much of this book. I don’t have kids, but After The End hit close to home for me in other ways. I had no idea what to expect from this book, and am pleasantly surprised I’m giving it an 8/10!! Thank you so much to @putnambooks and @meagankharris for the digital copy (and for recommending this to me!!)⁣
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Pip and Max Adams’ 3 year-old son, Dylan, has a brain tumor. His case is terminal. His quality of life is almost non-existent, and he is severely disabled. His parents are faced with a decision no one should ever have to make: take Dylan to the U.S. for a new treatment that might give him a few more years, or let him go. The first half of After The End shows us “Before”. Faced with the most horrible decision of their lives, Pip and Max do not agree on which course of action is in Dylan’s best interest, and they eventually face each other in court to let the judge decide. The second half is “After”, alternating between two different timelines: one in which the court sided with Pip, and the other with Max.⁣
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I was WITH these characters every step of the way. The alternate timelines in the second half was EXACTLY what I wanted from this book, and that's exactly what makes it unique. The first half was great, but the second half was incredible. I tore through it desperately wanting an answer to which parent was “right” (I sided very firmly with Pip), but that’s not what this book is about. When we make a life altering decision, we can’t look down both paths and see where each one leads. We use the information we have at the time to make the best decision we can, and that’s all we can do. For anyone who has ever wondered “what if”, After The End explores that idea in such a powerful way, and I was absolutely glued to the story.⁣

I will not be reviewing this book. It is a book that I typically would gravitate to, however, for some reason my timing is off, and it has not held my interest. instead of giving it a poor review, I will read and review at a later time. thank you.

This is not what I expected from Clare Mackintosh....I wanted a thriller but this was not it. A good read nonetheless,

As a parent, this book rocked me. What choices you make as a parent can seem tough day to day, but the decision Max and Pip are faced with is unbearable. This book was so unique I don't think it's getting near the attention and accolades it deserves. I don't reread too many books, but I want to read this one again soon. Pick it up - you won't regret it!

I have loved all of Clare’s previous books, and so I assumed I would love this one too. Unfortunately this book is a lot different than her previous books and I had a very difficult time getting into the story. It was also extremely depressing and as such, it just was not for me. I have chosen not to post a negative review on my social media for this book, but have posted raving reviews of her others books instead.

Warning, my review contains spoilers. However, this is not really a thriller so I don't think my review will spoil the book. The book deals with one of those cases we keep reading about in the news. A couple with a terminally ill child want to take their child to another country for treatment but the hospital feels it is not in the child's best interests. The case ends up in court. In this case, though, the parents disagree on the child's treatment. The father wants to take his son to the US for new "experimental" treatment which MAY give the child more time to live. The mother, however, feels that the child has suffered enough and even with the US treatment will not be able to live a meaningful and pain-free life. The child has suffered brain damage and is paraplegic. It is a parents' worst nightmare. Naturally there is always hope for a miracle cure, something that will give them longer time with their son, but at the same time, especially the mother has seen how much their son has suffered over the last year in the hospital. What makes this book especially interesting is that the author provides two endings, so to speak. One in which the court refuses the request to transport the child to the US and one in which it agrees. It becomes apparent that the decision to take the case to court is the point of no return for the parents' marriage. Both outcomes lead to the marriage falling apart. The author does a great job of describing all the issues faced by the parents and how long an effect this kind of situation has on people. A very emotional and well thought out book which I really enjoyed.