Thank you to Penguin Group, Putnam, and NetGalley for an advanced read in exchange for this review.  Max and Pip have a strong marriage.  They are best friends and have been together for a long time.  Their young son, Dylan, has a brain tumor.  They are soon faced with the unthinkable.  Doctors put a decision into their hands, and they cannot agree.

What is interesting about this book is that it shows what happens if both decisions have a chance.  This book hurts.  There really isn’t a right or wrong answer – it’s more two parents who struggle with what is more important: quality or quantity of life.  The pain and loss they have to struggle with is unthinkable, and I’m not sure what I would do if faced with the situation.  Max and Pip are both equally likable, and I found myself so engrossed in their story that I did not choose a side.  Their choiceless choices are heartbreaking. At times, the switch back and forth from each scenario was a little bit confusing, but it also somehow works with the story.  5 stars.

Ugh, I’ve gone back and forth with how I feel about this book. For a good bit, it was a 5 star read. Then there was whatshould have been “the decision” and the book (and subsequently the rating) took a nosedive. Then the very end came and I thought strongly the entire thing might have been ruined. I think the author would have done a better job not diverging the storyline. Making a decision and having one outcome. Instead, she made confusion, an ending that was weird, and the book seemed to focus more on the relationship outcome than the child who determined the outcome. The dad was American, but the dialog was still very British, so there was a disconnect in character development and personality there that bothered me quite a bit. Pip’s ending was just strange at the very, very end. The author made a very difficult, very real personal choice in her own life and I know she admits to her daily struggle with that. I can see where this book was a way for her to personally explore both sides of the decision. I can see how that would have been quite cathartic for her. However, for the purpose of entertaining and eliciting a strong emotional reaction and attachment to this book from readers, I feel she should have chosen a verdict and stuck to that one storyline. The diverging and exploration of both sides of the coin took away the impact this book could have had. 3.5 Stars is my final rating. I wish it hadn’t split.

This was an emotional book to read about one of the most difficult life choices. The author does a great job developing each and every character. We get a deep insight into each of them. I admire the author’s courage in writing a book so close to home. I found the second half of the book confusing with the two different scenarios. The passion of the author’s writing is evident in this book and I will continue to follow this talented author. #NetGalley #AfterTheEnd

I received a egalley of this novel and leave my thoughts below.

This is a tough novel.

Not tough in the sense of needing to slog through it, or be of the type that requires careful reading of each page, to the point that reading a chapter takes weeks rather than minutes. Instead, this is a book that asks a lot of questions, and while employing a little literary sleight-of-hand that some might initially turn their nose up at, is ultimately a rewarding, deep story.

The subject matter of this story, without giving much away, is one that will likely make many people want to put the Kleenex box nearby. This is a powerfully told story of love, loss, and an exercise in the what if’s that we often keep in the back of our minds. While I take the ending to be a bit more bittersweet than other might, you will definitely want to have this book in your hand sooner than later. Fully recommended!

Right from the beginning Author's Note MAchintosh hits your with emotion and never lets up. This one is painful and hopeful, and happy and sad. It is not a light read, so keep your kleenex close.

t’s almost impossible to fathom. Your child, your little boy is sick, he has cancer. Surely that can’t be right, adults and old people get cancer, but a child? It’s just not fair. Max and Pip have to face the ugly truth, their son is very ill and he will need treatment to extend his life. The treatment will be ugly, painful and have terrible side effects, but it’s worth it to have more time with their son, surely? This book will break your heart, you will read about children and parents who discuss cancer and its treatment like they are discussing the weather, or the outcome of a baseball game. You will have a ringside seat to the small triumphs and the major setbacks and you will cry. Mackintosh makes you care, makes you question what you would do if you were in the same situation, and makes you thank all the stars above that you are not.