Because I Knew You
How Some Remarkable Sick Kids Healed a Doctor's Soul
by Robert Macauley
Narrated by Robert Macauley
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Pub Date Aug 05 2025 | Archive Date Not set
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Description
As one of the few pediatric palliative care doctors in the United States, Bob Macauley was used to people saying, “I’m so glad I don’t have your job.” To which he would explain that palliative care is more about living than dying, then offer to share some of the inspiring stories he witnessed on a daily basis. He might mention that also being an Episcopal priest helped him console people in the hardest situations. But he never revealed the true reason for his career choice: he didn’t want anyone else to hurt the way he had when he was a kid.
A Note From the Publisher
Robert Macauley has been the Cambia Health Foundation in Pediatric Palliative Care at Oregon Health and Science University since 2017. Prior to that, he directed the Department of Clinical Ethics as well as the Pediatric Advanced Care Team at the University of Vermont College of Medicine. He is the author of Ethics in Palliative Care: A complete guide (Oxford University Press, 2018). He lives with his wife and four kids in Portland, Oregon.
Advance Praise
"A mix of plangent emotion and deep insights into end-of-life medicine, delivered in limpid, moving prose." —Kirkus STARRED Review
"Because I Knew You is a closely observed memoir of personal and professional development. Macauley is an ethicist, cleric, and physician whose own emotional suffering have opened his heart and honed his skills in ways that makes healing possible." —Ira Byock, MD, best-selling author of The Four Things That Matter Most, Dying Well, and The Best Care Possible
“Robert Macauley’s Because I Knew You is an extraordinary book—a tender, raw, personal, and deeply sophisticated inquiry into life and loss. [...] Even if life spares you the need to face the deepest challenges presented in Because I Knew You, to read it is to heal from any pain. It is a work for the ages.” —Robin Oliveira, author of My Name Is Mary Sutter, I Always Loved You, Winter Sisters, and A Wild and Heavenly Place
"Part memoir, part manual, Bob's beautiful book will take you all sorts of places that are otherwise very hard to get to. Go! Learn, as the author himself did, how brave, honest, wise, and generous humans can be." —BJ Miller, author of A Beginner’s Guide to the End and the Ted-talk "What Really Matters at the End of Life"
“A profound and totally engrossing exploration of the painful yet beautiful world of children facing serious illness. To their remarkable courage Bob Macauley adds his own fascinating journey, not only as the doctor who cares for them but someone in need of healing, too. Pick up this book to be inspired, but rest assured that the human stories and life lessons will remain with you long after you put it down.”
—Elisha Waldman, MD, author of This Narrow Space: A pediatric oncologist, his Jewish, Muslim, and Christian parents, and a hospital in Jerusalem
“With tenderness, grace, and hard-won insight, Dr. Macauley shares with us his painful yet life-celebrating journey with terminally ill children. Amid tragedy, he insists on each patient’s humanity, uncovering what they love, what they dream to be, discovering with them ways in which to fit their dreams into their brief yet abundant lives. The core of this mesmerizing and unexpectedly uplifting book is what these children teach him. Their courage, their insistence on life lived with joy, changes the good doctor who possesses a painful past, indeed heals the good doctor. Because I Knew You is an instant classic and a book especially suited to our times.” —Connie May Fowler, author of Before Women had Wings and A Million Fragile Bones
“Certainly, this is a must-read for anyone considering becoming a clinician; but really it is for anyone who seeks inspiration for what it means to be a loving witness to the struggles of others and how we can be transformed by such presence.” —Blyth Lord, Executive Director, Courageous Parents Network
“By reminding us what really matters, and inspiring us to make a difference when we are most needed, Because I Knew You turns grief into courage and hardship into hope.” —Stephen P. Kiernan, author of Last Rights: Rescuing the end of life from the medical system and The Baker’s Secret
Available Editions
EDITION | Audiobook, Unabridged |
ISBN | 9798228586345 |
PRICE | $17.47 (USD) |
DURATION | 12 Hours |
Links
Available on NetGalley
Featured Reviews

Published June 2025.
Robert Macauley is a pediatric palliative care doctor telling his story throughout his career. With his background of also being a priest, of being a medical ethicist, and in navigating parenthood, he brings a raw honesty to the emotional complexity of his work and perhaps how his own childhood trauma has impacted how he shows up for the people he helps.
Because I knew You weaves together stories of some of the patients he's cared for over the years and how they've impacted his role moving forward. The stories are heartfelt, heart wrenching and hard. Macauley documents some of the misunderstandings of his field, such as the distinction between palliative care and hospice, and how pediatric palliative specifically comes with it's own hurdles vs adult palliative care. He speaks truthfully about burnout and the impact his job has on his family and friends.
Overall, while this book was emotional and heavy, it was beautiful.
Thanks to the author and publisher for providing a review copy through NetGalley.

This book touched me in many ways. I love how Dr. Macauley teaches us you can turn pain into positive. He shares some deeply personal details which brings him to the decision to become a pediatric palliative care doctor. It is commendable to me, the job he performs. To see that his patients touch him just as much if not more than he touches them.
Their stories are heartbreaking and wrecked me. There were several times I have to use my Kleenex.
I listened to the audiobook which is narrated by the author. I love books in which the author narrates. He did a wonderful job.
Thank you NetGalley and Talkbox Productions for the advanced listening copy of this book. All opinions are my own.