Knocking on Heaven’s Door: The Path to a Better Way of Death by Katy Butler

In this visionary memoir, based on a groundbreaking New York Times Magazine story, award-winning journalist Katy Butler ponders her parents’ desires for “Good Deaths” and the forces within medicine that stood in the way.

Katy Butler was living thousands of miles from her vigorous and self-reliant parents when the call came: a crippling stroke had left her proud seventy-nine-year-old father unable to fasten a belt or complete a sentence. Tragedy at first drew the family closer: her mother devoted herself to caregiving, and Butler joined the twenty-four million Americans helping shepherd parents through their final declines.

Then doctors outfitted her father with a pacemaker, keeping his heart going but doing nothing to prevent his six-year slide into dementia, near-blindness, and misery. When he told his exhausted wife, “I’m living too long,” mother and daughter were forced to confront a series of wrenching moral questions. When does death stop being a curse and become a blessing? Where is the line between saving a life and prolonging a dying? When do you say to a doctor, “Let my loved one go?”

When doctors refused to disable the pacemaker, condemning her father to a prolonged and agonizing death, Butler set out to understand why. Her quest had barely begun when her mother took another path. Faced with her own grave illness, she rebelled against her doctors, refused open-heart surgery, and met death head-on.

With a reporter’s skill and a daughter’s love, Butler explores what happens when our terror of death collides with the technological imperatives of medicine. Her provocative thesis is that modern medicine, in its pursuit of maximum longevity, often creates more suffering than it prevents.

This revolutionary blend of memoir and investigative reporting lays bare the tangled web of technology, medicine, and commerce that dying has become. And it chronicles the rise of Slow Medicine, a new movement trying to reclaim the “Good Deaths” our ancestors prized.

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

Katy Butler (Katherine Anne Butler, b. 1949) is a former finalist for a National Magazine Award and a winner of the Science in Society Prize from the National Association of Science Writers. Her writing has appeared in the Wall Street Journal, the New Yorker, the NY Times, Best American Essays, and Best American Science Writing.
Born in South Africa’s Great Karoo desert and raised in England, she graduated from Wesleyan University and quickly fled West to San Francisco, where she studied Zen Buddhism, interned at an alternative weekly, and landed at the San Francisco Chronicle, where she covered riots, cult scandals, the right-to-die movement, and other news from the margins. She left in her early 40s to become a freelance magazine writer, publishing dispatches in the New Yorker about the AIDS crisis, a female impersonator who became a Zen monk, a disappointing Valentine’s Day, and the afternoon that Mickey Hart of the Grateful Dead fitted the Gyuto monks with microphones. In her late 50s, she joined the “rollaboard generation” and plunged into helping her aging and ailing parents, who lived on the opposite coast. That led to a New York Times magazine article that drew an overwhelming response and her first book, “Knocking on Heaven’s Door.” (Scribner, Sept. 10 2013.)

Earlier in life, she worked as a crossing guard, an incompetent waitress, an even more incompetent bookkeeper for an embattled dairy, and as a cabin cleaner in a zen monastery. She has lived on an abandoned avocado plantation in the Venezuelan rainforest 6 miles from the nearest road, spent a muddy winter in a monastery in southern France, and sung “Row Row Row Your Boat” with the inmates of a locked dementia ward. She teaches writing at Esalen Institute and lives just north of San Francisco. She interviewed Jeff Bridges for Tricycle; wrote from personal experience about downward mobility among baby-boomers for Mother Jones; and limned a volunteer’s-eye-view of the implosion of the Howard Dean campaign for

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Katy Butler

Katy Butler, author of Knocking On Heaven’s Door: The Path to a Better Way of Death (Simon & Schuster Scribner)

Katy Butler Discusses Knocking on Heaven’s Door (Corte Madera, CA)

Author Katy Butler discusses her book Knocking on Heaven’s Door, on September 11, 2013.

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