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 care-giving, and Katy became one of the twenty-four 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 pacemaker,
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
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
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