We were privileged to meet Clare Mackintosh at an event in Penarth organised by Griffin Books and hear her reasons for writing this story and why it had taken twelve years for her to be able to do so. It was difficult to read the novel in places, knowing that it stemmed from personal experience of tragedy; and the scenes in the hospital are particularly powerful. But, as Clare said, the story expresses the experience of losing a loved one, perhaps not a child, and the grief which most of us also will go through in our lives– a subject made even more poignant at this time of a pandemic.

The story is also a tour de force of structure, dealing with the ‘what ifs’ of action, going backwards and forwards in time and showing different imagined outcomes. The title encapsulates the moment when a decision has to be made as to whether or not to continue with medical interventions to keep Dylan alive. And so the book is in two interrelated parts, the first ‘Before’ and the second ‘After’. We see events, chapter by chapter, from Pip and Max’s perspective, understanding gradually how it is they each arrive at such opposing views. The doctor, Leila, who treats the boy, also has a part to play. She is the character who begins and closes the book; and we appreciate her anguish and exhaustion in dealing with such a sensitive case.

The threads are drawn together as the story concludes with a prospect of future happiness for the parents after the despair they have endured. As readers we emerge with a greater understanding that life does go on, even after the end.

After the End by Clare Mackintosh is published by Sphere. It is her fourth novel.  Buy now from your local bookshop.