Book Review – After The End by Clare Mackintosh

Published: 25th June 2019
Started reading: July 1
Finished reading: July 10
Trigger warnings: Cancer storyline, child death, sexual references


Max and Pip are the strongest couple you know. They’re best friends, lovers—unshakable. But then their son gets sick and the doctors put the question of his survival into their hands. For the first time, Max and Pip can’t agree. They each want a different future for their son.

As the consequences of an impossible choice threaten to devastate them both, nothing will ever be the same again.


This is a book for which you cannot fail to develop an emotional connection. Told with the utmost poignancy and leaving a lasting impact, this is a very personal story from Clare Mackintosh in what is a departure from her usual twist-laden thrillers, and the writing is suitably excellent.

After The End tells the story of Dylan, a terminally ill three-year-old boy. His parents, Pip and Max, are a very close-knit couple and spend most of their time at his bedside in the Intensive Care Unit, but then fail to agree on his future. Pip believes Dylan should be allowed to die so his suffering can end, while Max wants to do anything possible to prolong his life.

The dispute goes all the way to a high-profile court case, and it is here in particular that it becomes a truly compelling read. Once the case is over, the book takes an unexpected direction around the halfway point, but throughout all of the events that follow, Dylan is the story’s ever-present driving force.

The book mostly alternates between the POVs of Pip and Max. I thought they were both extremely well-written, and Mackintosh conveys their feelings perfectly as events gradually unfold. I found Max’s POV slightly more interesting to read, and his Americanisms display a fine attention to detail.

The first half of the book is also told from the POV of Leila, one of the doctors in charge of Dylan’s care. I would have liked for Leila to be featured a bit more, as I liked her as a character, she had a good storyline, and an interesting perspective.

Most of the characters in the book were well developed and authentic. There was also some great diverse representation, which is usually badly lacking in this genre. Aside from Leila, we have Alistair and Tom, a gay couple who are an absolute delight to read.

The writing style is powerful and engaging, with an emotive tone that cannot fail to make the reader get completely lost in the story. My main criticism, however, is the slow pace of the second half of the book. It made it feel dense and it was often repetitive, even though the story held my interest.

When you finally get to the end, it feels very fitting, and it reflects the magnitude of the court case as well as how almost impossible it is to know which decision is the right one. It just makes your heart go out to any parents of young children that have to go through such tragedy.

Overall, this is book that carries exceptional power and emotional weight. Mackintosh, already one of my favourite authors, could hardly have done a better job in telling a a richly detailed and profound story of love and loss.


A highly thoughtful and poignant book that I mostly enjoyed. It is written well and carries great emotional heft.

My rating: ⭐⭐⭐⭐

6 thoughts on “Book Review – After The End by Clare Mackintosh

  1. Aside from a slow second half, this sounds like a great book to sink your teeth into! Great review, Stephen! Eventhough you really loved the book, you also mentioned what you didn’t like. And I appreciate that!

    Liked by 1 person

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