After the End

Fiction | Novel | Adult | Published in 2019
400
Novel • Fiction
•
Horror & Suspense•
Mystery & Crime FictionBirmingham and London, England; Houston and Chicago, United States; contemporary, ending 2019.
2019
G.P. Putnam's Sons
Hardcover • 2019
Adult
16+ years
Max and Pip are devoted parents whose young son, Dylan, is critically ill after treatment for a brain tumor. When his doctor presents them with an agonizing choice about his future care, the once-unshakable couple cannot agree. Told through the alternating perspectives of Max, Pip, and Dylan’s doctor, the novel opens as love, parenthood, and marriage collide with an impossible medical decision.
Emotional
Melancholic
Contemplative
Hopeful
Suspenseful
41,831 ratings
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Mixed feelings
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Reviewers praise Mackintosh’s perceptive writing, keen observation, emotional authenticity, and compassionate characterization of parents confronting an agonizing decision about their critically ill son. Several found the novel both deeply moving and thought-provoking, with fully realized characters and an unexpectedly page-turning first half. Criticism centers on the later structure: some reviewers found the second half overlong, less compelling, repetitive, and occasionally confusing. Kirkus also calls the novel occasionally overwrought and questions the credibility of Max’s development and choices.
This is a strong choice for readers who want emotionally demanding literary fiction about love, marriage, parenthood, grief, and an impossible medical decision. Its brisk plotting may appeal to those who appreciate page-turners, while its moral complexity makes it especially suitable for book clubs. Readers drawn to thought-provoking stories with multiple perspectives and hope alongside heartbreak should consider it. However, depictions of a critically ill child and parental grief may be overwhelming for some, particularly anxious parents.
41,831 ratings
Loved it
Mixed feelings
Not a fan
Dylan’s British mother and Max’s wife, who faces an impossible decision about their son’s care and disagrees with her husband.
Max and Pip’s two-year-old son, hospitalized in pediatric intensive care with a terminal illness that forces his parents into a devastating decision.
The Iranian physician overseeing Dylan’s hospital care and one of the three characters whose perspective narrates the family’s opening crisis.
400
Novel • Fiction
•
Horror & Suspense•
Mystery & Crime FictionBirmingham and London, England; Houston and Chicago, United States; contemporary, ending 2019.
2019
G.P. Putnam's Sons
Hardcover • 2019
Adult
16+ years
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