I'm interested in the concept of hospice and the topic of death, but I just did not connect to the material in this book.

Perhaps because I read it too fast, since it is exceedingly short and brief. Perhaps because I was reading it off a list of best graphic novels of 2023 (see below), but it is hard for me to consider it a graphic novel since it is really a series of still life studies and portraits where the words printed on the page don't necessarily have a direct connection to the image. And the words are really matter-of-fact instructions, sort of pithy, sort of just there.

It's not bad, and it's kind of interesting, but it's too brief and shallow for me.

(Best of 2023 Project: I'm reading all the graphic novels that made it onto NPR's Books We Love 2023: Favorite Comics and Graphic Novels list.) ( )

Rating: 3.5

Illustrator and graphic journalist Wendy MacNaughton has a degree in social work and likes to “tell the stories of overlooked people and places.” Some time ago she visited a Zen hospice in San Francisco on a regular basis. Twice weekly for about a year, she talked to and drew pictures of the dying, their loved ones, and hospice caregivers and produced a small limited-edition book of her illustrations to share with those accompanying people in their last months, weeks, or days. Many found the little book very helpful, and it’s now being more widely published.

This spare little text provides many illustrations of those at the end of life, their families, and hospice staff. Most of the drawings appear to be rendered in ink and wash, though there are a number of pencil sketches of MacNaughton’s Aunt Tildie as she neared the end. This is a very gentle and reassuring little book. It contains few words, and it places no significant cognitive demands on the reader. As palliative care physician BJ Miller observes in the foreword, we all talk too much and place too much value on words. We think we can fix things. When someone is dying, we must accept the fact that we cannot. The important things that he and MacNaughton remind us about include being present, attentive, and observant. They also point out that aesthetics, the environment around the dying person, can be very important. Near the end, one artist had some of her works nearby. There are many illustrations that show plants or flowers, things of beauty, near the patient.

MacNaughton says we need to take the lead from the dying person, which I certainly believe to be true. At one point she suggests it is that person, not us, who is in charge, which I’m less sure about. I don’t think anyone really is. MacNaughton‘s central message is built around “The Five Things” that one needs to be say to the dying person to experience a feeling of completeness: I forgive you; Please forgive me; Thank you; I love you; Goodbye. (These things can continue to be spoken to the person even after he or she is gone.) The author also says it’s okay to cry, which perhaps requires some qualification. A few years ago, author/palliative-care nurse/practising Buddhist Sallie Tisdale counselled in her book that it was important not to burden the dying person with one’s own distress and grief. I think that’s wise advice.

I do like the simplicity of this book. It presents the most basic points in ways that are easily absorbed at a stressful time. I don’t think it would’ve been a bad thing to add a couple of mindfulness practices—about breathing in a conscious way, for example—to help family and friends of the dying with their own afflictive emotions.

The text concludes with a list of helpful books for adults and children, as well as some useful websites.

I thank the publisher and NetGalley for providing me with an advance reading copy. ( )