I wasn't as taken with this contribution to the "grief industry" as some others seem to be. The author's stated objective was to write about "a subject of denial" in today's society. One would therefore presume that her intent is to add to the field of knowledge in this area. However, having read similar material, I thought she presented little that was truly original. In fact, at times it was such as exercise in sentimentality that anything worthwhile was simply overwhelmed. Additionally, the author's shifting agenda from chapter to chapter irritated me. Was this book designed to be a paean to its human subject, to expose the "shortcomings" of the American health establishment, as a practical end-of-life treatise, or to illuminate the conflicts and emotions of those forced to journey with the person who is terminally ill? The author seemed to want to address all these things, but because she threw everything, including the kitchen sink, into her narrative, no subject seemed completely developed.

I thought the sections in which Anna, Nils, and other family members and friends were simply allowed to speak, without interjection by the author, were the most effective parts of this book. I also found the author's unnecessary overuse of the superlative in her descriptions of Anna's personality and behavior rather off-putting. Ditto for the author's minute-by-excruciating-minute account of Anna's final days and hours, which I found so detailed as to be intrusive. I don't really need or care to know that one friend was "gently and lovingly" cleaning off her bottom while another friend was hovering poised with the ointment! God save me from ever having my final days described in such graphic, personal terms after I have been rendered incapable by an illness of the ability to edit what is said! And I'm curious about the in-laws (Nil's parents). They are barely mentioned, and remain fleeting shadows throughout the book. But surely they were not as unsupportive as this narrative makes it seem. Did they simply decline to participate? If so, why?

Of course, no book of this nature would be complete without the requisite bashing of the government and medical establishments. Medical professionals are lumped together and described as aloof, impersonal, inefficient, careless, and so forth. But these are hardly original criticisms, and are once again presented with no effort at a solution. The fact is that today, doctors are responsible for presenting an array of therapies that they never had in the past. Does anyone really want to go back to the mythological "good old days" when all a doctor had to offer were some herbs and soothing words? Yes, I would want a doctor I can interact with on an equal basis, who will objectively and compassionately discuss my options with me, and who stays on top of his profession. But I wouldn't want to crawl into bed with him, and I would never be so selfish as to expect him to hold my hand if he can no longer help me, having done the best he could, if in so doing he was taking time away from helping another patient who still had a future! As for "arbitrary" government rules and regulations, well, if you want to feed at the public trough, you have to accept some oversight and limitations. It's called competing demands for finite resources.

If people want to read a book on this subject that truly offers unique insight, is compassionate and at the same time educational and on point, I recommend Jerome Groopman's "The Measure of Our Days: New Beginnings at Life's End", or "A Private Battle" by Cornelius Ryan (unfortunately out of print) as distinctly superior alternatives to this book.

This book inspires, educates, and provides direction for individuals and families who face choices for living with life-threatening illness. As a family studies teacher, I encourage students to read books that give them more options for living their lives. Myra MacPherson has written engagingly about the realities of living with a life-threatening illness and surviving the death of a family member. Unlike other writers, MacPherson expands the account of Anna and her family with information that enables readers to make informed decisions about illness, health care, caregiving, helping children cope, hospice care and grief support.

Myra MacPherson's book about Anna Johannessen and her family is the most moving and most inspiring story about how she and her friends and family deal with her terminal illness I've ever read. It's an inspiration to deal with death and dying much more openly and honestly than people usually do and at the same time a stinging indictment of the insensitivity of the medical establishment and the health insurance industry. "She came to live out loud" touches the heart without being a tearjerker in any way. I first heard about this book on an NPR talk show and was moved by the way Ms. MacPherson talked about her meeting with Anna and how she had been welcomed into the most private moments of the family. A wonderful book, I recommend it wholeheartedly. (By the way, you can listen to the archive edition of The Diane Rehm Show by going to Http://www.wamu.org/dr/shows/drarc_990222.html#thursday)