When I Die: Lessons from the Death Zone

by Philip Gould

Written during the last few months of Philip Gould's life, this is a hugely inspiring and ultimately uplifting look at his "lessons from the death zone"   On January 29, 2008, Philip Gould was told he had cancer. He was stoical, and set about his treatment, determined to fight his illness. In the face of difficult decisions he sought always to understand the disease and the various medical options open to him, supported by his wife Gail and their two daughters. In 2010, after two hard years of chemotherapy and surgery, the tests came up clear—Philip appeared to have won the battle. But his work as a key strategist for the Labor party took its toll, and feeling ill six months later, he insisted on one extra, precautionary test, which told him that the cancer had returned. Thus began Philip's long, painful, but ultimately optimistic journey toward death, during which time he began to appreciate and make sense of his life, his work, and his relationships in a way he had never thought possible. He realized something that he had never heard articulated death need not be only negative or painful; it can be life-affirming and revelatory. Written during the last few months of his life, this book describes the journey Philip took with his illness, leaving to us what he called his lessons from the death zone. This courageous, profoundly moving and inspiring work is as valuable a legacy to the world as anyone could wish to bestow—hugely uplifting, beautifully written, and with extraordinary insight.

Genres: Nonfiction, Memoir, Psychology, Biography, Death, Essays

228 pages, Hardcover

First published April 19, 2012

Reviews

[Rebecca · Rating 4 out of 5]

(3.5) Gould may be familiar to British readers as a key strategist of the New Labour movement and one of Tony Blair’s advisors. In 2008 he was diagnosed with esophageal cancer and decided to pay for private treatment at New York’s Sloan-Kettering hospital instead of going for a radical operation through the NHS. This would prove to be a fateful decision, and Gould is honest about facing up to mistakes and pain in this cancer memoir.

“Cancer can at one and the same time destroy and transform,” he insists, and again and again he looks for the positive. After surgery the cancer came back, and that toad Blair exhorted him, “now you have to go on to a higher spiritual level still. You have to use this recurrence to find your real purpose in life.” That’s all well and good, but as Gould later writes, in a rare moment of metaphorical fancy, “the third diagnosis of cancer was entirely different. This was like being hit by a ten-ton truck on a wet, cold night in Indiana.”

So now that he was in what he called “the Death Zone,” what would Gould do? He spent time with his family, including vacations in Venice with his wife, Random House CEO Gail Rebuck, and added material to his political manifesto, The Unfinished Revolution. He also worked on this book, literally right up until a few days before his death in the hospital in November 2011. Mostly he came to terms with death: “This is the most intense time of my life. … Death provides the creative tension in everybody’s life.”

The most striking moment of the book is when Gould visits his burial plot in Highgate Cemetery. “This morning I stood at my grave and I thought: God, I do feel very, very happy to be going to this place. That is a small victory for a different view of death.”

Gould’s own account is fairly short, about 140 pages, but it’s supplemented by short reminiscences from his wife and two daughters. Daughter Georgia’s, especially, is a very good blow-by-blow of his final week. All royalties from the book went to the National Oesophago-Gastric Cancer Fund.

From his letter to his daughter Grace: “if you are yourself, if you trust yourself, if you believe in yourself your life will be fine. As for the rest of it: be generous and warm-hearted and always send a thank-you card. This is all you need to know.”

[Huw Rhys · Rating 2 out of 5]

At many different times, this book is fascinating, insightful, heart rending, informative, inspirational, frustrating, infuriating – but above all fascinating, in all meanings of the word.

At times, it's a 6 star read - at others, it dips below the scoring zone altogether.

(Lord) Philip Gould was generally recognized as one of the main “brains” behind the New Labour brand, and this is his response to his battle with terminal cancer.

Bear in mind that he made his name by being a spin doctor – he started off in advertising, selling coals to Newcastle and sand to Arabs; then he sold us Tony Blair for a decade or so, and by golly did we swallow it. You can’t help thinking therefore that a leopard doesn’t change its spots – and maybe I’m too cynical, but in this book, you get the sense he’s trying to sell the idea of a “good death”, his “good death”, to someone or another.

It’s almost the words that aren’t written that stimulate the most thought;

The apparent contradictions – a gentler word for hypocrisy couched in a bit of ignorance, and a bit of arrogance – that permeate the whole tale are astonishing; Labour are supposed to be the party who champion the NHS, yet their thinker in chief can’t wait to get treatment privately – either in Harley Street or in a private clinic in the USA – the moment he hears he is ill. The cancer treatment is mentally and physically exhausting – so to help him overcome the rigours, he is able to fly away to luxurious and exclusive hotels in parts of the world that most of us can only read about; when recovering from operations, he can afford to rent luxury apartments close to the hospital where he is being treated. Once, in a private hospital in New York, he actually has to share a ward with someone else – his disgust is palpable. This is no ordinary working class person overcoming an illness here – this is a rich, privileged, arrogant, ignorant snob – and the person mainly responsible for “positioning” New Labour, supposedly the political party of the working classes in the UK?

As if he’s aware that he hardly practices what he’s preached, he makes the point towards the end of the book that the only thing he and his wife had really fallen out about over the years was moving house so that their daughters could attend a decent state school. It’s almost as if he can stick to “socialist” principles as long as it’s not himself who’s affected

You keep thinking though that this is just another spinning campaign for him though – he creates a catchword which appears on the front page “The Death Zone”, he writes slogans such as “Cancer is an iconic disease; but icons crumble”. There’s some good copy here…

He says that you have to accept that you are going to die if you are going to die a “good” death – and once you have done this, you are in the Death Zone. Is this just more spin though? And for whose benefit is all this spinning written? Is it for his family? His friends - and if you’re the sort of person who loves name dropping, then you’ll love this book “Nigella popped around with a few snacks”, “Tony Blair sent me a text” and so on – or for those people who didn’t always see eye to eye with him – and there are plenty of these, many mentioned in the book.

But there are some tremendously poignant passages in this book as well – this in particular bought a lump to my throat.

“I wept for the lost opportunities. I wept for the lost moments of happiness. And in the end, I wept for the lost companionship”.

If this book really is written for his family, then much of the pomposity, arrogance, duality and sales spin can be forgiven. What I found really rewarding about this book though was not its main subject matter – but rather the insight it gives into way in which the UK was conned for a decade by a team of con men extraordinaire.

[Susan Watson · Rating 5 out of 5]

A remarkable book, cannot recommend it highly enough.

[Mary Karpel-Jergic · Rating 3 out of 5]

This is an account of one man's endurance of cancer and subsequent death. It is a poignant and honest articulation of coping with the horrors of cancer and its treatments. He makes a number of interesting observations about himself and his illness and does his best to articulate what he refers to as the 'cancer zone' - "when you reach that place where you have been told - and you believe - that you are going to die within a certain amount of time." Whoever you are and what ever your background this must be a hideously awful situation to find yourself in and I am impressed by his attempt to put it in words. But...

I can't help but be deeply irritated by the fact that he was an advisor to Tony Blair and a key person in New Labour yet opted for private health care. A typical champagne socialist. Unlike mere working class mortals who follow NHS protocols, this man starts at the London Clinic in Marylebone and when diagnosed asks a leading NHS consultant who he should go to for his best possible life chance. How many people would be able to ask a leading consultant? Then he is advised of two, one being attached to the world famous Sloane Kettering hospital in New York. He chooses New York and does so because not only can he afford the private health care, he can afford a hotel apartment for himself and his wife. Awful to have cancer but nice to think that you've got the best in the world to treat you and you can afford a stay in New York.

As it so happens, this choice proved wrong because the surgeon opted for moderate rather than radical surgery and this led to the cancer returning rather quickly. However, he then returns to his private oncologist and then gets an appointment with a professor Cunningham who suggests another specialist, this time in Newcastle. So off he goes again this time to Newcastle - accessing the best in the field thanks to his monetary and social status.

But, with all this mobility and access to the 'best' the outcome is sad. Diagnosed in January 2008 he died on the 6th November 2011.

I also did not like all the name dropping and especially didn't like Tony Blair's suggestion upon hearing of the return of the cancer that "I had to find meaning in this recurrence, had finally to come to terms with the purpose of the cancer". Really? Cancer has a purpose!

[André · Rating 4 out of 5]

A story of life becoming death from the point of view of Philip Gould as he knew he was about to die. These lessons from the Death Zone are a really interesting input into the discussion of our relation with death in general and with imminent death in particular. Gould did not shirk from all the bad parts, but he clearly tried to focus on making the best of the time he had, which meant both maximizing the worthy moments with his closest people and sharing his experience with the world.
Humanity is always in dire need of stories to help us think of death and deal with death while escaping both romanticizing and overdramatizing it. Gould surely manages that. His final years seemed filled with choices and agency, of personal progress, of emotional achievement.
Obviously not all preannounced deaths allow for this attitude, some far from it, but the perspective is quite valuable.
As I neared the end of the story - and his life - I felt like I was reading an adventure, both grim and heroic, but always very real. After the end of Gould's own narrative, the book includes words from his daughters and wife and a message from a friend, all of which had me inevitably teary-eyed.

[Brad Marshall · Rating 5 out of 5]

Powerful and inspiring, a must read.

[Ashutosh SHUKLA · Rating 5 out of 5]

This book was quite different, in the sense that the author was so driven to complete the book, even on his deathbed. So high was his sense of purpose during this times, that he may not be able to type but was dictating in slurred speech to his wife on his hospital bed. I think Gail deserved more than this, but there was nothing stopping Philip Gould. Last part of the book is actually written and completed by authors family, wife and two daughters.
The book is written in a succinct way, but it gets serious and funny during the later half, like when author goes to look for a place for his grave and jokes around with his kids.
I could resonate with few of the authors observations while he was in the hospital for instance, when your eyes are closed or you are being operated upon, nurses and doctors talk about you in a way that you are an object and are not even listening . Things are quite different with your eyes open.

[Maureen Whyman · Rating 3 out of 5]

Quite a brave and insightful read into one person’s experience of cancer and approach to death, however a bit muddled at times (perhaps understandably) in terms of its purpose. Not at all impressed by the ‘champagne socialist’ approach to dealing with his illness, and therefore I didn’t warm to him or his family. The best lesson for readers was not about how to die well, (we don’t all have close family so experiences are completely different) but to reinforce that wealth and privilege do not buy health. I cannot get my head round why you would go to NYC for a cancer op when obviously there would be a need for the good old NHS to follow up!

[Suzanne · Rating 5 out of 5]

What a remarkable book. It caught my eye sitting alone on the ‘returns’ shelf in the library. I was drawn to it and now understand why. Once I started reading I could not stop. I completed it in one sitting. A beautiful and moving account of the authors illness and subsequent death. He has given voice to our greatest fears and the strength to face death with courage and acceptance. The book simply shines with generosity, kindness and love.

[Matt Gilchrist · Rating 4 out of 5]

A moving and fascinating read. I understand his contention that life gets more intensely wonderful once it is limited. I also think this can happen just through an appreciation of life's beauty anyway. But I thought this was a brilliant book - and I never thought I'd cry reading an email from Alastair Campbell...

[Prabin · Rating 4 out of 5]

It takes a lot of courage to reflect on life when facing this situation and salute to the author for having a courage to write this book for instilling and passing that reflections. It is a different and that everything we are always running after doesn’t matter anymore.

[Jane · Rating 4 out of 5]

The last section written by Gould (some postscripts are penned by his wife and daughters) is at times astonishingly wise and moving.

[Saul Annett · Rating 5 out of 5]

A remarkable book by a remarkable man.

[richard · Rating 4 out of 5]

Moving at times, and definitely an eye-opening reminder if one were needed of one's own mortality.

[Gydle · Rating 2 out of 5]

Gould's journey to death is, like every journey of that kind, completely personal and completely overwhelming and intense for both him and his family. For anyone who has had a relative die of cancer, this is familiar. This book has two important messages for those with terminal illness: 1) medical care is never perfect, and doctors are not miracle workers. 2)at some point there is nothing more that can be done to stave off death. You can deny this, and continue the medical interventions - there is always a doctor who will help - and die in an ICU or the ER, or you can accept the impending demise and say your goodbyes and spend time with those you love. Gould chose the latter, and it was a wise choice. This was inspiring to read.

What I didn't like was all the blow-by-blow of his illness and decline as written by his daughters and wife. I hate to say this, because I have been there as a daughter and know how intense it is, and how this is all you can think of for ages after your father has died. But aside from you, no one really needs to know all the sordid details of how every day progressed, what all the physical symptoms were. What would have been more welcome would have been a more thoughful exploration of how this experience really felt from the inside. Did it change the way they lived their lives? Interacted with those they loved? Thought about their own eventual death? Felt about life and death, in general? I didn't see any shifts here, nothing profoundly moving. It was all very pat -- not surprising, really, from a family that is probably used to media sound bites and turns of phrase.

I also really didn't like all the elitist name-dropping, the amazing luxury getaways, the fact that as a Brit with the supposedly amazing NHS he chose to go to NYC and get treated, and then he and his wife both lambasted the yankees for their horrible hospital and blamed that doctor for not doing the job properly. The truth of the matter is that this kind of thing happens all the time - doctors do their best, but they are not perfect, they cannot see individual cells, and the human body is a fragile thing. A similar situation occurred with my own father, at the esteemed Mayo Clinic, with the best of the best.

It's nice his friends stuck with him to the end. This doesn't always happen. But I don't give a rat's ass that they're VIPs. I would rather have heard about the ones that didn't come and how that made him feel. It was all wonderful. Which didn't ring true.

[Louise Armstrong · Rating 4 out of 5]

I sometimes think I've gone completely cuckoo, so I enjoyed reading this book because, look, here's a sensible and successful member of society thinking about the kind of issues I find interesting, and, coming to some similar conclusions.

1. There is a judgement after we die, but it's a self judgement. You, yourself will decide what path you will take. Those who are afraid turn away from the light and are lost.

2. There is a light. Gould's wife wrote the last chapter, and although she knows most people will think she was hallucinating, for a brief second, at the moment her husband died, she experienced that light.

I admire a person who holds a responsible position in society being brave enough to tell the truth as she experienced it. I wish science could be brought to bear on what happens when we die. It is too important to be left to religion. Who wants to be lost for ever? After all, we build schools and hospitals rather than churches now, and therapy and reality make overs teach us more efficiently than an old book how to live well, so why can't matters of the spirit be updated?

[Gary Willmott · Rating 5 out of 5]

This book has been on my bookshelf for some years now and I started it without any great intent - just dipping into it really; I ended up reading it in a couple of days (it is quite short).
A really lovely, challenging, moving document of how Gould deals with diagnosis of oesophageal cancer and the subsequent prognosis.
He writes eloquently on the nature of death and the way his relationship with it changes and develops over the time of his illness.
He comes across as a sometimes selfish man but one who clearly is committed to his wife and family and his friends. Above all he seems to be courageous in the face of the fate that awaits him.
When my father was ill with cancer we experienced the process of how cancer develops and the road that one goes down in its treatment and the palliative care when things take a turn for the worse. This book gave me a new insight into what we went through and a broader insight into the way in which the prospect of death can, possibly, be a force for growth and good.

[Fairy-fay Thomson · Rating 3 out of 5]

I enjoyed reading this from 2 angles. The first being the chapters which follow the journey of confusing decisions each cancer patient has to make - private vs public, aggressive surgery vs tamer alternatives. Practical and well written. The chapters which had me balling my eyes out were those final few days. Written by Philip, his daughters and wife. Extremely moving. At times it was a bit of a name dropping, back slapping who's who of the Labour Party but one should expect that from a man who gave so much to his love of politics.

[Bryony Thomas · Rating 5 out of 5]

I read this in the last fortnight of my own father's life, who also died from oesophageal cancer. So, I'm hardly an objective reviewer. I found it fascinating. Mainly, I was jealous of the closeness of his family... but that's my issue, nothing to do with the book. Find words hard. It's just a very human story, told by a man in pain. I'm no more reconciled with my loss from reading it.

[Sarah Price · Rating 4 out of 5]

Personal and heartfelt account of Philip Gould's battle with cancer and the impact that it has on him and his family. There was only one point (towards the end of the book and also his life) when it slipped a little - otherwise, a really interesting read. I also liked the inclusion of material from others.

[Hilma · Rating 5 out of 5]

All of us will die at some point. Not everyone will be able to articulate how it feels. But to understand even a fraction of the experience somehow helps, especially if you are not the person dying. An excellent and thought-provoking book, which has helped me enormously.

[Iola Shaw]

. I only wish I could have read this 2 years ago, I would have been far better informed to support my sister in the short time she knew she was in the death zone and trying to have the best death she could.

[Catherine Baum · Rating 5 out of 5]

Anyone who is going to die needs to read this...

[Jane · Rating 4 out of 5]

A hugely moving story of determination and positivity in the face of death, with valuable lessons for the living.

[Virginia · Rating 4 out of 5]

A very honest attempt to make sense of life's ending from a New Labour guru. Tony Blair comes across unexpectedly well.

[Michael Lower]

An amazing book about the author's battle with cancer and the experience of knowing that one will die within three months ('the death zone'). Emotional and brutal at the same time.

[Dave Whalley · Rating 5 out of 5]

Very moving and thoughtful

[Sam · Rating 4 out of 5]

Very inspiring.

[Sebnem · Rating 5 out of 5]

very moving very real... it is not a story it is life.

[Rachel · Rating 5 out of 5]

makes you think