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We Know How This Ends: Living while Dying
Nautilus Book Awards — Silver Award Winner 2010 had been a very good year for Bruce H. Kramer. But what began as a floppy foot and leg weakness led to a shattering he had amyotrophic lateral sclerosis. ALS is a cruel, unrelenting neurodegenerative disease in which the body’s muscles slowly weaken, including those used to move, swallow, talk, and ultimately breathe. There is no ALS is a death sentence. When death is a constant companion, sitting too closely beside you at the dinner table, coloring your thoughts and feelings and words, your outlook on life is utterly transformed. The perspective and insights offered in We Know How This Ends reveal this daily reality and inspire a way forward for anyone who has suffered major loss and for anyone who surely will. Rather than wallowing in sadness and bitterness, anger and denial, Kramer accepted the crushing diagnosis. The educator and musician recognized that if he wanted a meaningful life, then embracing his imminent death was his only viable option. His decision was the foundation for profound, personal reflection and growth, even as his body weakened, and inspired him to share the lessons he was learning from ALS about how to live as fully as possible, even in the midst of devastating grief. At the time Kramer was diagnosed, broadcast journalist Cathy Wurzer was struggling with her own losses, especially her father’s slow descent into the bewildering world of dementia. Mutual friends put this unlikely pair—journalist and educator—together, and the serendipitous result has been a series of remarkable broadcast conversations, a deep friendship, and now this book. Written with wisdom, genuine humor, and down-to-earth observations, We Know How This Ends is far more than a memoir. It is a dignified, courageous, and unflinching look at how acceptance of loss and inevitable death can lead us all to a more meaningful and fulfilling life.
- GenresMemoirNonfiction
200 pages, Paperback
First published April 1, 2015
21 people are currently reading
467 people want to read
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Displaying 1 - 30 of 39 reviews
February 24, 2015
I could see this dual memoir about disability and loss being very helpful for people who have just received a diagnosis of terminal illness. It reminded me a fair bit of The End of Your Life Book Club, another book about making the most of life under the shadow of death. Kramer is a former college dean coming into his fifth year with ALS; Wurzer is a Minnesota public radio broadcaster who has helped bring Kramer’s story and blog to a wider audience.
Kramer never indulges in self-pity, instead facing the practical and emotional challenges of his disability with good humor and courage. “Above all, I know I cannot fix this. That would only be childish. All I can hope is to work it, and perhaps some way forward will emerge.” He often uses wordplay to shed light on his condition, punning on “grave” and “gravity,” for instance. I came to find the insistence on “dis ease” instead of “disease” grating, however.
Wurzer’s father had Alzheimer’s for the few years before his death from cancer. She opens each chapter with some words about her family’s experience facing terminal illness, along with commentary about Kramer’s situation; her sections are distinguished from Kramer’s by a change of font. Overall, I didn’t see what Wurzer’s co-authorship added to the book. Kramer’s blog could surely have provided enough content, and the limitation would have produced a more focused narrative.
I also wished the book had been arranged chronologically rather than thematically, to give a better sense of the progression of ALS. My favorite chapter was #22, “Faith, Part III: Wrestling with Angels,” in which Kramer meets the Dalai Lama and learns that blessings are not to be received passively but actively given. It is heartening to see how much Kramer crammed into his life in the way of travel and experiences (like skydiving and yoga) even as his body began failing him. He is also gracious when referring to people who responded to ALS differently, whether that was making a bucket list or investigating assisted dying.
We know how this story ends – if not the book itself. ALS is a cruel neurodegenerative disease that gradually takes away all of a person’s capacities. At 55, Kramer is still plugging away. But his story should be a wake-up call for all of us, terminal illness or no: “The autopilot of living from event to event is completely gone. Pay attention!”
Kramer never indulges in self-pity, instead facing the practical and emotional challenges of his disability with good humor and courage. “Above all, I know I cannot fix this. That would only be childish. All I can hope is to work it, and perhaps some way forward will emerge.” He often uses wordplay to shed light on his condition, punning on “grave” and “gravity,” for instance. I came to find the insistence on “dis ease” instead of “disease” grating, however.
Wurzer’s father had Alzheimer’s for the few years before his death from cancer. She opens each chapter with some words about her family’s experience facing terminal illness, along with commentary about Kramer’s situation; her sections are distinguished from Kramer’s by a change of font. Overall, I didn’t see what Wurzer’s co-authorship added to the book. Kramer’s blog could surely have provided enough content, and the limitation would have produced a more focused narrative.
I also wished the book had been arranged chronologically rather than thematically, to give a better sense of the progression of ALS. My favorite chapter was #22, “Faith, Part III: Wrestling with Angels,” in which Kramer meets the Dalai Lama and learns that blessings are not to be received passively but actively given. It is heartening to see how much Kramer crammed into his life in the way of travel and experiences (like skydiving and yoga) even as his body began failing him. He is also gracious when referring to people who responded to ALS differently, whether that was making a bucket list or investigating assisted dying.
We know how this story ends – if not the book itself. ALS is a cruel neurodegenerative disease that gradually takes away all of a person’s capacities. At 55, Kramer is still plugging away. But his story should be a wake-up call for all of us, terminal illness or no: “The autopilot of living from event to event is completely gone. Pay attention!”
March 24, 2015
"I don't know how much longer I will live. I know that I am dying. But this is not new knowledge, and it is not ALS. It has always been so. Disease only changes the circumstance and the speed, but the knowledge remains as it was."
Well.
I keep running into books that I dislike but that make me feel like a shitty, heartless person for disliking them. Like this one.
I thought that this would be an insightful memoir into how an incurable disease and the knowledge of impending death affects one man's life. And, in some parts, it is:
"All of us need to find the holy balance between the fixable and the inevitable."
"The ALS person I have become is so easy to disrupt, so easy to push off balance, so easy to move into painful and difficult spaces, that I hardly recognize him. Yet I know it is me."
But the rest of the time, it's filled with sappy, confusing, overwrought sentences like these:
"But for me, the demarcation between old normal and new normal is so complete and specific, so compelling, that I realized that to try to bring the old religious symbols of fixing with me into this new, ALS-defined space would only exacerbate the demise of the person I knew that I had to become."
"The damnedest things things suddenly become very clear- past pain, human frailty, regrets, joys, and visions, such visions of color and sound and wholeness beyond physical limitation."
And there are much more of the latter type of sentences than the former, I'm afraid.
Once I got more than a third of the way through and the book continued to be painful to read, I realised that I just couldn't make myself do it any longer, no matter how much I wanted to like this book. Once Bruce started talking about disease versus dis ease (which I'm still very confused about) I had already mentally checked out.
And yet...
I still feel like a terrible person. Because of course I empathise with Bruce- he's been through circumstances so compromising, so tough, so painful, so unfair- and he's reacted admirably. He seems like a down-to-earth, genuine guy who's doing the very best with what he's got and trying to learn everything he can from his disease and diagnosis. And I think that this memoir could have been really good- it was just not written well at all.
I had this same problem with Night. I didn't like it, and it was a memoir written by someone who had experienced terrible tragedy. How could I criticise a book written by a Holocaust survivor? But I did. Because in both that case and the case with Living While Dying, it isn't the story or the author that I dislike: it's the writing.
So, I don't know. Maybe other people will read this and love it. I found it agonising. Maybe I have a shrivelled, blackened heart. Maybe I am a cold, soulless, she-demon who has set out to terrorise memoir authors. All I'm saying is this: it's wonderful to try to get your story out there, especially when it's powerful and should be told, like one about disability or genocide or death or persecution. But you have to acknowledge that memoirs are still books, and no matter how admirable the story, poor writing can't be swept under the rug.
P.S. I forgot to mention that I was given an ARC of this from the publisher in exchange for an honest review. Rest assured, I will never let this sway any of my opinions. You can't buy my approval with a free galley- you need chocolate for that. Chocolate and money.
P.P.S. I feel like I should include some links regarding this subject matter, because even if I didn't like the book, I agree with the message. Here is a link to the blog that Bruce has kept since his diagnosis, upon which this book is based. And here is a link to a fact page about ALS, and I highly encourage you to visit alsa.org is you want to know more about the disease or get involved with their organisation.
Well.
I keep running into books that I dislike but that make me feel like a shitty, heartless person for disliking them. Like this one.
I thought that this would be an insightful memoir into how an incurable disease and the knowledge of impending death affects one man's life. And, in some parts, it is:
"All of us need to find the holy balance between the fixable and the inevitable."
"The ALS person I have become is so easy to disrupt, so easy to push off balance, so easy to move into painful and difficult spaces, that I hardly recognize him. Yet I know it is me."
But the rest of the time, it's filled with sappy, confusing, overwrought sentences like these:
"But for me, the demarcation between old normal and new normal is so complete and specific, so compelling, that I realized that to try to bring the old religious symbols of fixing with me into this new, ALS-defined space would only exacerbate the demise of the person I knew that I had to become."
"The damnedest things things suddenly become very clear- past pain, human frailty, regrets, joys, and visions, such visions of color and sound and wholeness beyond physical limitation."
And there are much more of the latter type of sentences than the former, I'm afraid.
Once I got more than a third of the way through and the book continued to be painful to read, I realised that I just couldn't make myself do it any longer, no matter how much I wanted to like this book. Once Bruce started talking about disease versus dis ease (which I'm still very confused about) I had already mentally checked out.
And yet...
I still feel like a terrible person. Because of course I empathise with Bruce- he's been through circumstances so compromising, so tough, so painful, so unfair- and he's reacted admirably. He seems like a down-to-earth, genuine guy who's doing the very best with what he's got and trying to learn everything he can from his disease and diagnosis. And I think that this memoir could have been really good- it was just not written well at all.
I had this same problem with Night. I didn't like it, and it was a memoir written by someone who had experienced terrible tragedy. How could I criticise a book written by a Holocaust survivor? But I did. Because in both that case and the case with Living While Dying, it isn't the story or the author that I dislike: it's the writing.
So, I don't know. Maybe other people will read this and love it. I found it agonising. Maybe I have a shrivelled, blackened heart. Maybe I am a cold, soulless, she-demon who has set out to terrorise memoir authors. All I'm saying is this: it's wonderful to try to get your story out there, especially when it's powerful and should be told, like one about disability or genocide or death or persecution. But you have to acknowledge that memoirs are still books, and no matter how admirable the story, poor writing can't be swept under the rug.
P.S. I forgot to mention that I was given an ARC of this from the publisher in exchange for an honest review. Rest assured, I will never let this sway any of my opinions. You can't buy my approval with a free galley- you need chocolate for that. Chocolate and money.
P.P.S. I feel like I should include some links regarding this subject matter, because even if I didn't like the book, I agree with the message. Here is a link to the blog that Bruce has kept since his diagnosis, upon which this book is based. And here is a link to a fact page about ALS, and I highly encourage you to visit alsa.org is you want to know more about the disease or get involved with their organisation.
August 10, 2015
My View:
“This isn’t a journey, this is life.”
Beautifully written; eloquent and touching yet never ever morbid authors Kramer and Wurzer discuss the unmentionable “the art of dying”: for it is an art, a way of looking at the world, of looking at and reassessing relationships, of seeking meaning in every day and facing the constantly changing challenges of di ease. For Bruce H Kramer it is his new reality, we are all dying just some of us have a better road map than others. Wurzer shares Kramer’s philosophical discussions on all things including his illness; “In each loss we experience, there is change, and in loss there can be growth, even during life’s final transformation, death, where the most profound lessons are taught. Each loss offers a teachable moment…an opportunity to grow until growth is no longer possible, a road map to the ultimate outcome.”
There are profound messages here for the terminally ill, the carers, family and colleagues of the terminal ill and for those who need reminding that life is not a practice run, live it well and live it now. This is a dual story of dementia and ALS and the new friendship between Wurzer and Kramer, one that will know will end shortly.
Beautifully written.
“This isn’t a journey, this is life.”
Beautifully written; eloquent and touching yet never ever morbid authors Kramer and Wurzer discuss the unmentionable “the art of dying”: for it is an art, a way of looking at the world, of looking at and reassessing relationships, of seeking meaning in every day and facing the constantly changing challenges of di ease. For Bruce H Kramer it is his new reality, we are all dying just some of us have a better road map than others. Wurzer shares Kramer’s philosophical discussions on all things including his illness; “In each loss we experience, there is change, and in loss there can be growth, even during life’s final transformation, death, where the most profound lessons are taught. Each loss offers a teachable moment…an opportunity to grow until growth is no longer possible, a road map to the ultimate outcome.”
There are profound messages here for the terminally ill, the carers, family and colleagues of the terminal ill and for those who need reminding that life is not a practice run, live it well and live it now. This is a dual story of dementia and ALS and the new friendship between Wurzer and Kramer, one that will know will end shortly.
Beautifully written.
April 17, 2021
Way back when, I listened to the MPR radio segments that Cathy Wurzer did with Bruce Kramer and recognized he was an amazing man. I knew there was a book but didn’t seek it out until I got the hard news that my nephew Marc Williams, son of my late sister Lolly, had been diagnosed with ALS.
I can’t say I know my nephew although he is only 16 years younger than I. But as he was growing up I had entered adulthood and moved across country from Ohio to Seattle. We never connected although we were part of our big and boisterous family during a couple reunions in the 90s when his four boys were toddlers and babies. We had almost nothing in common—he is a conservative guy raising a devout Catholic family, working in finance, tight with his siblings but not with our larger family. But I wanted to have some inkling of what he is facing and as usual, I turned to a book for help.
Especially as I couldn’t connect in person due to Covid, the book helped. Very few people could face ALS the way Bruce Kramer did and I only hope my nephew is dealing with this diagnosis with all the strength of spirit in him. I hope to visit him in 2021 and listen to whatever he might have to say about his life during this time.
This is an amazing book for anyone, temporarily able or permanently disabled. Kramer speaks of his dis ease, not disease, and the way he has chosen acceptance but not resignation is incredibly instructive for us all. Well worth reading.
I can’t say I know my nephew although he is only 16 years younger than I. But as he was growing up I had entered adulthood and moved across country from Ohio to Seattle. We never connected although we were part of our big and boisterous family during a couple reunions in the 90s when his four boys were toddlers and babies. We had almost nothing in common—he is a conservative guy raising a devout Catholic family, working in finance, tight with his siblings but not with our larger family. But I wanted to have some inkling of what he is facing and as usual, I turned to a book for help.
Especially as I couldn’t connect in person due to Covid, the book helped. Very few people could face ALS the way Bruce Kramer did and I only hope my nephew is dealing with this diagnosis with all the strength of spirit in him. I hope to visit him in 2021 and listen to whatever he might have to say about his life during this time.
This is an amazing book for anyone, temporarily able or permanently disabled. Kramer speaks of his dis ease, not disease, and the way he has chosen acceptance but not resignation is incredibly instructive for us all. Well worth reading.
November 1, 2020
Most people avoid talking about disease and death, and if you’re one of those people, then this is an important book to read. Bruce Kramer is honest about his changing outlook, his opinions on the medical staff that treat him, and the love of his family.
It’s highly probable that we will all lose much of our physical strength before we die. What do we do when that begins to happen? What do we do even before that?
It’s highly probable that we will all lose much of our physical strength before we die. What do we do when that begins to happen? What do we do even before that?
May 16, 2020
Inspirational
I would recommend this book to anyone diagnosed with this disease or knows someone who is dealing with this. It is sad, yet gives a sense of hope.
I would recommend this book to anyone diagnosed with this disease or knows someone who is dealing with this. It is sad, yet gives a sense of hope.
May 8, 2016
I need the input from people who have gone before me
I have stage IV breast cancer. I was initially diagnosed in 2000. I am still here, but I am not as active as I used to be and periodically I think, "this is it". This book was very helpful as he found new ways to normalize as he got weaker. Love is where it is at. His sharing was so helpful and anyone else going through this (though his was ALS), end of life will find this thoughtful and not sappy. I appreciated what he shared.
I have stage IV breast cancer. I was initially diagnosed in 2000. I am still here, but I am not as active as I used to be and periodically I think, "this is it". This book was very helpful as he found new ways to normalize as he got weaker. Love is where it is at. His sharing was so helpful and anyone else going through this (though his was ALS), end of life will find this thoughtful and not sappy. I appreciated what he shared.
April 19, 2015
Touching stories but with what started to feel like lecture in spots. The way the narrative switched between the two authors without notice left me wondering who was offering their thoughts too many times. I found that very annoying and almost stopped reading on that basis. For me that really dragged the book down. I was reading on Kindle so maybe there is some apparent transition in print that is not evident digitally.
July 4, 2024
I started this book while my dad was still alive, but have just been able to return to it a year after his death from ALS. It was too raw at the time, and Bruce seemed unlike my dad, in ways that felt painful. But now I am in a place to appreciate this voice of ALS, dis-ease, disability, and joyful living in the places we find ourselves. Thank you, Bruce, for writing this for all of us.
July 8, 2017
What gorgeous writing. I wrote out a lot of excerpts from this book. Bruce Kramer does a beautiful job of writing about the challenges of living into dis ease, living your life without your hands over your eyes, embracing the love and doing your best to transcend the fear. An excerpt:
"The gifts of dis ease are many. Balance, honesty, empathy, small kindnesses that ease suffering, even synesthesia if only for a little while--are all gifts. But the gifts exceed the sum of the good things. They are also the hard parts, and they remind us that even if there were a world without pain and suffering, there is a need to live the gift that life truly is."
Also:
"The fact is that none of us can predict with full certainty our life's trajectory. We know how it ends but we are not sure of what it means. Finding those things that center you--yoga or prayer or meditation, music or reading or just sitting in the darkness, will help you remain in the moment when all around you feels chaotic. And know in your heart that chaos is indicative of normalcy."
"The gifts of dis ease are many. Balance, honesty, empathy, small kindnesses that ease suffering, even synesthesia if only for a little while--are all gifts. But the gifts exceed the sum of the good things. They are also the hard parts, and they remind us that even if there were a world without pain and suffering, there is a need to live the gift that life truly is."
Also:
"The fact is that none of us can predict with full certainty our life's trajectory. We know how it ends but we are not sure of what it means. Finding those things that center you--yoga or prayer or meditation, music or reading or just sitting in the darkness, will help you remain in the moment when all around you feels chaotic. And know in your heart that chaos is indicative of normalcy."
June 2, 2023
I suppose I read this book in the hopes that by doing so I could stave off the time when I interact with this subject by encountering my own "dis ease." There is some wisdom here, and I took notes. Unfortunately, much of the wisdom is drowned in adjectives, phrases, and abstract wording. I wanted to hear his stories. I wanted to feel what he felt, to see concrete examples of what he was trying to express. I realize the author loved philosophy and chose to make this not a memoir but more of a treatise. Nonetheless, I find it difficult to be moved by the abstract. And untangling, really grasping, some of the writing would require more time than I'm willing to give.
October 30, 2022
Cathy Wurzer has always been a favorite journalist of mine and I love her contributions to this amazing book!! Bruce Kramer has made the journey to the end of his days with ALS and given us all a view that will resonate with me for many days, weeks, months. . . . The love and what life is truly all about. I recommend pacing yourself to absorb this treatise with care and reverence. The messages are profound.
March 24, 2022
A person giving a diary account after being diagnosed with ALS. A book of fear, strength, love, grace, honesty, and emotion. It’s a magnificent story showing his courageous
everyday battle with the disease. Tells about his loved ones, caregivers and all the people who tried to comfort him during the difficult times.
everyday battle with the disease. Tells about his loved ones, caregivers and all the people who tried to comfort him during the difficult times.
January 25, 2018
Applicable understanding of living through disease, change, depression, and more. Honest, soul-searching thoughts. Not a step-by-step tutorial but thought-provoking on making your days, even if they are your last, as loving and positive to those around you as possible.
Thankfully I rate this a 4, although I was able to make numerous connections because of my own dis ease.
Thankfully I rate this a 4, although I was able to make numerous connections because of my own dis ease.
February 3, 2018
Beautifully written (and co-authored in a wonderful pairing with Cathy Wurzer). Elegant language. Amazing insight. I need to re-read it, especially because "I know how this ends."
June 16, 2018
A difficult book for me to read, for many reasons.
February 5, 2019
Very insightful.
March 24, 2019
Book club selection.
November 22, 2016
Very moving. Much to learn here.
March 25, 2015
How does one really come to terms with terminal illness or mortality – whether for one’s self or a beloved family member – and what does it mean to “Live while Dying”? Driven by professional passion to teach and inform and fueled by experiences of loss, authors Kramer and Wurzer dissect and wrestle with these questions. Kramer’s physical, emotional, and spiritual challenges of embracing his terminal diagnosis of ALS take center stage; Wurzer’s loss of her father to dementia and cancer parallel and complement the telling of living while dying.
In 26 short pithy chapters, the duo addresses a variety of topics through related experiences. While the succinct chapters could stand as individual blog entries, the succinct nature is no doubt due to Kramer’s rapidly dwindling energy level and urgency to share his story before losing all ability to communicate and impending death. Although not stated as such, the real essence of this book is the universal tension between mastery and mystery. When young, healthy, and enjoying vitality, we focus on mastering our physical bodies, environment, careers, and assorted external trappings. Yet, when confronted with our mortality, whether through impending death of self or sudden death of a loved one, we are often stopped cold in our tracks. Such moments can awaken us to the mystical/sacred aspect of our being and help us remember what is truly important and meaningful.
Kramer shares his very human emotions of anger, frustration, disappointment when feeling diminished by disease and approaching premature death. In spite of this, he is able to see that he is so much more than his physical body and embrace the gifts of intellectual and spiritual growth bestowed by ALS. Kramer, ever the education leader, lovingly offers this final opus as a guide to encourage us: “ALS only overwhelms my body. My soul still sings, now for all to hear. My spirit breathes, revealed as my skin is pushed inside. The picture I so carefully access is now a negative reversal of the person I am… it has taught me, it has revealed to me pure unsullied, uncontaminated, unbelievable love. ”
In 26 short pithy chapters, the duo addresses a variety of topics through related experiences. While the succinct chapters could stand as individual blog entries, the succinct nature is no doubt due to Kramer’s rapidly dwindling energy level and urgency to share his story before losing all ability to communicate and impending death. Although not stated as such, the real essence of this book is the universal tension between mastery and mystery. When young, healthy, and enjoying vitality, we focus on mastering our physical bodies, environment, careers, and assorted external trappings. Yet, when confronted with our mortality, whether through impending death of self or sudden death of a loved one, we are often stopped cold in our tracks. Such moments can awaken us to the mystical/sacred aspect of our being and help us remember what is truly important and meaningful.
Kramer shares his very human emotions of anger, frustration, disappointment when feeling diminished by disease and approaching premature death. In spite of this, he is able to see that he is so much more than his physical body and embrace the gifts of intellectual and spiritual growth bestowed by ALS. Kramer, ever the education leader, lovingly offers this final opus as a guide to encourage us: “ALS only overwhelms my body. My soul still sings, now for all to hear. My spirit breathes, revealed as my skin is pushed inside. The picture I so carefully access is now a negative reversal of the person I am… it has taught me, it has revealed to me pure unsullied, uncontaminated, unbelievable love. ”
February 9, 2021
Bruce Kramer was a university dean who, when diagnosed with ALS (Lou Gehrig's Disease), decided to write a blog about "living while dying"- called the Dis Ease Diary He eventually joined forces with Cathy Wurzer, an MPR personality and journalist, and this book is their final collaboration. Bruce Kramer died just a week before this book was released.
The book starts each chapter with Wurzer's comments, followed by Kramer's writings... many portions collected from his extensive blog. It's a short read, but heavy - emotionally, spiritually... seriously heavy. That's to be expected, I suppose, as it's the thoughts of a man on a slow, inevitable slide into the grave.
I can't give any kind of value judgement on Bruce's ALS observations (the "gift" of ALS?) but I imagine they would be a great comfort to someone diagnosed with the disease. His main objective seems to be to find the grace in every moment, even as his body betrays him. As an "able bodied" person (still "living in denial," Bruce might say), I can only appreciate this idea on a theoretical level. I agree with the philosophy, but I don't know if I could adopt the same attitude in similar circumstances.
As for the writing, it's honest and straight forward, sometimes inspiring, sometimes depressing. Bruce is prone to go overkill on metaphor and his chapters don't tie together neatly... the result of writing for a blog, I suppose. His instance on the concept of "dis ease" (obviously extremely important to him) was a stumbling block every time I ran across it.
Wurzer is the better writer, and it would have been a better constructed read with more of her voice. But then, this is Bruce's book and Bruce's story, not hers.
Nobody is getting out of here alive! We all live like that's untrue, but Bruce shows us how quickly the truth of mortality can be crammed right into our faces. I can only hope that when my time comes, I'll have as much grace and poise as Bruce Kramer.
The book starts each chapter with Wurzer's comments, followed by Kramer's writings... many portions collected from his extensive blog. It's a short read, but heavy - emotionally, spiritually... seriously heavy. That's to be expected, I suppose, as it's the thoughts of a man on a slow, inevitable slide into the grave.
I can't give any kind of value judgement on Bruce's ALS observations (the "gift" of ALS?) but I imagine they would be a great comfort to someone diagnosed with the disease. His main objective seems to be to find the grace in every moment, even as his body betrays him. As an "able bodied" person (still "living in denial," Bruce might say), I can only appreciate this idea on a theoretical level. I agree with the philosophy, but I don't know if I could adopt the same attitude in similar circumstances.
As for the writing, it's honest and straight forward, sometimes inspiring, sometimes depressing. Bruce is prone to go overkill on metaphor and his chapters don't tie together neatly... the result of writing for a blog, I suppose. His instance on the concept of "dis ease" (obviously extremely important to him) was a stumbling block every time I ran across it.
Wurzer is the better writer, and it would have been a better constructed read with more of her voice. But then, this is Bruce's book and Bruce's story, not hers.
Nobody is getting out of here alive! We all live like that's untrue, but Bruce shows us how quickly the truth of mortality can be crammed right into our faces. I can only hope that when my time comes, I'll have as much grace and poise as Bruce Kramer.
March 1, 2016
Pretty good, but not quite what I was expecting. This title caught my eye because of the subject matter: the author (Bruce Kramer) was unexpectedly diagnosed with ALS, an incurable, progressive muscular degenerative disease. It is an incurable disease that ultimately shortens the life of those who suffer it. The result is a series of thoughtful essays on coming to terms with having a terminal illness, and how it affects your inner and outer life. Cathy Wurzer, the co-author, chimes in at times with her own stories on dealing with the terminally ill; her own father had Alzheimer's disease and she was responsible for his care towards the end of his life.
These two complementary perspectives make for some thoughtful, emotional, and poignant essays. Other than the theme, there isn't really much narrative connecting all these essays; they can almost be read in any order, and aren't really meant to be read more than one at a time (I can't imagine finishing this in one or two sittings). I was surprised at Kramer's frequent flights of poetic fancy; he has a nice lyrical prose, and he often likes to use lots of allusions, metaphors, and "big words" to describe his feelings. When I discovered he was a former college professor, I wasn't surprised; it certainly makes his predilection for wordiness and (overly) flowery language obvious in retrospect!
There were times in the book I wished Kramer had toned down his "classical literature lecture" mode, and used language more accessible to every day readers. I chose this book because I lost a father-in-law to cancer about 18 months ago; I thought reading this would help me understand what would have been going through his mind during his illness. Suffice it to say, my father-in-law and Kramer are two VERY different people, and I doubt their feelings would have been expressed similarly. In any case, I'm glad I read the book...but I don't think it's going to be very accessible for some readers (who may want to read a book of this subject) due to the author's writing style.
These two complementary perspectives make for some thoughtful, emotional, and poignant essays. Other than the theme, there isn't really much narrative connecting all these essays; they can almost be read in any order, and aren't really meant to be read more than one at a time (I can't imagine finishing this in one or two sittings). I was surprised at Kramer's frequent flights of poetic fancy; he has a nice lyrical prose, and he often likes to use lots of allusions, metaphors, and "big words" to describe his feelings. When I discovered he was a former college professor, I wasn't surprised; it certainly makes his predilection for wordiness and (overly) flowery language obvious in retrospect!
There were times in the book I wished Kramer had toned down his "classical literature lecture" mode, and used language more accessible to every day readers. I chose this book because I lost a father-in-law to cancer about 18 months ago; I thought reading this would help me understand what would have been going through his mind during his illness. Suffice it to say, my father-in-law and Kramer are two VERY different people, and I doubt their feelings would have been expressed similarly. In any case, I'm glad I read the book...but I don't think it's going to be very accessible for some readers (who may want to read a book of this subject) due to the author's writing style.
March 27, 2015
I dove into this book with some trepidation. The author, a former college dean, is battling ALS and while I originally thought it was only an ALS memoir I was quite mistaken.
I'm interested in books that explore life's big questions and this book, which is a fairly quick read, is thoughtful in its explorations of fully living while facing terminal illness and disabilty. Sadly, Kramer's an expert on that. However, Kramer's interesting concept of dis ease (which sometimes gets a little thick) expands the book beyond ALS to anyone who deals with life's battles. Kramer is a wonderfully lyrical writer. He is brutally honest about his circumstances but I appreciated his decision not to pummel the reader with voyeuristic details.
I wasn't sure why his co-author Cathy Wurzer wrote introductions into each chapter until I learned they do a radio series of conversations on Kramer's journey with ALS. Wurzer is a public radio broadcaster. She leads readers into each chapter, which is a similar format to their radio series. I listened to a few of their conversations on line and they are similar to the content of the book. It gives some context to what comes next and grounds the reader a bit.
I'm amused by other comments about not wanting to read books like these because they are so heavy and depressing. Here's the deal: we're all going to die and Kramer tries to challenge our cultural myth of immortality. All of us will face disease and disability but we chose instead to ignore those facts. He suggests we embrace the inevitable, embrace the losses, and live as fully as possible until you can't. I got that message loud and clear and while that isn't a terribly new message, Kramer tries to engage readers in a discussion of death and dying and it's a discussion well worth having. Kudos to Kramer for having the courage to push us to have these tough conversations with ourselves and others and he does it in such a poetic way.
I'm interested in books that explore life's big questions and this book, which is a fairly quick read, is thoughtful in its explorations of fully living while facing terminal illness and disabilty. Sadly, Kramer's an expert on that. However, Kramer's interesting concept of dis ease (which sometimes gets a little thick) expands the book beyond ALS to anyone who deals with life's battles. Kramer is a wonderfully lyrical writer. He is brutally honest about his circumstances but I appreciated his decision not to pummel the reader with voyeuristic details.
I wasn't sure why his co-author Cathy Wurzer wrote introductions into each chapter until I learned they do a radio series of conversations on Kramer's journey with ALS. Wurzer is a public radio broadcaster. She leads readers into each chapter, which is a similar format to their radio series. I listened to a few of their conversations on line and they are similar to the content of the book. It gives some context to what comes next and grounds the reader a bit.
I'm amused by other comments about not wanting to read books like these because they are so heavy and depressing. Here's the deal: we're all going to die and Kramer tries to challenge our cultural myth of immortality. All of us will face disease and disability but we chose instead to ignore those facts. He suggests we embrace the inevitable, embrace the losses, and live as fully as possible until you can't. I got that message loud and clear and while that isn't a terribly new message, Kramer tries to engage readers in a discussion of death and dying and it's a discussion well worth having. Kudos to Kramer for having the courage to push us to have these tough conversations with ourselves and others and he does it in such a poetic way.
April 19, 2015
I received an advance copy from NetGalley in return for an honest review.
Bruce Kramer, a college lecturer, has been diagnosed with ALS (MND to those of us in the UK). This book chronicles the journey of his thought and life experiences as he is slowly dying (we know how this ends, right? Very, very few people survive MND, the rates of diagnosis and the amount of people living with this disease are fairly static, and it's mainly because people keep dying, and the newly diagnosed take their place as PALS (people with ALS)).
I'm a speech and language therapist working in a big hospital, sometimes I have patients with MND/ALS, so in an attempt to know the enemy (the disease not the patients!) I requested this book on netgalley. It can be difficult to hear the authentic voices of PALS because by the time I see them they're usually end stage. Bruce's voice is one of those authentic ones. He knows what ALS is like because he has it, and because he's a thinker.
His description of dying from ALS as being death by a thousand paper cuts is very apt. The slow decline of functionality, one loss at a time. His views on the worth of a very disabled individual rang very true for me too - the disabled, whether by disease, heredity, accident or whatever, still have immense value, and I was glad to see Bruce assert that. His thoughtfulness towards his wife, Ev, and their family, and his consideration of their burdens and feelings was also great to read. He seems like a guy I'd like to have known.
There's more to come on this review...
Bruce Kramer, a college lecturer, has been diagnosed with ALS (MND to those of us in the UK). This book chronicles the journey of his thought and life experiences as he is slowly dying (we know how this ends, right? Very, very few people survive MND, the rates of diagnosis and the amount of people living with this disease are fairly static, and it's mainly because people keep dying, and the newly diagnosed take their place as PALS (people with ALS)).
I'm a speech and language therapist working in a big hospital, sometimes I have patients with MND/ALS, so in an attempt to know the enemy (the disease not the patients!) I requested this book on netgalley. It can be difficult to hear the authentic voices of PALS because by the time I see them they're usually end stage. Bruce's voice is one of those authentic ones. He knows what ALS is like because he has it, and because he's a thinker.
His description of dying from ALS as being death by a thousand paper cuts is very apt. The slow decline of functionality, one loss at a time. His views on the worth of a very disabled individual rang very true for me too - the disabled, whether by disease, heredity, accident or whatever, still have immense value, and I was glad to see Bruce assert that. His thoughtfulness towards his wife, Ev, and their family, and his consideration of their burdens and feelings was also great to read. He seems like a guy I'd like to have known.
There's more to come on this review...
June 7, 2015
This is a nice book about confronting terminal illness. Which is a pretty weird thing to say and sort of a weak-sauce review, but it pales in comparison to the powerful radio interviews (http://www.mprnews.org/topic/living-w...) between Bruce Kramer and Cathy Wurzer. As much as I truly like Wurzer as a journalist and as much as I know I'd like her as a person, I felt her parts were the weakest of the book. She shared a little about her father's Alzheimer's diagnosis and mentioned her failing marriage, but, for me as a reader, I don't feel like she revealed herself and her perceptions, and maybe that was on purpose to protect the living and to not outshine the words and wisdom of Kramer. This is maybe more for mainstream protestant Christians, but I think anyone can benefit from reading the words of one who knows he is dying and who faces life and his fears with honesty, courage, thoughtfulness, dignity, and compassion. I didn't find this as endearing as Scott Simon's Unforgettable, but I do think it's a worthwhile read, especially considering Kramer's diagnosis was around the same time of Brittany Maynard's, and she chose assisted suicide whereas he chose hospice, and the operative in all of this is choice -- we should be able to choose how we live and die in as much as we have agency to do so. Lots of food for thought. And lots of compassion and sympathy for Kramer's family and for Wurzer herself.
February 18, 2015
For readers who have had experience of caring for someone with a progressive disease Bruce Kramer's story of living with ALS gives an extraordinary insight into what it is like for the sufferer. It should certainly open eyes and encourage honesty. Bruce's recognition that fighting a progressive disease is pointless- you might as well rage against the fading of the light- is revelatory. He instead refers to "new normalcy" as the way of coping with each progression of his illness. This is something we should all accept as we move through life's stages instead of bemoaning what we can no longer do. Particularly thought provoking is how he describes how his illness has turned him inside out. He can no longer conceal his feelings and emotions behind an outer shell. He just can't. Everything becomes visible and, by this being so, he finds reward in the understanding, love and empathy of friends and family. His weakness paradoxically becomes his strength. This is a deeply thoughtful book which contains good advice for us all, healthy or sick, and shall benefit those who read it.
April 22, 2015
Bruce Kramer was diagnosed with ALS several years ago, and passed away shortly before the publication of this book, which collects his thoughts along with those of Cathy Wurzer, the public radio journalist who produced an extended series of radio pieces about him (and with him).
To write a memoir about one's last years on earth, and living with an incurable disease is a surely a difficult thing. Kramer's overarching theme is one of honesty. He struggles to face his own mortality honestly. The human mind's instinct is to flinch away; to deny our mortality. I commend the authors for tackling a difficult task and wrestling with their private pain in such a public way. Having said that, I found the writing uneven. The insights are at times profound, but the reader is just as likely to get a trite platituide. As a nonbeliever, I found Kramer's religious language grating at times, although a religious person would probably be less annoyed by it. I found myself very ambivalent about this book, which may have been part of the authors' intent.
To write a memoir about one's last years on earth, and living with an incurable disease is a surely a difficult thing. Kramer's overarching theme is one of honesty. He struggles to face his own mortality honestly. The human mind's instinct is to flinch away; to deny our mortality. I commend the authors for tackling a difficult task and wrestling with their private pain in such a public way. Having said that, I found the writing uneven. The insights are at times profound, but the reader is just as likely to get a trite platituide. As a nonbeliever, I found Kramer's religious language grating at times, although a religious person would probably be less annoyed by it. I found myself very ambivalent about this book, which may have been part of the authors' intent.
October 30, 2016
This book is an interesting compilation of Bruce Kramer's observations and thoughts during his 4-year journey with ALS. He does not dwell at all on symptoms or even particularly on his own situation, other than to illuminate the possibilities of actually living even though the prospect of certain death is always present - or as present as you allow it to be. Cathy Wurzer moves from objective journalism to intimate observer and there is not doubt that her ear and her encouragement allowed much of Kramer's thinking to be formed into this book. One can learn a great deal, even if not close to a terminal illness. The book is short and an "easy" read, but leaves the reader with some lasting messages. This feels like a book to which one might return, just to be reminded of the joy in possibility and living.
March 27, 2015
We Know How This Ends is a wonderful story of parallel lives experiencing heart-ache, tragedy, joy, and acceptance. ALS and Alzheimer's disease together provide insight and wisdom as the two authors get to know each other.
We all have two things in common: we are all born. We all will die. Of these things we can be sure. And if we are given an opportunity to prepare for death, we have been given a gift. It is in the reading of this book that we can see how this difficult knowledge can become a gift.
One of the reasons that this book works on so many levels is in its polar opposites: life/death, happiness/sorrow, activity/stillness, rudeness/kindness.... And the list is endless.
We all have two things in common: we are all born. We all will die. Of these things we can be sure. And if we are given an opportunity to prepare for death, we have been given a gift. It is in the reading of this book that we can see how this difficult knowledge can become a gift.
One of the reasons that this book works on so many levels is in its polar opposites: life/death, happiness/sorrow, activity/stillness, rudeness/kindness.... And the list is endless.
December 6, 2016
Great insights into the end of life issues, not just from a physical perspective but more of a spiritual journey through the end of life peace and assurance of finality. I enjoyed all the great insights from both Bruce and Kathy. They are both excellent writers, and this is a great example. This would be an excellent book to read with someone side by side who is facing any end of life issues, and even someone you love and care for that is important to you. We don't deal with this subject enough, and this book does is in a beautiful way.
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