The Journey's End: An Investigation of Death and Dying In Modern America

by Michael Doring Connelly

In the tradition of Atul Gawande’s Being Mortal, this compassionate work helps individuals develop a more accepting view of dying while teaching them what to expect and how to navigate the healthcare system at the end of life. In elderhood, the health care system has a narrow view of how to provide care. It focuses on extending a patient's life at all costs, with an over-reliance on machines and procedures, instead of caring holistically for the person. Accordingly, many of us will likely spend our final weeks in long-term care facilities or an ICU. Dying at home, peacefully, and surrounded by family is almost impossible in our world--and our fear of death is a major contributor to this impossibility. Fittingly, the central idea of this book is that in old age, or when facing a terminal diagnosis, it is more important to understand your life rather than to extend it. While this may seem simple, its implications are profound. A natural death means accepting that, at some point, we are old enough or sick enough to die. In our cynical and overly clinical age, it is difficult to reflect on the meaning of one's life, but that kind of honest introspection is exactly what we need. Accordingly, The Journey’s End seeks to help people manage their healthcare, their expectations, and their decisions in the final phase of life.

253 pages, Kindle Edition

Published April 4, 2023

About the author

Michael D. Connelly served as the CEO of Mercy Health, one of the nation's largest health systems, from 1994 to 2017. Currently, he is the CEO Emeritus of Mercy Health (now Bon Secours Mercy Health).

He has global experience with health systems in Germany, the United Kingdom, Denmark, Sweden and Spain and has also visited health facilities and orphanages around the world, including in Port-au-Prince, Haiti; the Mathare slums in Nairobi, Kenya; Kingston, Jamaica; Georgetown, Guyana, and Panguma, Sierra Leone.

He has extensive governance experience and has chaired the following boards: Catholic Charities USA, the Urban League of Greater Southwestern Ohio, the National Catholic Health Association, Catholic Medical Mission Board (CMMB) in New York City, and Premier, Inc. He also chaired the United Way for Greater Cincinnati (the sixth largest United Way in the US) in 2013.

He has published 17 articles in various healthcare journals, and currently lives on Johns Island, South Carolina.

Reviews

[Gizzard · Rating 3 out of 5]

This should have been two books. A great book on how to think about medical care as we approach the end of life. I would have recommended it far and wide if it would have only lightly touched on costs. But half of this is about insurance and costs.

And while most of his thoughts on insurance and paying for medical care are good or at least worth thinking about, they muddy the water here. Especially since not all of this part is backed by studies as most of the rest of the book is. It really felt like he had his chance to give all of his opinions, and he wasn't going to let that go.

Additionally, he says little about the predatory insurance industry. He also doesn't seem to have any understanding of the middle class. He brings up the overconsumption of the medical system repeatedly without any real examples.

I'd love a book strictly on end of life decisions. I'm getting there and have friends struggling with their 80+ parents saying - enough. Most of this is just a reflex. Almost all of these people have trouble with accepting a mobile, relatively active parent is just done with testing and drugs. Nor do they weigh the effects of testing and treatment on quality of life, even while honoring their parent's choices.

[Ann · Rating 5 out of 5]

Most of us would prefer to die at home surrounded by those who love us, but these days we are more likely to die in the hospital or a long care treatment facility.

"The Journey's End" is a well observed and researched description of changes in the medical world and how that impacts End-of-Life (EOL) care. In a clear but scholarly way, the author explains how the myriad parts impact each other and what would need to be done to make the difficult changes. The Bibliography is extensive and provides sources to consider that can improve EOL care. There are notes and an index.

Beyond that, the book lists the important documents and processes that one must understand and complete to guide their own death. HIGHLY RECOMMENDED.

Author Michael Doring Connelly was CEO of one of the nation's largest health systems from 1994 to 2017. He is currently CEO emeritus of Mercy Health (now Bon Secours Mercy Health System).

[Laura Steinert · Rating 5 out of 5]

It is somehow rewarding to read a book in which the author confirms all my ideas about death and dying. I was surprised that this Catholic doctor would be so supportive of end of life decisions focused on "do no harm" and not endlessly prolonging life through medical intervention.