After the End is one of those books you cannot read on the bus or on your lunch break. It must be read in privacy where you are free to cry your heart out. It is the story of Pip and Max, a couple deeply in love with each other and their young son, Dylan. It opens with a trial, the judge preparing to decide whether than son will be allowed to die or whether further heroic measures will be attempted to prolong his life. Unlike the infamous cases in the news, this is not a case of the parents versus insurance of the National Health Service, but parents against each other.

The story begins being told in alternate chapters by Pip, Max, and their doctor Leila. Their son Dylan has a brain tumor that was partially removed and treated with radiation. They are waiting weeks for him to wake from his coma and to be able to breathe on his own. Pip spends her days in the hospital. Max travels for work but is present as much as possible. When they learn that his tumor is growing, Leila and the NHS recommend letting him rest until he dies but Max researches proton treatment in the U.S. It’s very up to the moment with the Go-Fund-Me campaign and the viciousness of social media. Pip and Max do not agree on what to do next…so what happens next?

I have only myself to blame for the aching, tired eyes that came from crying. After all, anyone reading the book description knows they are in for a tearjerker. I did not, however, expect to care so very deeply for Pip and Max. Mackintosh does an excellent job of making them real people whose motivations are ones we can understand and identify with. She makes an excellent case for giving up and for heroic measures – making clear how terribly difficult this is.

Believe me, even if you’re not a tearful person, this book is going to reach deep and squeeze them out.

I received an e-galley of After the End from the publisher through NetGalley.