Abstract

In June 2000 Peter Houghton, a counselor in palliative care, was weeks from death due to cardiomyopathy. He had made his preparations and had said most of his good-byes. Then he was offered the chance to participate in a clinical trial. Six months later he was not only still alive, but planning a long distance walk for charity and writing this book about his experiences.

With humor and honesty, his story chronicles the uneven path back from the brink of death. Combining knowledge drawn from his counseling work with other dying people and his unique personal experience, he describes what dying really feels like and explains the physical processes it involves. He also raises profound questions about medical trials and palliative care, and especially about our attitudes to life and death, and the way we approach death.

Peter Houghton gives us an education on the process of dying and death itself. He witnesses dying and death from the outside as a counselor in palliative care and observing those who were dying, their death and their carers. He then through his own seemingly terminal illness, experienced the process first hand, to the point of death. Then as a participant in a new clinical trial he was given a return to life.

With humour and honesty he relays his own bumpy path on moving towards death and back from the brink, together with his counseling work with other peoples' dying processes. He gives an in-depth picture of the physical deterioration processes of the body and resultant physical pain leading to death, also detailing the medical processes involved. Equally well described is what it feels like: the psychological processes and emotional pain, through the stages of denial, anger and hopelessness to acceptance and transformation.

Towards Wholeness
This book was written after his surgery, although it has much more than a simple account of his recovery and subsequent events. As a counselor in palliative care, he has experience and knowledge of death and the dying process; much of the book is taken up his thoughts on the subject, illustrated with various anecdotes. He also describes the actual process of dying, and outlines treatment strategies for symptom control.
Bulletin of Medical Ethics
Drawing upon his extensive professional experience as a counselor in palliative care, Houghton raises many profound questions in each of the areas he discusses, and is not afraid to admit his own previous misconceptions…this is a book that contributes significantly to our knowledge of the natural dying process.
Journal of Beliefs and Values
With great honesty, sensitivity and humor Peter Houghton has chronicled and reflected upon his physical, mental and spiritual journey, which was far from being without set backs and deep self-questioning... This is a deep and challenging book and offers a rewarding read.
Plus
To me, the strength of the book was about its ability to refocus and question the care provided, as a recipient rather than a provider. This presented me with some thought-provoking questioning and reasoning induced in my own reflective practice.
British Journal of Occupational Therapy
Peter Houghton had been a counselor in palliative care, Then he experienced what appeared to be a mild heart attack but which turned out to be cardiomyopathy, a chronic disorder affecting the muscle of the heart. Although drugs could control his condition to some extent, slowly, imperceptibly, it worsened until he was weeks from death. At the 11th hour, a doctor friend read a notice of a clinical trial of the Jarvik Heart Assist Device for end stage cardiomyopathy patients, which led to a pioneering operation to install a pump to take over the failing left ventricle of Peter's heart. I was eager to read Peter's resulting book because of the probably unique set of experiences he brought to the writing of it. Not only had he no doubt derived many insights from working for many years with dying patients but also he had actually experienced the final stages of dying himself-yet was able to report back on that experience. As someone who has cared for a dying relative and worked as a volunteer in a hospice, I was hoping to learn something from Peter's account. I did indeed learn much from it…Houghton personally is still struggling to make sense of his restored life and the renewal of his relationships. At 60 he doesn't want to return to work, and he never wants to counsel a dying person again. Unsure why, he suggests that it might be because of having seen the things from the perspective of the counseled. That is a particularly salutary reflection to take away from this book
Human Givens
Peter Houghton has for many years been a counselor in palliative care. He was Director of the Birmingham Settlement where he founded Britain's first money advice center and worked with adolescents in trouble; he is also the founder of The National Association of the Childless in the UK. He is now actively engaged in fundraising for the Artificial Heart Foundation and is in the process of founding the Extra life Society for people who rely on mechanical support to stay alive.
In On Death, Dying and Not Dying, Peter Houghton tells his own story. A palliative care counselor, he was given weeks to live. This book tells how he prepared for dying, until a new clinical trial gave him his life back. In the midst of this moving tale, there is much useful information.
Church Times

This book is appropriate for the general public as well as students and clinicians. The author has a conversational style of writing that is both easy to read and refreshing. The insight he is able to offer is unique. He identifies not only his emotions during subsequent events, but is able to link these to appropriate interventions that clinicians can make.

Perhaps the most intriguing feature of this book is the connection the author is able to make with the reader. Although the subject matter is difficult, the style in which the information is presented places appropriate emphasis on the emotional and technical aspects.

Although this topic is not new, this is the only book that provides clinicians with an insight into a patients experience while also providing direction for clinical practice.

Lisa Stepp PhD, RN, APN, AOCN, CRNH (Private Practice)