Katy Butler was living thousands of miles away when her old but seemingly vigorous father suffered a crippling stroke. She flew East and in time became her parents’ part-time caregiver, thoroughly re-embroiled in the childhood family dynamics she thought she’d left behind.
Her father’s natural suffering was bad enough. But in time she saw it prolonged by an advanced medical device — a pacemaker — that kept his heart going while doing nothing to prevent his slide into dementia, near-blindness, and misery. When he said, “I’m living too long,” Katy and her mother faced wrenching moral questions, faced by millions of America’s 28 million caregivers. Where is the line between saving a life and prolonging a dying? When do you say to a doctor, “Let my loved one go?”

After doctors refused to disable the pacemaker, Butler set out to understand how we had transformed dying from a natural process to a technological flail. Her quest had barely begun when her mother, faced with her own grave illness, rebelled against her doctors and met death head-on.

Part memoir, part medical history, and part spiritual guide, Knocking on Heaven’s Door is a map through the labyrinth of a broken medical system. Its provocative thesis is that technological medicine, obsessed with maximum longevity, often creates more suffering than it prevents. It also chronicles the rise of Slow Medicine, a movement bent on reclaiming the “Good Deaths” our ancestors prized. In families, hospitals, and the public sphere, this visionary memoir is inspiring passionate conversations about lighting the path to a better way of death.