As a Palliative Care physician of nearly 30 years experience, I have not read a better reasoned or more convincing argument for good palliative care integrated into all aspects of medicine. Sadly, I must agree with Dr Gawande that the continued need for my discipline to exist is a measure of failure, and that true success would see all health care systems capable of doing what palliative care now does as a specialty. This book, written from within medicine, and by a specialist in a discipline often seen as opposing, or at least failing to understand palliative care, is a far more powerful means to that end than any number of earnest lectures from the likes of me. It is so because it is beautifully written, deeply considered, erudite and above all deeply personal. EVERY medical student should read it, and be required to have as much skill and comfort in having difficult but crucial conversations as they do in naming muscles and writing prescriptions.