We Know How This Ends

Living while Dying

2017
Author:

Bruce H. Kramer
With Cathy Wurzer

Surprising lessons in finding joy and personal growth in the last months of life

Written with wisdom, genuine humor, and down-to-earth observations, We Know How This Ends is far more than a memoir about life with ALS. It is a dignified, courageous, and unflinching look at how acceptance of loss and inevitable death can lead us all to a more meaningful and fulfilling life.

Security and immortality are both superstitions; the best we can do is make an adventure of our lives. In this exquisite book, Bruce H. Kramer finds adventure in the most unlikely of places: the death sentence that is ALS. We Know How This Ends is a moving tale that teaches us more about living well than any self-help book ever can.

Dan Buettner, New York Times best-selling author of The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest

2010 had been a very good year for Bruce H. Kramer. But what began as a floppy foot and leg weakness led to a shattering diagnosis: he had amyotrophic lateral sclerosis. ALS is a cruel, unrelenting neurodegenerative disease in which the body’s muscles slowly weaken, including those used to move, swallow, talk, and ultimately breathe. There is no cure: ALS is a death sentence.

When death is a constant companion, sitting too closely beside you at the dinner table, coloring your thoughts and feelings and words, your outlook on life is utterly transformed. The perspective and insights offered in We Know How This Ends reveal this daily reality and inspire a way forward for anyone who has suffered major loss and for anyone who surely will. Rather than wallowing in sadness and bitterness, anger and denial, Kramer accepted the crushing diagnosis. The educator and musician recognized that if he wanted a meaningful life, then embracing his imminent death was his only viable option. His decision was the foundation for profound, personal reflection and growth, even as his body weakened, and inspired him to share the lessons he was learning from ALS about how to live as fully as possible, even in the midst of devastating grief.

At the time Kramer was diagnosed, broadcast journalist Cathy Wurzer was struggling with her own losses, especially her father’s slow descent into the bewildering world of dementia. Mutual friends put this unlikely pair—journalist and educator—together, and the serendipitous result has been a series of remarkable broadcast conversations, a deep friendship, and now this book.

Written with wisdom, genuine humor, and down-to-earth observations, We Know How This Ends is far more than a memoir. It is a dignified, courageous, and unflinching look at how acceptance of loss and inevitable death can lead us all to a more meaningful and fulfilling life.

Awards

Nautilus Book Awards — Silver Award Winner

Bruce H. Kramer (1956–2015) was dean of the College of Education, Leadership, and Counseling at the University of St. Thomas in St. Paul, Minnesota. He created The Dis Ease Diary (http://diseasediary.wordpress.com), a popular blog about life with ALS.

The host of Minnesota Public Radio’s flagship news program Morning Edition, Cathy Wurzer has been broadcasting conversations with Bruce H. Kramer about his ALS experiences since 2011. She is also the cohost of Almanac on Twin Cities Public Television, the longest-running weekly public affairs program in the nation.

Security and immortality are both superstitions; the best we can do is make an adventure of our lives. In this exquisite book, Bruce H. Kramer finds adventure in the most unlikely of places: the death sentence that is ALS. We Know How This Ends is a moving tale that teaches us more about living well than any self-help book ever can.

Dan Buettner, New York Times best-selling author of The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest

Yet what comes through most powerfully in Kramer's story is not the pain but the quiet surge of gratitude and joy he has discovered in confronting his imminent death.

Next Avenue, Twin Cities Public Television

The revelatory journey that Bruce H. Kramer and Cathy Wurzer take us on is full of insight, wisdom, sorrow—and joy. This beautiful book should be required reading for all patients, caregivers, and clinicians to better understand that there can be growth and peace and exuberant life even while dying.

Jon Hallberg, M.D., University of Minnesota

As Bruce’s yoga teacher, student, and friend, I have witnessed the story behind this magnificent tale of becoming. I have watched his strength, his grace, and his willingness to love. Bruce’s prose is courageous and penetrating, elegant and unprecedented. This book will change your life.

Matthew Sanford, author of Waking: A Memoir of Trauma and Transcendence

Bruce H. Kramer turns his diamond-hard diagnosis like a prism, reflecting light and joy in surprising places. We need to hear this story now. The honesty and clarity of Kramer and Cathy Wurzer invite us to consider how we live in the face of impending death or unwanted change.

Susan Allen Toth, author of No Saints around Here: A Caregiver’s Days

Poetic and practical in embracing the inevitable.

MinnPost

Kramer is an excellent writer, a former college professor of education, spinning language in fascinating ways to make the reader stop and think, fell, and explore the profound lessons of a man facing death. He shows great wisdom, and the lessons presented in his book apply to all.

Mainstay

We Know How This Ends is a hopeful book. And a serious, joyful, literate, nuanced, bracing and funny book.

The Huffington Post

There are so many true words of wisdom in this book.

The Caregivers’ Living Room

Kramer is a powerful writer with a gift for crafting fresh descriptions, situations and emotions that are often reduced to clichés. He provides anyone with a terminal disease, and anyone caring for someone with one, with an eloquent guidebook on how to cope with eventual loss and embrace the days that are left.

The National Book Review

A gripping account.

Star Tribune

Contents

Prologue

Cathy Wurzer

1. Parallel Lives

2. The Footman Snickers

3. A House Built on Sand

4. A Delicate Dance

5. Disease and Dis Ease

6. Faith, Part I: Fulfilling What Is Meant to Be

7. The Tell

8. It Isn’t Just about You

9. The Gift

10. Happy Anniversary

11. Faith, Part II: It’s Your Choice

12. Handbook for the Recently Dis Eased

13. Time Traveling

14. Tripping the Light Fantastic

15. Killing the Buddha

16. The Gravity of It All

17. Ready to Fall

18. The Metrics of Measurement

19. A Death-Defining Feat

20. The Non–Bucket List

21. The Widening Gyre

22. Faith, Part III: Wrestling with Angels

23. Inside Out

24. Dis Ease Yoga

25. Faith, Part IV: What’s Love Got to Do with It?

26. We Know How This Ends

Acknowledgments

UMP blog: Bruce H. Kramer on finding a place of balance and harmony while living with the "dis ease" of ALS.

Almost to the day that I turned fifty, I experienced a phenomenon that many of my older and wiser friends easily recognized. I would get up in the morning, look in the mirror, and wonder, Who is that old man staring back at me?

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