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Five questions for… Clare Mackintosh

Published June 11, 2019 by Caroline Carpenter

Clare Mackintosh is best-known as a writer of psychological thrillers, but her new book takes her in a different direction. She talks about writing it below:

What is the premise of After the End?
Two parents, Max and Pip, have to make a life-altering decision about their critically ill son—and they don’t agree. 
What inspired you to write it?
Twelve years ago my son was in intensive care, and the doctors put his future in our hands. I asked the consultant what would happen if my husband and I couldn’t agree, and the doctor said, ‘you have to: the alternative is unthinkable.’ After the End is about the unthinkable. There have been several high profile cases in recent years where parents have disagreed with the medical professionals caring for their children. Each time, I’ve been struck by how the whole world has an opinion on what should happen, despite knowing few of the details. I thought how awful it would have been, when my husband and I were in hospital with our own son, if we’d had such additional pressure. 
One of my favourite poems is Robert Frost’s “The Road Not Taken”, and I’ve spent years wondering what would have happened if we’d made a different decision; if we’d taken a different path. Writing After the End enabled me to explore those ‘what ifs’ and examine how we come to terms with the decisions we make. 
 Why did you decide to tell the story from multiple points of view?
I don’t want to spoil what happens in the novel, but structurally the book depends on seeing more than one viewpoint. Aside from that element, it was also important to me to explore how differently Max and Pip saw their son. When it’s just you and your partner, they’re the most important person in the world to you, but as soon as you have children, that all changes. Max and Pip love each other, but they love their son more. I was interested in exploring how two people can be torn apart by the very person they have in common. I chose to include the viewpoint of the intensive care consultant, Leila Khalili, because I wanted to show how such difficult cases impact on the medical professionals, and how differently people can behave and appear, when under stress. 
Your previous novels are psychological thrillers, so this book marks a change of tone for your fiction writing—what were the biggest challenges for you as an author?
On the face of it this seems like a genre leap, but oddly it hasn’t felt like one at all. After the End is just as tense, just as suspenseful as my thrillers, and my writing has always had a strong focus on emotion and relationships. I Let You Go, is in many ways a study in grief, as much as a psychological drama. The biggest difference for me as a writer was that After the End is perhaps more character-lead than plot-lead. I am used to plotting my novels in intricate detail, but this time my preparation was in getting to know Max and Pip. After that, they wrote their own story. 
How much research did you have to do for this book?
As a former police officer who has previously written crime novels, I have a new-found respect for crime writers with no experience of policing. After the End was completely out of my comfort zone in terms of setting, and I had to do a huge amount of research around Dylan’s medical condition, and the legal framework in which the book is set. Dr Leila Khalili is Persian, and by far my favourite part of the research process was the Iranian food I ate (and cooked) as part of building her character! 

After the End will be published by Sphere on 25th June 2019.

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