When she saw me with an advance copy of Michelle Hills’ amazing debut, The Wrong Order of Things, a non-medical friend told me, “I could never read that, how can you bear it?”
I’m glad she said this to me, because the conversation that resulted made me utterly sure of how much EVERYONE needs to read this wonderful book, which is truly one of the most beautiful, powerful, uplifting and insightful books I’ve read in a long time.
A book ostensibly about children’s palliative care risks being overly sentimental, bleak, or some kind of textbook. In The Wrong Order of Things, Michelle Hills manages to be truly human, warm, funny, and to challenge readers’ assumptions around how we should, or should not, talk about difficult things.
A consultant in children’s palliative medicine, Hills invites readers into her world. One which is frequently misunderstood and often hidden from public view. The book gently challenges the assumption that children’s palliative care is all about dying, revealing a speciality devoted to helping children (and their families) live as fully, joyfully, and comfortably as possible, often over many years.
What makes this book exceptional is its humanity. Drawing on composite stories inspired by thousands of children and families she has cared for, Hills creates a series of deeply moving narratives that illuminate the realities of serious childhood illness. All the stories are fictionalised to protect confidentiality, but they feel completely authentic. Every child, sibling, and parent is portrayed in vivid human detail, so each chapter is a lovely individual story in its own right, all of which add up to a wonderful whole.
This is never a bleak book. There are moments of grief, of course, and I acknowledge I cried more than once as I read it. What shines through, though, is love, not sadness. Hills writes about children living their best lives, complete with parties, pets, concerts, festivals, heroes and friendships. Children are children. They may have complex diagnoses or life-limiting conditions, but they need to play, explore, laugh and adventure. Hills shows us how parents and siblings can be supported to be more than carers. Life continues to be lived, even in the shadow of life-limiting illness.
One of the book’s greatest strengths is its exploration of communication. Hills shows us, with sensitivity and honesty, how children often understand far more about their illness than adults realise. She tackles the difficult subject of talking to children about death and dying with remarkable clarity, making a compelling case for openness, honesty and age-appropriate conversations. The message is never prescriptive, but it is profoundly thoughtful: children deserve truth, compassion and a voice in discussions about their lives.
Reading this book, I was reminded strongly of a wise mentor of mine who used to speak about practising “sensible medicine” by which he meant doing the right thing by the patient and family, not doing test for the sake of them. I’ve adopted an aphorism in my own career: “just because you can doesn’t mean you should,” which I share with trainees often, and Hills illustrates this so effectively in so many of the stories.
My favourite story in the book is that of a young boy terrified by “fireworks” exploding in his head, only for the mystery to be solved through careful listening and the discovery of popping candy hidden inside some chocolate he’s been eating. It is a delightful example of the detective work that lies at the heart of excellent clinical care.
Alongside the patient stories are reflections from Hills’ own family life, including touching and often humorous anecdotes about raising children and caring for beloved pets. These personal sections broaden the book’s appeal, inviting readers to reflect on their own experiences of loss, love and decision-making. They also reinforce one of the book’s central themes: conversations about illness, grief and mortality belong to all of us, not only to those facing a medical crisis.
Perhaps most importantly, The Wrong Order of Things succeeds because it never loses sight of the people at its centre. Hills writes with obvious expertise, but she wears that expertise lightly. What shines through is kindness, humility and a profound respect for the children and families she serves.
This is a book for healthcare professionals, certainly, but it is equally a book for parents, teachers, carers and anyone interested in what it means to accompany others through life’s most challenging moments. It is informative without being didactic, emotionally powerful without being overwhelming, and hopeful without ever denying reality.
Beautifully written, deeply compassionate and unexpectedly uplifting, The Wrong Order of Things is a remarkable exploration of children’s palliative care and a moving celebration of lives lived with courage, love and joy.
