Book: We Know How This Ends: Living while Dying by Bruce H. Kramer and Cathy Wurzer

Nautilus Book Awards — Silver Award Winner

In We Know How This Ends, Bruce H. Kramer confronts his ALS diagnosis with clarity, courage, and grace. Faced with a terminal illness, he chose to embrace his reality rather than resist it—offering powerful insights on living fully, even in the face of death.

At the same time, broadcast journalist Cathy Wurzer was navigating her own grief as her father declined from dementia. Brought together by mutual friends, Bruce and Cathy began a series of candid conversations that blossomed into a deep friendship and this extraordinary book.

Written with wisdom, humor, and humility, We Know How This Ends is more than a memoir—it’s a profound reflection on loss, acceptance, and what it truly means to live. The book was the catalyst for Cathy to create End in Mind as a way to carry forward Bruce’s legacy and help others to live with the end in mind.

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Below are Discussion Guide Questions. If you’d like to download the Discussion Guide, click the button below.

Discussion Guide Questions

1. “Disease has always been with me, lying in the depths of collective human need, illuminating life’s inevitable sharp edges, it's dangerous borders, its precarious balance between good living and catastrophic existence.” How does the distinction between disease and dis ease help you understand experiences you have? When have you recognized dis ease in yourself or others? What did it reveal to you?

2. After Bruce’s diagnosis, he gained an acute awareness of his own mortality, became much more open in discussion, conversation, and in his needs from friends, caregivers, and family. How did his story make you change your view of your own mortality? Has that awareness brought any transitions to your approach to relationships?

3. After his diagnosis, and especially as the disease progressed, Bruce was very keen to the toll of his dis ease on his caregivers. “No person can give without receiving and receiving will never be authentic without learning to give.” What caregiving have you given or received? How have you balanced that caregiving? How have you provided support and relief to a caregiver?

4. Chapter 13 discusses time traveling. Bruce took many naps, read voraciously, and was incredibly reflective. During this time, he states that what is important becomes very clear. If it’s costing you nickels of energy instead of feeding your soul, it’s a waste of a precious gift of time. What feeds your soul? What choices have you made this week that fulfilled you? Drained you?

5. Vulnerability in disease, in able-bodiedness, in relationships are all themes throughout the book. Bruce grew close to people through showing his vulnerability. At first, it was incredibly difficult for Bruce to ask for help, but once he let ALS become his teacher, he realized that we can only grow through showing our vulnerabilities. When was the last time you showed your vulnerabilities? How do you think it affected outcomes?

6. Adaptive Yoga was a surprising shift for Bruce. It taught him that you can indeed practice yoga without being able to move your arms and legs, that it deepens connections with those who practice with you, and that receiving is a gift. Even when breathing became difficult, weekly yoga was a routine not to be missed. Even through a physical decline, Bruce grew through his yoga practice. It truly helped him through grief and loss with each paper cut of his dis ease. What is your adaptive yoga? What has helped you focus your mind, body, and soul to feel more connected to your true self?