Publication Date: June 3, 2025
As one of the few pediatric palliative care doctors in the United States, Bob Macauley was used to people saying, “I’m so glad I don’t have your job.” To which he would explain that palliative care is more about living than dying, then offer to share some of the inspiring stories he witnessed on a daily basis. He might mention that also being an Episcopal priest helped him console people in the hardest situations. But he never revealed the true reason for his career choice: he didn’t want anyone else to hurt the way he had when he was a kid.
The phrase “palliative care” typically causes people to think of older adults who are dying. However, Robert Macauley presents a different definition.
As a pediatric palliative care physician, Macauley shares inspiring stories of children and their parents in Because I Knew You. Through his first-person narrative, readers witness the doctor’s own struggles in navigating life and death.
While celebrating the children who have actually gotten better, he also remembers those who didn’t. In doing so, he ensures that the memory of these young lives will continue.
It’s also a study into the humanness of those charged with working with terminally ill children. Doctors experience the same emotions, but it can be a roller coaster of pain.
Because I Knew You offers an uplifting story about how good things can come out of devastating scenarios.
Robert Macauley has been the Cambia Health Foundation in Pediatric Palliative Care at Oregon Health and Science University since 2017. Prior to that, he directed the Department of Clinical Ethics as well as the Pediatric Advanced Care Team at the University of Vermont College of Medicine. He is the author of Ethics in Palliative Care: A complete guide (Oxford University Press, 2018). He lives with his wife and four kids in Portland, Oregon.
