When you first look at the cover of East of the Mountains by David Guterson, you see a dark gray sky with barren mountains and a field full of dying grass.  Throughout the picture runs a gravel road which passes an apple orchard on the way to the mountains in the background.  The cover provides a good visual of the story that Guterson tells.  This is a story of a doctor named Ben Givens who was recently diagnosed with terminal colon cancer.  He has three months to live, and intends to travel east of the mountains to end his life on his own terms. 

Ben Givens is in a tough spot in his life.  He was recently diagnosed with colon cancer after finding a painful lump on his side, his wife has died, he does not see his kids enough anymore, and he is nearing the end of his life at age seventy two.  Knowing that he has three months to live, he comes up with an elaborate plot to tie up his loose ends and go on one last trip to end his life.  This includes planting certain objects in his home to look like he just stepped out for a few hours, packing a few pairs of hunting clothes along with his shotgun, and preparing food and supplies for his two hunting dogs who will be traveling with him.  Ben’s plan is to go on one last hunting trip in a wilderness area he is familiar with and then shoot himself so he does not have to suffer anymore. 

After loading up his Scout with all of his materials and his two dogs, he set out for the mountains.  His plans are quickly altered when one of his dogs climbs up into the front seat area and causes Givens to crash his vehicle.  He wraps the Scout around a tree, giving him a nasty gash on the forehead and a huge black eye.  His dogs escaped the accident unharmed, but now Givens was stuck in the middle of nowhere on a rainy night.  A young, hippie couple arrived shortly while driving to nowhere in particular, and helped Givens to safety.  They fed him some snacks and struck up conversation about how Ben is incredibly lucky that he did not die before arriving at a local town.  Givens paid a towing company to scrape his vehicle off the side of the road and then decided he must continue on with his plans.  Not having a vehicle would make his remaining days much more difficult, but he said goodbye to the hippie couple and started walking with his dogs. 

Ben and his dogs slept in nature and hunted birds with his shotgun in order to eat.  He kept some of the birds in his coat for when he needed them and made sure his dogs enjoyed some bird as well to stay nourished.  He starts to have flashbacks to his past where the author tells of his father and his future wife, Rachel.  His father instilled great values in Ben, such as honesty and staying away from alcohol.  His mother pushed him to make the best of himself and ultimately convinced him to enter the medical field.  Then there was Rachel, the single most influential person in Ben’s life.  Readers get a sense in this book that Ben misses Rachel terribly and is looking forward to meeting her in another life.  They met near Ben’s home where Rachel was picking apples for the summer.  They constantly snuck off together where they kissed and fell in love.  Their relationship was forced to an end one day when Rachel left for nursing school and Ben entered the Army. 

A big portion of the book is dedicated to Ben’s time spent in the Army.  He enlisted against his father’s wishes and was an infantryman in the Army’s ski patrol.  He traveled around the world and nearly froze to death, but made some great memories along the way.  Ben entered tense battles where his friends were shot and killed right next to him.  His best friend, Stackhouse, was shot three times, including once in the chest, but thanks to Ben, was saved after open heart surgery.  Not only did Ben witness his friend’s chest cracked open, but he helped pump fluids into Stackhouse and stop bleeding from other bullet holes.  This was also a large influence on his decision to become a doctor.  He realized that he could do more with his natural talents and could help save people’s lives.  The most important memory from his war days was the time he met with Rachel in a foreign country.  When they met up, both Rachel and Ben looked older, but were still immensely attracted to one another.  They decided to get married on their second day together and vowed to stay together until death.  Rachel mentioned that she wanted their ashes to be buried next to each other one day so they can intermix and become a beautiful flower. 

After Ben’s flashbacks, we are brought back to his current situation.  He is still out in the wilderness with his two dogs, walking slowly toward his final destination.  Suddenly, he hears wolves and wolfhounds in the distance running at him full speed.  There were a total of ten or twelve wolfhounds chasing a single wolf than ran right by him, causing his two weaker dogs to join in the chase.  Ben knew that wolfhounds were bred and trained to kill anything that moves, and knew that his two hunting dogs were in serious trouble.  He slowly chased the pack of dogs and when he finally found them, the wolf was dead and being eaten by the hounds.  One of his dogs, Tristan, was nowhere to be found.  His other dog, Rex, was badly hurt with huge open gashes all over his body.  One of the wolfhounds still had Rex by the neck, forcing Givens to shoot and kill the hound in order to save his own dog.  The dog’s owner arrived soon by dirt bike and accused Ben of killing his innocent hound.  The crazy man ended up stealing Ben’s family heirloom shotgun and took off.  Being the doctor that he is, Givens used local tools available to suture his dog’s wounds the best he could until he could find a veterinarian.  The gun did not matter at this point; he just wanted to make sure his dog lived another day. 

The problem was that Ben and Rex were in the middle of nowhere.  Ben was determined to save Rex, so he carried him in his arm for several miles until he reached a small town.  There was a small restaurant in the town where Ben grabbed a small bite to eat.  He then bribed a local truck driver with sixty dollars to take him and Rex to the vet’s office.  The man obliged, and struck up friendly conversation along the way.  Rex ended up having his makeshift stitches removed and replaced in the vet’s operating room where Ben helped again with an operation.  Rex was tired and would undoubtedly be sore for a few months, but the vet and Ben managed to save his life.  Givens was happy to have Rex by his side and felt that he had done something good near the end of his life. 

At this point, Givens had a realization.  He was laying in an old hotel room feeling miserable, realizing that he needed to live out his final days.  Givens had met so many nice people who went out of their way to accommodate him and his dog.  In addition, Givens realized that he was making many people happy just by being alive, including his family who would be very worried by now.  Ben decided that he would call his kids and return home with Rex as soon as possible.  His kids would know about his plans, his journey, his sickness, and would help him live out the last three months of his life. 

Ben walked to the local bus station and bought a ticket for his hometown.  While traveling, he talked to a young girl about philosophy and religion, and what might happen in the afterlife.  Givens informed her that he was a doctor and the young girl directed his attention to a group of three young Mexican men in the rear of the bus.  One of the men was clearly sick but refused treatment.  Using Ben’s medical knowledge and the girl’s fluency in Spanish, they managed to tell the men that the sick one needed to get to a hospital or he would likely die.  Givens had a feeling that the boy had Tuberculosis, a condition that one should not ignore.  The boys denied treatment and said that they needed to work and make money, so at the next bus stop Ben called an ambulance to come pick up the man.  Both Ben and the young girl knew the man was in the country illegally and could be deported, but he would be better off deported than dead. 

After the young man and his brother were transported to the hospital against their wishes, Ben noticed the other young Mexican man standing around, not knowing what to do next.  Ben ended up buying him dinner and calling the local job services bureau where he found the man a job picking apples at the nearby Wolfhound Orchard.  Ben and the man ate steaks together, Ben paid for dinner, and they rented a car to leave town.  The two set out for the Orchard to make sure the man would have a job, and Ben stayed the night in a small cabin on the Orchard’s grounds.  The Mexican man came into Ben’s cabin late at night and lit a fire for him in order to say thanks.  While in the cabin, another person entered to tell Ben that a woman was in labor and the baby would not come out.  Ben did not think twice to get out of bed and run as quickly as a seventy year old man could run to her cabin.  When he entered the cabin, he saw an overweight woman with a blue baby that was obviously stuck.  After some manipulation of the baby’s arms and umbilical cord, Ben delivered the fifteen year old girl’s baby.  He was the hero of the night and returned to his cabin for some much needed sleep.

In the morning, Givens is woken up again by the lady-of-the-house at the Wolfhound Orchards.  Ben realized that this is the home of the man who stole his shotgun on the dirt bike, and this was likely his wife or mother.  He told the woman the story of his dogs and his gun, but did not care to get revenge at this point.  Ben simply wanted to be home again near his family and those he loved.  The woman felt bad for him and was thankful that Ben delivered a baby the night before, so she decided to drive him home, several hours in each direction.  Before they left in her truck, Ben saw the man who stole his gun approach and walk toward the woman’s house.  Ben yelled for him and walked up to him, not looking for confrontation, but knowing that something had to be said to make things right.  He told the bad man that the shotgun is cursed and the man can have it.  It was somewhat of a relief for Ben to give up on his gun.  He said that guns never bring anything but bad luck and the man had his share of bad luck on the way. 

While driving back to Ben’s hometown over the mountains, the woman and Ben had great conversation about life and how valuable it is to an individual.  This reinforced Ben’s thoughts even more that he belongs at home with his family.  He needed to live out the rest of his days with his kids so they know the truth about him and can feel closure when Ben dies.  He eventually returns to his small home and finds things exactly how he left them.  Being at home provided him with comfort and a feeling of relief.  Ben curled up in his warm bed and pulled Rex’s bed alongside his.  The story ends with them both laying in their own beds next to each other, a man with his companion, both wanting to live to see another day. 

East of the Mountains is a dramatic book which makes you think about how valuable life is.  Ben Givens was a man who had given up on life due to his age and terminal illness, but realized through his journey that you can never give up on life.  His medical knowledge and simple, yet witty personality led him to make friends and provide valuable services to those he met along the way.  The plot is intertwined and the flashbacks add another level of complexity to the story.  In addition, Guterson’s writing style is rich and descriptive, allowing the reader to form a mental image of the settings which Ben Givens travels through.  Overall, this book is rated a 4.5 out of 5.