Compassionate, informed advice about healthcare decision making

published by Hank Dunn - August 28th, 2012
22 Years, 3 Million Books

A couple of weeks ago I passed the three million mark for books sold. Mostly it was the Hard Choices book but also 80,000 or so Light in the Shadows. Who could have predicted?

In 1990 I had been a nursing home chaplain for seven years when the Fairfax Nursing Center published the first edition. We printed 1,000 books. I told my administrator I thought we could sell enough to pay for the printing. We sent copies of Hard Choices to 100 other nursing homes in Virginia and sold 4,000 books. It was a simple 36-page booklet to help patients and families with end-of-life decisions.

Lucky timing on my part

In 1991 a federal law, The Patient Self-Determination Act, kicked in, which required all hospitals, nursing homes and hospice programs to inform patients or their families of the right to an advance directive and a right to refuse treatment. Hard Choices did just that. Lucky timing on my part. We sold over 50,000 copies in 1991 as facilities were scrambling to comply with the law.

I tweaked the book a little and released the revised edition in 1992. The book was selling very well. We only accepted cash sales so there was no invoicing nor credit cards to process. It was so easy I decided to start my own publishing company. In 1993 A & A Publishers, Inc. was incorporated. The name came from my kids, Aaron and Ashley. The following year I released the Third Edition of Hard Choices.

I left the nursing home in 1996 to have my life changed by being a hospice chaplain. I gathered so much experience and was touched by so many lives, I was inspired to write a follow-up to Hard Choices. Light in the Shadows: Meditations While Living with a Life-Threatening Illness explores the emotional and spiritual issues brought on by a terminal illness.

“Looks like you have found your niche Hank.”

It was 1999 and I gathered my hospice co-workers to publicly “release” the new book. After my little presentation to my friends, a social worker came up to me and said, “Looks like you have found your niche Hank.” I immediately responded, “My niche found me.”

It was so. I became a nursing home chaplain out of a period of unemployment. Needing work I had the opportunity to work half time at the nursing home. That was the fall of 1983 and by that winter I asked the nursing home if we could make it a full-time job . . . they said yes. I was chosen as the point person to speak to all patients and families at the nursing home about end-of-life decisions. I read everything I could on the topic.

“Hank, but do not put it in writing.”

I first proposed writing a pamphlet about the hard choices at the end of life in 1986. To a person the nursing home Ethics Committee said “No way. Do what you are doing, Hank, but do not put it in writing.” Two years later the medical literature mounted pointing to the futility of many treatments on nursing home patients. I could wait no longer and I went ahead and wrote a draft. That same committee said, “This is great! Go for it.” Classic “easier to get forgiveness than permission” scenario.

My niche found me.

I had buried enough 52-year-olds to know there is no guarantee on my life.

By 2000 I had buried enough 52-year-olds (my age at the time) to know there is no guarantee on my life. I had paid off some debts. Kids were out of college. Books were selling well and I made some income speaking. I was going to ask the hospice for a year sabbatical but then I thought, “If I can live without a paycheck for a year, why would I come back to work?” So I quit my day job at hospice in August. In 2001 I did a major revision of Hard Choices with the Fourth Edition. In 2002 sales passed the 1 million mark and reached in 2 million in 2007.

In 2004 I traveled with my sister and her family to Thailand. I had been planning a second edition of Light. The jet lag had me up at 2am, wide awake for days. I got on my laptop and banged out most of the new chapters I included in the second edition. I published it in 2005. It included the first published revision of my poem “Giving Up and Letting Go” to “Giving Up, Letting Go, and Letting Be.” You find that now in the 2009 Fifth Edition of Hard Choices.

Oh yeah . . . we now take credit cards and will invoice you.

It is truly humbling to think that my words have impacted so many people. I am grateful.


Photo by Weston MacKinnon on Unsplash

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Quality of Life Publishing Co. is the proud publisher of Hank’s books, as well as other branded educational materials for health care & end-of-life care.

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Volume Discounts for Branded Book Orders

Minimum quantity for branded books is 100. English and Spanish branded books are sold separately. Click here for more information or contact us with questions.


  • 100 to 249 copies: $4.50 each
  • 250 to 499 copies: $3.50 each
  • 500 to 999 copies: $3.00 each
  • 1000 to 1499 copies: $2.25 each
  • 1500 to 1999 copies: $1.75 each
  • 2000 to 3999 copies: $1.60 each
  • 4000+ copies: $1.45 each


  • 100 to 249 copies: $7.00 each
  • 250 to 499 copies: $4.50 each
  • 500 to 999 copies: $3.50 each
  • 1000 to 1499 copies: $2.50 each
  • 1500 to 1999 copies: $2.00 each
  • 2000 to 3999 copies: $1.85 each
  • 4000+ copies: $1.70 each

Volume Discounts for Unbranded Book Orders

Each title/language sold separately.

  • 1 to 9 copies: $8.00 each
  • 10 to 24 copies: $5.75 each
  • 25 to 49 copies: $4.50 each
  • 50 to 99 copies: $4.00 each
  • 100 to 249 copies: $3.50 each
  • 250 to 499 copies: $3.00 each
  • 500 to 999 copies: $2.50 each
  • 1000 to 1499 copies: $2.00 each
  • 1500 to 1999 copies: $1.50 each
  • 2000 to 3999 copies: $1.35 each
  • 4000+ copies: $1.20 each