Written by American author David Guterson, East of the Mountains, 1999, tells the story of seventy-three-year-old retired cardiothoracic surgeon Dr. Ben Givens. Following a recent terminal colon cancer diagnosis, widower Dr. Givens sets off on one final hunting trip with his two dogs: Tristan and Rex. In order to save himself and his family from a long painful death, Dr. Givens plans to commit suicide on the trip, staging it to look like an accident.

One of the major themes of the story is death. Dr. Ben Givens's terminal cancer diagnosis, his planned suicide, and the death of his wife Rachel are central to the narrative. Ben’s other experiences of death are also significant—the death of his mother following a long illness led to him training to be a doctor. The near-death of his friend then led to his ambition to become a surgeon.

Perspective is also a significant theme. Ben’s perspective on life and death changes from the beginning of the novel to the end. Although nothing physically changes for him, and he is still dying, he no longer wishes to end his life prematurely but desires to live what is left of his life to the fullest.