Admissions: A Life in Brain Surgery

Writing as someone who has been operated on by Mr Marsh nearly 30 years ago, and to whom I am eternally grateful. If you were looking for a book full of happy endings of successful treatments and satisfied patients then don't read this book (although I am sure there will be hundreds/thousands of such cases). This is candidly and brutally honest about his own shortcomings, as well as of the healthcare systems he was part of. There are many regrets, failed relationships both personal and professional. The stories are all still very interesting, and full of lessons to be learned, even if sometimes that lesson is too late for some. Considering also what we know now about Mr Marsh's condition (spoiler alert - see his latest book), some of this book is remarkably prescient, even in the very first sentence talking about his "suicide kit", and ending with his thoughts on the balance of ongoing treatment versus being able to "ease the suffering" as it's euphemistically put. All that aside, it's still very engaging, interesting, and fascinating to hear the thoughts, warts and all, of a long and very distinguished career.

This is an interesting further account of Henry Marsh's career. This book is more reflective than Do No Harm, as he comes to terms with advancing age and his eventual death. I enjoy his wry humour, his ability to criticize himself and his honesty about when things go wrong, or he gets them wrong. He comes across as a very human man, and not all surgeons manage that along with the ability to operate on people. Clearly he has agonized over some decisions and their outcomes. Well worth reading.

Truly wonderful book. And very different to his first which was an insightful and fascinating insight into medicine and neurosurgery from the perspective of an expert. Rather than “more of the same” this is very different. Didn’t grip me at first. But as I got into it started to appreciate it was more the story of a life, perspectives on medicine, the NHS, and how our lives and culture compares to this places as distant in miles and outlook as Nepal and Ukraine. At times gentle. At times rather deep. I found reading (and listening as the audio book narrated by the author was rather wonderful) to the views of a gentleman towards the latter end of his career and life reflecting not just on what he had learned professionally, but also personally, warm, comforting and genuinely thought provoking. “I wish I were a sea squirt, If life became a strain, I’d veg out on the nearest rock And reabsorb my brain” “75% of our lifetime medical costs will be incurred within the last 6 months of our life incurring expenses against the statisticians odds and inflicting a cost on society” “I am a neurosurgeon. I know that everything I am, everything I think and feel, consciously or unconsciously, is the electrochemical activity of my billions of brain cells, joined together with a near-infinite number of synapses (or however many of them are left as I get older). When my brain dies, ‘I’ will die. ‘I’ am a transient electrochemical dance, made of myriad bits of information; and information, as the physicists tell us, is physical. What those myriad pieces of information, disassembled, will recombine to form after my death, there is no way of knowing. I had once hoped it would be oak leaves and wood.”

I was eager to read the follow up to his first book, Do No Harm, and was not disappointed. Admissions (a great title for a medic, chosen by his wife) is more reflective - about his family, his education and career. His passion for fine woodworking, coupled with his DIY skills (and errors) is cleverly weaved into his dedication to neurosurgery. In fact, great care is needed in both creating a masterpiece in wood and operating on the most challenging of organs, the brain. The difference, of course, is that a tiny mistake in brain surgery can have catastrophic consequences. What comes through so clearly is Henry Marsh's great humanity, generosity, and treating patients as vulnerable, worried people, and not as objects. He is frustrated - and angry - as doctors and surgeons have been relegated and subsumed within a managerial culture in the NHS, and he often despairs at his impotency in working and training surgeons in hospitals in Nepal and Ukraine given the lack of resources and experince (and not least his lack of understanding the languages). This is a very readable, bitter sweet account of his life and work, plenty of sad regrets, but many joyous high points. We all hope that when we need medical care we will be treated by such a professional as Henry Marsh, who is frank, honest and sympathetic - and an expert at doing the job. The NHS should pay a lot more attention to the frontline Henry Marshes of this world and less to the profit and loss obsessed paper-pushers.

book looked old, blackened at the edges of the cover and frayed at the edges of the spine.

My father was a neurosurgeon...retired in the early 90's. This was a very interesting read. Marsh is a consummate writer. While I do not hold his world view and find it tragic that he feels death will be the solution for people who lack faith in the God of the Lord Jesus Christ, I still enjoyed his perspective on many moral issues. I know I would enjoy conversing with him over a cup of coffee. He reminded me somewhat of my father. It is rare in today's world to find a truly deep thinker who can articulate his thoughts in an understandable as well as winsome fashion. I gave the book to my son who is an anesthesiologist.

Having enjoyed 'Do no harm' I was interested in reading his follow-up book which although not quite as compelling as the first book is very well worth reading.

Le riflessioni del grande chirurgo Henry Marsh a fine carriera. Ci sono gli aspetti personali: gli effetti del lavoro sulla vita familiare, le asperita del carattere, le illusioni e l'arroganza della gioventu, la tensione che lo ha sempre accompagnato. Ci sono di pari passo le rifessioni sui cambiamenti progressivi della professione del neurochirurgo in un sistema sanitario che cambia (in peggio) e che rischia di diventare sempre più simile a quello statunitense. L'intelligenza dell'autore rende il libro sempre interessante ma rispetto ad "admissions" sicuramente più malinconico e amaro

My self having undergone neurosurgery, this books gives great insights from doctors perspective. Must read (if they can) for people like me. Take care