ADMISSIONS

A retired British neurosurgeon delivers the follow-up to his well-received debut memoir, Do No Harm: Stories of Life, Death, and Brain Surgery (2015).

The author’s first book received rave reviews and sold well. While follow-ups to exceptional first books have a spotty record, readers who open Marsh’s sophomore effort will quickly realize that they are in the hands of a master. Now retired, Marsh looks back over his life and career but mostly recounts his volunteer work in Nepal and Ukraine, extremely poor nations with abysmal medical care. He meticulously describes his successes but, as usual, feels more distress at failures. Ironically, these occur too often because the patients in these countries often believe that doctors can work miracles, so they often insist on surgery even after a careful explanation that it’s unlikely to help. Operating on a cerebral hemorrhage or incurable brain tumor regularly converts a quick death to a slow, miserable one. American readers will note that this belies Marsh’s statement that “only in America have I seen so much treatment devoted to so many people with such little chance of making a useful recovery.” They will also learn of his admiration for American surgeons and his opinion—widely shared—that because they are paid each time they operate, they do so too often. In all his travels, the only nation where the subject of payment has never arisen is Britain. Marsh justifiably rages against elected officials who could eliminate the National Health Service’s most desperate need, money, by raising taxes but don’t because it might endanger their chances of re-election.

Another thoughtful, painful, utterly fascinating mixture of nut-and-bolts brain surgery with a compassionate, workaholic surgeon’s view of medicine around the world and his own limitations. Readers will hope that a third volume is in the works.