A British neurosurgeon delivers fascinating, often harrowing stories of several dozen cases intermixed with compelling digressions into his travels, personal life, and philosophy.
In 25 chapters, each built around a neurosurgical operation (infections and strokes but mostly tumors), the author provides vivid accounts of patients before and after surgery as well as encounters with Britain’s National Health Service, which is far skimpier than America’s system (even hospital beds are in short supply). The quality of medicine, however, is first-class. American neurosurgical trainees serve in his hospital, and Marsh admires but does not share the gung-ho optimism of America’s “death is optional” surgeons. While happy to recount dramatic cures, he admits that these are not routine in a neurosurgeon’s practice and that aggressive surgery often leaves patients with catastrophic brain damage. Few American surgeons, worried about being sued (a legitimate concern), would dare write, “I am more experienced than in the past and more realistic about the limitations of surgery….I have become more willing to accept that it can be better to let someone die rather than operate when there is only a very small chance of the person returning to an independent life.” Far more than the average doctor-memoirist, Marsh does not conceal his feelings, whether dealing with patients, colleagues, assistants, or superiors, and he spares no one when matters turn out badly. Readers will share his emotions, including contempt for a penny-pinching, meddling government. Unlike American doctor/government haters, there is no sour right-wing ideology or any impression that he is defending an obscenely high income. Nor does he trumpet his compassion; that is never in doubt.
Beautifully written and deeply moving—one of the best physician memoirs in recent memory.