AANS Neurosurgeon | Volume 28, Number 4, 2019


Admissions: Life as a Brain Surgeon by Henry Marsh, MD – A Review

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Admissions: Life as a Brain Surgeon
Henry Marsh, MD 
Thomas Dunne Books
St Martin’s Press 
New York 2017

Do No Harm, published in 2014, became a best-seller and made Henry Marsh, MD, a household name.  After publishing it, he retired from his practice in London. He now devotes his life to his hobbies of woodworking and construction as well as continuing his travels to Ukraine and Nepal, where he still does neurosurgery. This book, as well as his earlier one, honestly reflects upon his 40 years as a neurosurgeon.

The book begins and ends discussing his death. To start:

“I like to joke that my most precious possession, which I prize above all my tools and books, and the pictures and antiques that I inherited from my family, is my suicide kit, which I keep hidden at home.”

He closes the book by bemoaning the fact that England does not have an assisted suicide law. In between, there are valuable recollections and proof of his value as a storyteller.

Forthrightly, he admits his struggle with aggression and admits to being competitive and impatient. (Sounds like many neurosurgeons I know.) And as with his first book, he recounts miscalculations and surgical catastrophes. Many will appreciate his stories of real neurosurgical patients as much as I did.

In contrast, some may flinch at his harangue against American medicine:

“The faults of socialized health care are ultimately less than the extravagance, inequality, excessive treatment and dishonesty that so often come with competitive health care.”

But then he criticizes health care everywhere by saying,

“There has always been a tension at the heart of medicine, between caring for patients and making money.”

Despite his faults, throughout his neurosurgical career Dr. Marsh worked hard to reduce suffering and provide excellent care. He postulates that we often prolong life at a tragic cost for our patients and those who love them. In this era where burnout too often gets top billing, many neurosurgeons may find solace in reading the reflections of another neurosurgeon, especially one as gifted at writing as Dr. Marsh. Admissions is a ruminative and introspective memoir.

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