Book Review: Admissions by Henry Marsh

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BRUNO REYNELL DISCUSSES THE NEW MEMOIR BY NEUROSURGEON, HENRY MARSH

‘Only neurosurgeons understand how difficult it is to be so hated, especially when you haven’t even done anything wrong, and only tried to do your best.’ These are the words that neurosurgeon Henry Marsh recalls himself saying whilst trying to console a troubled colleague who had just lost a patient.

Reading his latest book Admissions: A Life in Brain Surgery, the unrelentingly demanding nature of neurosurgery is something that strikes you again and again. This is not a field of certainties, where the course of action to be taken is immediately obvious and indisputable. As such, when things do go wrong, the knowledge that a different choice could have been made is particularly onerous.

Admissions is an episodic memoir written after Marsh’s retirement from his full time job in the NHS, in which he recounts a series of poignant moments, taken from his life both within and outside the hospital. Like his previous book Do No Harm, there are still many captivating passages where he takes the reader into his operating theatre at St George’s Hospital, and details surgeries that he or others have performed.

However, in Admissions, Marsh has widened the scope of subjects he writes about. Indeed, several chapters of the book are spent describing his time spent in Nepal and Ukraine, chapters which serve as a sharp reminder of the privileges we in the UK enjoy with the NHS.

Another wider notion explored in Admissions is that of things coming to an end. First, of course, there is his profession. He looks back on his career and ponders what it has meant to him and whether he will miss it or not. However, inextricably bound to this is the idea of approaching the end of his own life. Marsh recalls the dementia that his father suffered from, and examines practices such as euthanasia as he tries to understand what lies in wait for him during his remaining years, as well as how he should approach these complex issues.

The frankness and unflinching honesty with which Marsh approaches such topics is a thing of rarity. He will not mince his words, and this is most apparent when he discusses the state of public healthcare in the UK. The NHS is something he has great belief in, and he directs great vitriol towards anything contributing to its deterioration, from privatisation to utterly unhelpful government targets.

However, despite the occasional ferocity of his language, Marsh’s writing is exquisite. Upon reading Admissions, you get the impression that he could easily turn his hand to writing suspense-filled thrillers, or the most elegant of nature writing, with equal distinction.

He would, however, most likely refute this claim, if his book is anything to go by; Marsh is harsh on himself, while at the same time effusive in his praise of others (should they be deserving of it). Overall, Admissions is the portrait of a surgeon weighed down by the responsibilities he feels, as well as the reflections of a man seeking to clarify his ideas on life and death. As such, you come out of reading it with enormous respect, both for the man and for the profession.