A Neurosurgeon to Die For … Revisited

It was eight years ago that I introduced you to the British Neurosurgeon Henry Marsh in a blog titled A Neurosurgeon to Die For. I wrote then that I hoped to be blogging about Mr. Marsh (neurosurgeons in England are misters) numerous times, but alas there was not much else to write about. He followed up Memoir #1 with Memoir #2 two years later and now, five years later, has written a book confronting his own terminal diagnosis. And now there is much else to write about.

It sounds odd for me, someone soon to be 71 in a few months, listening to someone soon to be 73 saying “at my age I have nothing to complain about”. In his video, indicative of some of the contents of his book, he makes a compelling argument for the patient having a choice of dying with dignity.

In his review of the book for the New York Times, Kieran Setiya writes: “It was said by the Roman philosopher Cicero that to philosophize is to learn now to die. He was echoed by the 16h-century essayist Michel de Montaigne, sometimes in earnest, at other times in jest: ‘If you don’t know how to die, don’t worry,’ Montaigne playfully concluded. ‘Nature will tell you what to do on the spot, fully and adequately’. We don’t need to learn the biological mechanics of dying in order to die. But it may help to know them in facing death. If the philosophers haven’t figured out how to do that – at least not to everyone’s satisfaction – might a physician have more luck? Henry Marsh is an author and retired doctor, in whom, said The Economist, ‘neuroscience has found its Boswell.'”

SUMMARY And Finally: The Matter of Living and Dying by Henry Marsh ...

There is an incredible amount of wisdom packed between the covers of this comparatively small 224 page book. Here is one of the more poignant, early passages:

“Hope is one of the most precious drugs doctors have at their disposal. To tell somebody that they have a 5 per cent hope of surviving is almost as good as telling them they have a 95 per cent chance, and a good doctor will emphasize the life-affirming 5 per cent without denying or hiding the corresponding 95 per cent probability of death … Hope is not a question of statistical probability or utility. Hope is a state of mind, and states of mind are physical states in our brains, and our brains are intimately connected to our bodies (and especially to our hearts).”

Regarding supposed medical facts, consider the following set of Marsh-isms:

“Surgeons all learn to take the medical journals, full of amazing results that we could never replicate ourselves, with a pinch of salt. And yet there is always an element of sour grapes as well, driven by the fear – like Snow White’s evil stepmother looking in the mirror – that perhaps there are other surgeons who are better than you are … so you have to learn as best you can, and this involves both deception and self-deception. All surgeons go through a difficult time at the beginning of their careers when they must pretend to their patients that they are more experienced and competent than they really are. In fact, this starts as soon as you become a doctor. There is nothing more frightening for a patient than a frightened doctor, and as a young doctor you are often frightened. So you have to hide your feelings from your patients. I don’t remember anybody ever telling me this- you just learn it instinctively.”

There is much more to commend from this book, and I leave the rest of the assignment of reading it to you.

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