Henry Marsh

One of my most favorite writers is Henry Marsh, longtime brain surgeon of the NHS before his retirement in 2015.

Little did I realize the double entendre of the book title when I first picked up his memoir Admissions. Once you have read the book yourself, you will know it isn't just narrative of patient admission under his care; Henry Marsh is making confessions or admissions of himself. And he had even been admitted to a psychiatric ward as a patient.

He didn't pretend to be perfect. He has his flaws as doctor and as human. Like most doctors, he has made his share of mistakes, hurt more people than we should have, and, at times, behaved not so properly. He was probably considered to be one of the worst offenders by the hospital managers. One good example is the sin of his wearing suits and ties to work, for which Henry Marsh considered a sign of courtesy to his patients, but then condemned as a breach of infection control in the NHS.

The next error picked up by the managers is his disinterest in diagnostic coding when patients were discharged. The penalty doubled when Henry Marsh didn't make sure that his juniors completed the computerized work. I don't have to tell you how the increasingly depersonalized health care system frustrated Henry Marsh.

If there is one lesson I learn well from his story, it is the way sick patients were handled in Nepal. One sixty-something man was brought to hospital with fixed and dilated pupils, after a catastrophic bleeding inside his brain. The scan showed an undoubtedly fatal bleed. Henry Marsh agreed. When the family was told there was no treatment, they took the brain-dead patient home, squeezing a respiratory bag connected to his lungs. The unusual hand-bagging story struck Henry Marsh as a very humane solution: "He could die with some dignity within the family home, with their loved ones around him, rather than in the cruel impersonality of the hospital."

I can't agree more.