This one is for you if you’re interested in the life of a brain surgeon that is happy to discuss his mistakes and criticise the NHS.
As patients, we tend to put our doctor(s) on a pedestal. Maybe it’s because we want to believe they are going to solve our problems, regardless of whether they can. Maybe it’s because so many patients can’t imagine the responsibility of being a doctor, so think that they must be ‘super human’ in some way. Whatever the reason, we often don’t want to hear about things going wrong. And we are quick to criticise when they do, even if we have been warned multiple times of the risks involved in a certain procedure. One of the things I loved most about this book was that Marsh was so comfortable with appearing human. Mistakes are made by people all the time. Some are big, some are small. Some have drastic consequences, others go unnoticed. But while we can easily recognise that mistakes are a part of our imperfect human nature, we don’t often extend this hand of understanding to medical professionals. Having retired in 2015, Marsh has a wealth of experience of working in the NHS which allows him to take you step by step through the introduction of increasing bureaucracy and government targets that have sadly become so dominant today. And for those that love a bit of gore, there are some fantastic descriptions of surgery itself in this delightfully short and easy to read book.
“The idea that my sucker is moving through thought itself, through emotion and reason, that memories, dreams and reflections should consist of jelly, is simply too strange to understand.” p1
“She would be added to the list of my disasters- another headstone in that cemetery which the French surgeon Leriche once said all surgeons carry within themselves.” p5
“‘Informed consent’ sounds so easy in principle- the surgeon explains the balance of risks and benefits, and the calm and rational patient decides what he or she wants- just like going to the supermarket and choosing from the vast array of toothbrushes on offer.” p36
“As patients we are deeply reluctant to offend a surgeon who is about to operate on us.” p37
“I dislike telling patients that their operation has been cancelled at the last moment just as much as I dislike telling people that they have cancer and are going to die. I resent having to say sorry for something that is not my fault and yet the poor patients cannot very well be sent away without anybody saying something.” p97/8
“The junior doctors work such short hours that they are desperate for even the most basic surgical experience.” p119
“how strange it is that I should now be listening to a young man with a background in catering telling me that I should develop empathy, keep focuses and stay calm.” p129 This was after Marsh had worked as a doctor for 30 years!
“Life without hope is hopelessly difficult but at the end hope can so easily make fools of us all.” p139
“Surgeons must always tell the truth but rarely, if ever, deprive patients of all hope…Nevertheless, sooner or later, most of the patients, like Helen, will reach the point of no return. It is often very difficult for both doctor and patient to admit that it has been reached.” p142
On the old X Ray system of hanging them up: “the system was completely reliable and quite unlike the computers that now dominate my working life.” p156