I enjoyed some areas of this book and even found it educational, but other parts were a little hard to follow. The ideas were unfocused at times, especially in the later part of the book.

I received this from the publisher in exchange for an honest review. I always enjoy reading the stories of doctors. I am very interested in the medical field and I truly find their stories and anecdotes fascinating. As for this book, I really enjoyed Dr. Marsh's stories of his time in the field and of his own medical experience. To me, as a person who has seen many different doctors in my young life, I have always been amazed by just how cavalier some doctors are when you are telling them about what is bothering you. There are few doctors these days that will take the time to listen to you and really want to help you rather than just refer you to someone else. I found it interesting to read how Marsh's experience turned from doctor to patient and what he experienced along his own journey. I also enjoyed reading about his experience as a retired doctor during the pandemic and how he although he did want to help he was nervous about being on the Covid floor. I still don't know how doctors and people in the medical field during the early days got up every morning and faced all the unknown.
There was some disjointed parts of the book and in the beginning especially a lot of medical talk that went over my head. However, putting that aside, I did enjoy this book and would recommend it to anyone that is interested in reading about a doctors own experience as a doctor but also a patient.

Title: And Finally
Author: Henry Marsh
Release Date: January 17th, 2023
Page Count: 242
Start Date: December 29th, 2022
Finish Date: January 17th, 2023

Review:

I'm not going to lie, I don't really know what I was expecting when I picked up this book. I actually can't even tell you why I picked it up. Once I found out what it was about, I was fully expecting a book full of depressing chat. I was expecting for this book to make me feel awful and overwhelmed. Especially when I found out that a doctor wrote it. However, I am happy to say that I was completely wrong. In fact, I am very impressed with how transparent the doctor was as he wrote this book. He even Made it easy for anybody to follow along with. If it was a little too complex, he took the time to explain it. I'm very impressed and very thankful that I read the book.

This was a bit of a letdown for me. I'm not quite sure what I was expecting, but I kept feeling like something was missing. The narrative was a little disjointed and rambled on at times, though there some good insights into how Marsh felt about his life as a surgeon and what he hoped he accomplished and what he wishes he could change. I wasn't a big fan of his take on assisted dying though. He is a supporter of this, but his thoughts on those who aren't just didn't sit well with me. He uses an 'us vs. them' mentally to say the only people who are against assisted dying are religious people who think people must suffer and therefore are the ones who cause all the suffering while pretending to be compassionate. I find this to be a rather ridiculous statement, especially from someone who claims to be a well-rounded and learned person. He should know there is never anything so black and white. Not all religious people are against assisted dying and not all atheists or non-religious people are for it. Attacking an entire group of people for your own perceived beliefs has never gotten us anywhere and has never ended well. Also his perceived beliefs on what he thinks religious people believe about dying and the afterlife is completely out of touch with reality. These beliefs may be held by some, but it is no way all-encompassing of the many beliefs of the world. I feel as though he's never actually sat down and listened to the many different things people believe and why. He just says he believes there is nothing after we die and more or less that anyone who believes in a higher power is an idiot. In his last years, he would do good to come to terms with his own prejudices.

I feel like Marsh had a story to tell, but wasn't really sure how to tell it, and ended up saying a lot of things that didn't need to be said while leaving out the more important parts. For some people this may be a great read into the insights of impending death, but for me, it definitely fell flat.

In this memoir and set of essay reflections, Dr. Henry Marsh walks through his retirement years from neurosurgery into finding out about aggressive prostate cancer and finally completing treatment. The doctor becomes patient narrative is interesting and might be useful for men navigating this difficult disease. His story is, of course, remarkable and not typical - as very few of us are brain surgeons. He does digress a bit into the weeds with some of the topics - so readers should not be expecting a straight patient/disease memoir. Was hoping to hear more about his family and particularly his wife’s journey with caring for someone with prostate cancer - but this is missing.

It is possible to be both the examiner and examined. I can speak with firsthand experience of interviewing hundreds, if not thousands, of people during my career as a freelance journalist, but also can say that I found myself in the reserved role of interviewee when it came time to discuss my once-fledging fiction career. Henry Marsh knows of this duality well, too. The British neurosurgeon had operated on many patients during his career — curing many of them of cancer, but also failing to help some of them, too. However, as he recounts in his latest book, And Finally, he came to be — at the age of 70 — a patient himself not long after he retired from practice. It turns out it was discovered that he had prostate cancer: a disease which affects perhaps as many as one in seven elderly men, but usually progresses so slowly that they die from something else in the meantime. Thus, this book recounts his anxiety about the role change from physician to patient. He frets about the life he’s lived, and also worries that he’ll slide into dementia well before any cancer could kill him — not developing Alzheimer’s is something of an obsession for him, according to this volume.

However, And Finally is more than a plague journal of sorts. It works as the memoir of a man looking back on his life. Being a former neurosurgeon, Marsh waxes philosophically about his career and the successes and failures he encountered while, in a sense, playing God. Speaking of which, he offers his thoughts on the afterlife. That’s not all. He additionally talks about his fear that his second wife will succumb to COVID-19. He discusses building a doll house for his daughter that has been passed down to his granddaughters. Fairy tales that he has dreamt up for them take up some real estate here, too. All in all, this is a book that doesn’t have much of a plot — much of it is rather random. Instead, this is the story of a man coming to terms that he’s nearing the end of his life, whether or not his cancer kills him immediately, and And Finally can be read as a series of thoughts and possible regrets that Marsh has had as he came to terms with his mortality. And that means jotting things down as he thinks of things, certain that if he hesitates the thoughts he has will vanish forever.

This is one of those books that’s tough to review because the story presented is so personal and raw. Death is not an appealing business and Marsh even contemplates the legalities of doctor-assisted suicide as he grapples with his diagnosis. Thus, the inclination one has to approach a book such as this is to be as gentle and careful as possible. Thankfully, Marsh is the type of person who seems amiable and agreeable, which makes hearing from a so-called “Old Timer” rather refreshing. After all, most people of a certain age — particularly if that age is, oh, 20 — don’t think about dying and aren’t usually forced to confront the reality that, like it or not, there will come a day when we will all cease to exist on this planet. I found, though, that And Finally was Marsh tapping into a sort of fountain of youth. Think of it this way: whether or not Marsh has died upon the completion of this book (which I want to keep vague to not spoil anything for would-be readers), he will have still left behind a physical product that will form part of the legacy of his time here on earth. As I’ve come to learn, writing can be a form of immortality — who knows what family member some 100 or 200 years from now will search through the archives of their ancestors and discover written artifacts such as this book? (Or, in my case, this book review and others of its ilk. Along with some bad poetry and questionable fiction, but let’s not go there.)

I suppose this goes a long way to say that And Finally is an interesting read. I’ll pause there. “Interesting” is an overused word that is a polite way of saying sometimes that one doesn’t know what they think of something that’s being presented to them. However, in my case, I’m using the word as literally as I can. While I have to admit that while some of the scientific-speak of this book — particularly around how the brain functions and human consciousness is realized — went above my pay grade, I did find myself compelled to keep reading anyway. Reading this book is a little like being a fly on the wall in your family doctor’s office after your ailment has been addressed and you’ve been sent on your way: the book does delve into how physicians treat their patients behind their backs and the things that they say to them to give them “false hope” and alleviate their fears in the face of some grim, if not unbearable, news. In that sense, you can probably see how I’m using the word “interesting” in its truest sense. While some may find this narrative to be rather disjointed in parts, as this book can read like a person having something of a one-sided conversation with himself, others, like myself, may find themselves being enchanted by a rather novel treatment of something everyone at some time is going to have to address: their death.

And Finally is therefore a celebration of life and knowledge. This is the narrative of a man who wants to put what he feels is important down on paper while he still has the chance. For that, we should all be appreciative. Don’t miss the opportunity to watch a professional within the top ranks of his profession admit his failings and mistakes, but also marvel at the sometimes wonderfulness of life. And Finally presents the rare opportunity to see someone interact with both ends of the spectrum when it comes to being the giver and the receiver. Thank God a book like this has been written, even if Marsh does have his doubts if one — sometimes including himself as one — exists. There’s something truly special about this one, and it’s, ultimately, magic.

And Finally offers much food for thought.
Author and neurosurgeon Henry Marsh was diagnosed with advanced prostate cancer shortly after retiring from his practice.
I had previously read his book Do No Harm, and thank St. Martin's Press and Netgalley for the copy of And Finally for review.
Many different topics make up this deceptively slim volume.
Marsh touches his on his career and overseas work, and experiences in his neurosurgery practice.
This contrasts to his account as a patient. He notes the change of being "no longer a self-important surgeon" but a client.
Marsh delves into philosophy, neuroscience and cognition, ethics. Existence and humanity, to the cellular level.
These thoughts shift throughout to descriptions of his cancer treatments and the science behind them, to preparing for death should that become the case.
It reads a bit unfocused at times, but memoirs are what the author wants.
There's a lot to unpack, and it won't be for everyone. I definitely recommend reading Do No Harm prior to And Finally.
For release on Jan. 17.

I have no idea what this book is trying to tell the reader. It seems to be the musings of a man who thinks he is old, despite only being 70, and, towards the end, a drily told story of his experience with prostate cancer.

I accepted the request to read/review this book simply because I love medical books that are also memoirs and this seemed very intriguing. I had no expectations and since I have not read any of the author's previous books, I didn't know if I would even like the writing. I am here to say I did. Whew! ;-)

This book is, for lack of a better word, cerebral and often-times disjointed. The author tends to flit from thought to thought, interspersed with his retirement and subsequent terminal cancer diagnosis, creating a jumble of memories and present time. For me, it worked. I didn't try to get anything out of this book except enjoyment and listening to a man who has lived a very full life [as he is very willing to tell you throughout the book] and I found it was like having a face-to-face conversation with someone who was just telling a story and how things they were talking about reminded them of something from the past and they add that into what they are currently telling you. Typically, I am not a fan of this, but for whatever reason, in this case, it worked for me and I really ended up enjoying this book immensely and I am so glad I was given the opportunity to read it.

The author narrates this and with his excellent diction and delicious [posh] English accent, it made this book even more of a joy to listen to. You can hear the emotion in his voice when he talks about difficult subjects and his pragmatism when he discusses his cancer diagnosis and it truly adds to the overall feeling of the book. I am so grateful I had the opportunity to listen to this book; for me, it made for a much better reading experience.

I was asked to read/review this book by St. Martin's Press and I thank them, NetGalley, Henry Marsh and Macmillan Audio for providing both the ARC and the audiobook ARC in exchange for an honest review.

And Finally is the first book by the acclaimed Neurosurgeon, Henry Marsh that I had the privilege of reading. In it, Dr. Marsh reflects back upon his time as a neurosurgeon and how that affected his outlook on medical practices as he faced a diagnosis of prostate cancer.

While I found the book as a whole to be full of interesting stories and philosophy, especially as someone with a similar science-minded, non-religious brain, I also found myself puzzled at times as to the placement of the stories within the chapters themselves. Much of it, albeit exceptionally well written and easy to follow, felt disjointed at times. That being said, the author’s own admittance to increasing dementia and side effects from cancer treatment give him an easy pass on his musings.

I would recommend this book for anyone who has experienced catastrophic medical diagnoses with an intent to understand the difficult decisions doctors face in relating bad news and poor prognoses coupled along with the struggle of deciding best treatment options. The fact that Marsh’s diagnosis came on the heels of the Covid pandemic also make this book very relevant and relatable.

Thank you to Netgalley, St. Martin’s Press, and Henry Marsh for this advanced reader’s copy in exchange for an honest review.

Henry Marsh is a retired neuroscientist. When he confronts a cancer diagnosis, he is faced with confronting things in his past that he has to reevaluate. He looks back on life and death decisions and has to find what works going forward. A deed and profound look at what life looks like from a unique perspective of a neuroscientist who has to face death.

Marsh confronts himself and offers up his thoughts on his life, his profession, and life in general in this volume that is less a memoir than a meditation. A neurosurgeon who has lived a big life and written two previous books about his experience as a physician both in the UK and in Ukraine, he's thrown for a loop when he's diagnosed with prostrate cancer. And even more so when a MRI reveals that his brain is no longer the fresh vital organ he's always had = a consequence of age. Thanks to Netgalley for the ARC. There aren't any particular insights here and at times it's indulgent but it's. worthy read.

Thanks to Netgalley, St. Martin's Press, and Macmillan Audio for the ARC and audioARC of this!

This was an interesting insight into the author's dealings with medical issues after having been on the other side of the interaction for most of his life, perfect for fans of When Breath Becomes Air. Dealing with it himself made him reflect on how he had delivered hard news to patients and their families and how he could've done things differently as a doctor, but also on the good he had done and the why behind it. At 70, he sounds more active and healthy than I am at 30, which is both inspiring and a little depressing. Overall, I found this very engaging and conversational, and easy to understand.

In "And Finally", Henry Marsh follows his career as a neurosurgeon that he detailed in his early books "Admission" and "Do No Harm", both of which I have read and enjoyed. He approaches the end of his career and his reaction to a diagnosis of advanced cancer. He role in life has transitioned from a provider to a patient- one that he struggles with. He traveled around the world providing medical care, and with the COVID-19 pandemic, is stuck at home. While his previous books focused more on his career as a neurosurgeon and the interesting medical cases he encountered, this is focused inward. There is not a cohesive journey throughout this book, outside of his journey to accept his diagnosis. I found it somewhat unfocused and meandering at times- musings more than a clear thesis, but it was still interesting to read about his latest stage of life.

Thank you to St. Martin's Press via NetGalley for the advance reader copy in exchange for honest review.

Thanks Netgalley for allowing me to read this book. A surgeon for many years is now retired. He is shocked when he is told he has cancer. He struggles with the diagnosis and being a patient. This book took us on a thoughtful journey about dealing with an illness.

Henry Marsh started out as a student of philosophy at Oxford, but “fled to the more practical world of medicine,” partly (perhaps) because he feared he was “not clever enough to understand philosophy.” For the next forty years he was a neurosurgeon, but modestly explains that he is not a scientist - to claim so would be to “like saying that all plumbers are metallurgists.” He became a man of practical action: he cuts open people’s heads and brains; he is a devoted woodworker and builder of things by hand (even though his roofs may leak). He runs. He bicycles. He hikes across mountain ranges. He keeps bees. He also keeps a journal, and - as his previous books (Admissions: A life in brain surgery and Do No Harm: Stories of Life, Death, and Brain Surgery) suggest - ponders questions personal, intellectual, and philosophical about his life and career.

Which is, apparently, coming to a close. After retiring from medicine, he volunteers for a study of brain scans in healthy people. He assumes his scan will be a fine example of a 70-year-old brain kept lively, supple, and unchanged from his long regimen of activity. But when he receives the copy of the scan, he is afraid to look at it. When he finally does, it shows him a shrunken brain speckled with “white-matter hyperintensities,” typical of aging. “…My brain is starting to rot. I am starting to rot. It is the writing on the wall, a deadline,” he says. But he feels fine, lives normally, so learns to shelve the distress.

As he does with some other symptoms, which he ignores or minimizes for years, choosing to think they indicated common older-man benign prostatic hypertrophy. When he at long last seeks medical attention, he initially wants to attribute his sky-high prostate-specific-antigen to pressure on the prostate from his bicycle seat as he rode to his appointment. However, what it really is is advanced prostate cancer. Strangely mixed with his dismay at this dire diagnosis is relief that he has likely been released from a greater fear of dementia, triggered by his father’s decade-long suffering and the ominous “pox” on his brain scan.

George Eliot’s magnificent novel Middlemarch describes a moment when the rigid, lonely, self-absorbed, and bitterly disappointed old scholar Causaubon has been diagnosed with an incurable heart ailment. “Here was a man who now for the first time found himself looking into the eyes of death—who was passing through one of those rare moments of experience when we feel the truth of a commonplace, which is as different from what we call knowing it, as the vision of waters upon the earth is different from the delirious vision of the water which cannot be had to cool the burning tongue. When the commonplace “We must all die” transforms itself suddenly into the acute consciousness “I must die—and soon,” then death grapples us, and his fingers are cruel…” Henry Marsh movingly explores that moment and the months that follow.

At this point, And Finally morphs into a more or less typical health-professional-gets-sick memoir. Theresa Brown’s recent Healing: When a nurse becomes a patient is one such - an expert oncology nurse is diagnosed with breast cancer, and discovers that being at the other end of the radiation beams is a revelation: all the things she never noticed or understood about what her patients actually felt or thought or experienced as she briskly gave treatments and managed complications while tut-tutting “Hey, we saved her life!” if they complained. Similarly, Marsh undergoes uncomfortable, embarrassing, and frightening procedures. Like many other patients, he frantically googles for information on survival rates, treatment options, complications. He, of course, is well equipped to understand the technicalities and statistical probabilities… and he still freaks out at times. Will he die of his disease, or with it? Will he see his granddaughters grow up? (Probably not, he concludes.) He cries. And he looks back on patients he realizes now he did not serve as well as he could have. He recalls a patient (an actor) whose delicate and difficult surgery left her with a permanently damaged face. He meets her again some years later, and she tells him: “I could see that you were so upset when you saw me after the operation, that I forgave you.” He muses on the difference between telling a patient he has a 5% chance of surviving versus a 95% chance - regardless of the actual number used, if there is any chance at all, they will take hope from it. He endures the indignities and depersonalization of the modern healthcare system: his anthropologist wife remarks that hospital patients ask each other the exact same question prisoners do when they meet: “What are you in for?” Information and instructions are provided in the form of generic printed handouts rather than conversation. Hospital balconies with lovely views are locked and off-limits to patients. Radiation departments are often deep in the lower levels, but those who have managed to place a sunlit window or even a mural of a beautiful landscape bolster their patients’ morale. (He got funding for and oversaw the creation of a garden for the use of neurosurgical patients at his hospital, and considers it one of the prime accomplishments of his career.)

This is a smallish book, but Marsh packs a lot into it. His voice is serious, clear, and steers well away from any sort of “inspirational” revelations or triumphant acceptance of his cancer as any sort of “gift.” There are detailed technical explanations of prostate cancer radiation treatments and brachytherapy, which may overwhelm a patient seeking a layperson’s understanding. Marsh’s personal beliefs do not include any sort of afterlife, and his discussion of the life-extension movement is bitterly critical. Even as he so longs to live, he pleads passionately in support of accessible, compassionate assisted-dying services. This is personal and powerful. A reminiscence about the elaborate doll houses he built for his beloved granddaughters is touching; a very long description of fairy tales he has written for them, overstuffed with dragons and unicorns and magical objects of all kinds, is less so. The book rambles and swerves at times, jumping back and forth from memory to contemplation of the future, from former patients to current doctors, from woodworking to brain surgery, from medical journals to children’s stories, from London to Ukraine (where he volunteered for many years, and his heart aches for that country’s woes now), from hope to terror and back again.

In a lovely passage, Marsh muses over his hoard of exotic woods with beautiful names he has collected - burr elm, spalted beechwood, cocobolo, sandalwood - and the places they came from, and what he planned to make with them. What will become of all of it? For “I am constantly having new ideas of things to make with all this wood – but the fact of the matter is, whatever happens, I will not live long enough to use even a fraction of it. I would look at my hoarded wood with deep pleasure, but as old age and decline approach, this pleasure is starting to fade and instead is replaced by a feeling of futility, and even of doom – of the future suggested by my brain scan. Besides, anything I now make will outlive me, and I should only make things that deserve to survive in their own right. I no longer have the excuse of the craftsman – who sees all the faults, often invisible to others, in what he has made – that I will do better next time.”

As it happens, Marsh’s cancer responds well to his therapies. He likely has more time ahead of him than he feared - but perhaps no more books. This rambling, effusive, thoughtful exploration of the mind of a man facing down the “commonplace” that he must die, and soon, is useful and moving.

I really enjoyed this heartfelt memoir. The author's insights into complex issues surrounding death and dying really made me think. Marsh's reflections regarding his surgical career and his cancer diagnosis were very moving.

Henry Marsh, the author of this book of memoirs, is a retired British neurosurgeon. This is the book he wrote after being diagnosed with a prostate cancer. He shares how he experienced the role switch from a doctor to a patient and what he learned in the process. The book is not morbid; he is very clearsighted even though at first he goes through all the states of mind, from denial and anger to acceptance just like any person would. Dr. Marsh says, "We have a duty to be optimistic." The book would be helpful to both doctors and patients. For the rest of us, it is equally educational and entertaining. There are many important issues the doctor discusses in the book: his assessment of his career, the issue of trust between the doctor and his patient, his thoughts on dying, the story of his family and his volunteer help to the doctors in Ukraine. But most of all, it is simply a pleasure to follow author's musings on whatever catches his mind's fancy.

This book was written by an older Neuro surgeon. he writes about his life having prostate cancer. Amusing and philosophical, it was one man's story about coming to terms with what is important to him and why he did the things he did.
Overall, not a bad book, just an okay book.

This is the first book i read by Henry Marsh and it's a reflection on life and death, illness and health. I don't always agree with the ideas but this is a book that you can't read and relax.
You read and think and reflect.
The MC was well developed, not always likeable, and interesting person.
I found it interesting and it's highly recommended.
Many thanks to the publisher and Netgalley for this ARC, all opinions are min