And Finally

Matters of Life and Death

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Pub Date Jan 17 2023 | Archive Date Jan 31 2023


From the bestselling neurosurgeon and author of Do No Harm, comes Henry Marsh's And Finally, an unflinching and deeply personal exploration of death, life and neuroscience.

As a retired brain surgeon, Henry Marsh thought he understood illness, but he was unprepared for the impact of his diagnosis of advanced cancer. And Finally explores what happens when someone who has spent a lifetime on the frontline of life and death finds himself contemplating what might be his own death sentence.

As he navigates the bewildering transition from doctor to patient, he is haunted by past failures and projects yet to be completed, and frustrated by the inconveniences of illness and old age. But he is also more entranced than ever by the mysteries of science and the brain, the beauty of the natural world and his love for his family. Elegiac, candid, luminous and poignant, And Finally is ultimately not so much a book about death, but a book about life and what matters in the end.

From the bestselling neurosurgeon and author of Do No Harm, comes Henry Marsh's And Finally, an unflinching and deeply personal exploration of death, life and neuroscience.

As a retired brain surgeon...

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Featured Reviews

this was a really well done memoir, I found the book to have a interesting topic and the book itself never left me bored. I enjoyed getting to know Henry Marsh from the book and enjoyed reading this. The concept was what was promised and I'm glad I was able to read this.

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I found this memoir to be incredibly interesting and so true in many ways.
As a medical professional myself, we never, ever think anything could possibly happen to us as with our patients, friends and even family! How could it?
Yet- when it does, it becomes an entirely different situation. You are no longer the medical person, but the patient. How awful and humbling!
This is a brutally honest sharing of aging, worrying, and learning of illness with a fear of endings!
Well said and well done!
Thank you to #Henry Marsh, #NetGalley and to #St. Martin's Press for this ARC and allowing me to read and to provide my own review. I truly enjoyed memoir!

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Henry Marsh's And Finally: Matters of Life and Death is the third book he has written about his life as a neurosurgeon, but in this volume, he has retired and is facing life as a patient. I found his first book Do No Harm especially beautiful, but this one is slightly different because Mr. Marsh has prostate cancer.
"I worked as a neurosurgeon for over forty years. I lived in a world filled with fear and suffering, death and cancer. Like all doctors, I had to find a balance between compassion and detachment. This was sometimes very difficult. But rarely, if ever, did I think about what it would be like when what I witnessed at work every day happened to me. This book is the story of how I became a patient."
Marsh did not become a patient willingly. He had symptoms for quite a while that he chose to ignore, but then berated himself for his denial. It was quite surprising to me that this particular physician never entertained the idea that he could be a patient, and that he chose to ignore his symptoms like so many of us do. He also says
"But as I approach the end of my life, I find myself besieged by philosophical and scientific questions that suddenly seem very important - questions which in the past I had either taken for granted or ignored. This book is also the story of my attempts to understand some of these questions, without necessarily finding answers."
This book did feel like it rambled a bit, but I think that's understandable in light of considering important questions. Marsh had operated in Ukraine, so I valued his thoughts on the devastation there. His takes on medicine seem more measured than before because he is experiencing things as a patient. Marsh's writing on end-of-life care and assisted dying is worthwhile reading for anyone getting older. I hope his remission lasts a good long while so he can write another book, or at least finish the dollhouses for his grandchildren.

Thank you to St. Martin's Press and NetGalley for providing me with a copy of this book. It will be published Jan. 17, 2023.

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A remarkable book. Facing the potentially terminal illness, Professor Marsh is reevaluating his long and eventful life and shares his sometimes bitter reflections. While I loved his two earlier memoirs, it is this latest one that I have found the most profound and personal. His openness and humbleness (not often seen in a neurosurgeon!) are very moving.

The main structure of this book is constructed around the diagnosis and therapy of his prostate cancer, and I think everyone who has dealt with malignant tumors will find his insights noteworthy. But no less interesting are his miscellaneous thoughts on subjects from neuroscience to excercises to euthanasia.

Switching places and becoming a patient himself, Professor Marsh for the first time truly realizes how it is to be, as he puts it, a member of ‘the under-class’ at the hospital. Therefore, I hope that this book will also be widely read by public health professionals and maybe will influence their attitudes and mindsets.

Thanks to the publisher, St. Martin’s Press, and NetGalley for an advanced copy of this book.

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We all have the same ending, it won’t be in the exact same way but still it is the same ending meaning our time on earth will come to an end, yet we all don’t really talk about it that much or too deeply. Why? People say it is too depressing. Henry Marsh doesn’t let this stop him. He writes about the decline and for him the “how” possibly cancer or Alzheimer’s. I appreciated that he shared his most intimate thoughts and the science while weaving in warm family reflections of time spent with his wife, granddaughters and memories of his mother. Reading this can make one feel less alone for the end that will come as it reminds us it is shared by all. I’ll close with this quote from the book, “Why is it that only in old age, and closer to death, I have come to understand so much more about myself and my past? We are like little boats that our parents launch onto the ocean, and we sail round the world, full circle, to return finally to the harbour from which we started, but by then our parents are long gone.” It is a read worthy of your time.

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This one was really interesting and was done in a workable way of some very serious topics. I’m not really sure what I expected going into this one, but I enjoyed what I got!

I’ve always been drawn to medical things, so this one was right up my alley. Sometimes I felt the terminology used was a bit to medical-ish, but it was pretty easy for me to figure out what he was talking about. The author, Henry Marsh, has written several books about his medical career, but this one was written after he retired – and when he found out he had prostate cancer. Henry is a retired neurosurgeon but still an active part of the medical community. This book flips between his life as a patient and his life as a doctor, and how being a patient has made being a doctor different. Throughout the book Henry discusses being haunted by his past patients and those he couldn’t help.

I really enjoyed how this book talked about death and disease and what actually matters in the end. The author did a wonderful job talking to his audience and trying to connect. I enjoyed learning more about the brain, and cancer, and the struggles we face when death is at our door. While this was my first by this author, I think I might read more just because I truly enjoyed his writing style.

Thank you to @netgalley and the publisher St Martin’s Press, @stmartinspress, for my advanced copy in exchange for this honest review. Check this one out January 17th!

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And Finally made me think and that's a pretty good recommendation for a book.

It made me think about aging, regret, and facing death. It's not a depressing book, though, The surgeon had a full life that he looked back on, brain surgery, his bedside manner, his volunteering in Ukraine and Tibet. He knows his advanced prostate cancer will end his adventurous life. It makes him sad, but like I said, it's not a depressing story.

I learned so much about the brain! Fascinating things. He once found a miniature ribcage inside a brain tumor he removed from a child. Yes! There can be little body parts inside of tumors.

The doctor has a lovely style of writing. It feels like he's talking to the reader while taking a springtime stroll.

Thanks to Netgalley and St. Martin's Press for allowing me to read and review And Finally.

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I had previously read “Do No Harm: Stories of Life, Death and Brain Surgery” by Dr Marsh and enjoyed it. So when “And Finally: Matters of Life and Death” showed up on NetGalley’s list of Biographies & Memoirs available for review, I naturally requested a copy. When the book I want to read isn’t immediately available, I put in a request and am always surprised when my request is granted.

As I read the book, I was reminded of Frank Sinatra’s signature swan song, “My Way,” (“And now, the end is near; And so I face the final curtain”)
as the lyrics seem to mirror the theme of the book: facing terminal prostate cancer and reflecting on a life mostly well-lived.

Dr Marsh takes the readers through his cancer diagnosis and treatment, and despite him being a renowned surgeon, he still came across as just another patient undergoing treatment but with the knowledge of what it all “really” meant. He also reflects on how he treated his surgical patients and perhaps he could have been a bit more empathetic to their situation and feelings.

I would recommend that anyone interested in this book consider first reading “Do No Harm: Stories of Life, Death and Brain Surgery” to get an idea of the kind of physician Dr Marsh was before tackling “And Finally: Matters of Life and Death.”

I recommend this book to anyone interested in how physicians view death or the idea of facing one’s own mortality.

4/5 stars

[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion which I have given here.]

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I have read Henry Marsh's other books and am always impressed by his clear lucid prose and vivid writing, In this memoir, he details his own experience as a patient as well as a doctor. This dual perspective is fascinating,

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My thanks to both NetGalley and the publisher St. Martin's Press for an advance copy of this memoir and meditation on life, health and what ties us all together.

My father always told me never buy a car a mechanic owned. Since it was his car, the mechanic might be slow to fix things, let things go longer, knowing that eventually they would get to it, but usually didn't. Doctors can be the same way about their health. They know symptoms, warning signs, know when their own personal check engine light has been on for quite a while, but eh only sick people get sick. Not doctors. Until they do. Then they become patients in a system that they know intimately, but not from the same side. They are patients now, and everything is not the same on the other side. And Finally: Matters of Life and Death is a book about being sick, aging, elder care, and what happens, by Dr Henry Marsh, a physician who has written much about health care, but never as a patient.

Doctor Henry Marsh had been retired from neurosurgery for a while and was looking forward to repairing and refurbishing a a small shed in the country for an office, when the world began to change. First COVID-19 which concerned him as his wife had a preexisting condition and quarantining might not be enough to keep her safe. Marsh had also taken part in a medical project to look at healthy brains, and when he finally looked at his scans found a brain that was aging in ways he did not want to think about. And he was diagnosed with advanced prostate cancer, symptoms of which he had been feeling, but had ignored or pushed to the side, thinking they were nothing to be concerned about, though he knew better. The book then goes into his life after finding out he has cancer, thoughts on why he ignored his obvious signs, the state of elder care in medicine. A lot of thoughts focused on what was happening to him, and what was going to happen, as we all would think, only Marsh had a lot more information to concern him.

The book is both a memoir and a journal almost of a plague year in more ways than one. Thoughts on treatment, the state of medicine, morality and mortality fill the pages. Before entering medicine Marsh had studied politics and philosophy so Marsh has quite a lot to draw on, and use as examples. The narrative does jump around a bit, like I said the book reads in many places like a journal so a lot of things might be discussed, left unfinished and started again later. The writing is good, honest almost to a fault. Marsh is hard on himself for allowing things with his health go so far, and makes a good case for people to take more of an interest in their own bodies, find physicians they trust, if possible, as Marsh is in England which is trying to catch up to the United States in the which is more horrible to get sick in race, and be your own medical advocate. Elder care is also discussed, and that is also a sad subject, and one that I believe readers are going to be seeing a lot of books about. Being a patient has opened his eyes a lot to what is considered good and fair treatment, which makes for interesting reading.

Doctor Marsh's cancer as I write this is in remission. I would recommend this for anyone who has has a loved one, or a friend diagnosed with cancer, any kind, just to get an idea of some of the thoughts that might be going through their heads, and the treatments and how they might be treated. Not an eye opener about medical care and how it has declined, more of a look at what humans do to deal with illness, and even more our own mortality. A very interesting book, that asks a lot of questions, mainly about how we think, feel, care and what we fear of the end.

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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


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.

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𝑵𝒐𝒕 𝒕𝒐 𝒑𝒖𝒕 𝒕𝒐𝒐 𝒇𝒊𝒏𝒆 𝒂 𝒑𝒐𝒊𝒏𝒕 𝒕𝒐 𝒊𝒕, 𝒎𝒚 𝒃𝒓𝒂𝒊𝒏 𝒊𝒔 𝒔𝒕𝒂𝒓𝒕𝒊𝒏𝒈 𝒕𝒐 𝒓𝒐𝒕. 𝑰 𝒂𝒎 𝒔𝒕𝒂𝒓𝒕𝒊𝒏𝒈 𝒕𝒐 𝒓𝒐𝒕. 𝑰𝒕 𝒊𝒔 𝒕𝒉𝒆 𝒘𝒓𝒊𝒕𝒊𝒏𝒈 𝒐𝒏 𝒕𝒉𝒆 𝒘𝒂𝒍𝒍, 𝒂 𝒅𝒆𝒂𝒅𝒍𝒊𝒏𝒆.
My interest in neuroscience happened when I found out my son was on the autism spectrum many years ago, add to that my own meningioma diagnosis as well as mental health issues throughout the family line. It is interesting to me reading a memoir about a retired neurosurgeon having to face his own diagnosis and looming death. Henry Marsh was diagnosed with advanced prostate cancer, the difference is with his vast knowledge of medicine, he knows too well the reality of his disease. It’s hard to convince yourself to look on the brightside when you’ve been privy to the tragic decline of many patients’ health. The aging process alone is disturbing, particularly when your career goes beyond the wrinkles and straight to the damage internally. There is no denying the evidence, but even with his own advanced cancer, he was in denial and took a lot of time before seeking help. Now that the doctor has become the patient, he recalls former patients who faced the same anxieties and fears, how callously he sometimes behaved. How different one’s perspective becomes when it is you who are facing the advanced stages of illness, and yet detachment is sometimes a necessary evil. It doesn’t bode well to let your emotions overtake you when a life is in your hands, and you must keep your head on straight. Doctors, they say, make the worst patients, they are not used to being the one in the bed, on the table looking for certainties about what is coming.

Marsh’s memoir isn’t solely about his advanced prostate cancer, he shares insights into the medical field and how it has changed through the years, dealing with patients with far more empathy than decades ago, he shares fascinating research about the brain including the science of sleep, writes about his youth, the madness of his own behavior, the memories of patients he has treated admitting that some were left with severe damage, such as facial paralysis. He is refreshingly honest about his journey as a neurosurgeon, the mistakes he made, the evolution of his career and skills. It reminds me that doctors are humans, not gods we wish could cure us. He has had a full life, likely outlived many patients he has treated, and yet there never seems to be enough time for all the things we want to do. He writes about his dear friend, a talented, world class potter, who was diagnosed with a malignant glioma two months before his own bad news, and it drives home the truth of how uncertainty so often takes over our lives. His ‘bravado’ is truly, he confides, denial that he doesn’t want to die. Despite having accomplished many things he set out to do, succeeding in his career, being born in circumstances far more fortunate than much of the world, he isn’t ready to confront the agony, the waiting, the monitoring of his health, the end of his days wrapped up in this disease. Who really is? Yes, he knows all too well death comes to us all, but it’s not much comfort when you feel your body is nearing its expiration date and you don’t have the haze of ignorance to soothe your fears.

It’s a beautiful read, informative too. When you are young and, if you’re lucky, healthy you don’t spend much time thinking about the aging process. It seems so far away, until it isn’t. This memoir is both educational and entertaining, and like Marsh I fear being decrepit whether it is natural or not! I too fear losing my brain function, more so now that I am monitored for my benign (so far) meningioma. He somehow fits philosophy in with science and it makes for an engaging read. Covid made many people worldwide all too aware of their fragility, mortality, hence this book should be easy for anyone to relate to. Yes, read it!

Published January 17, 2023

St. Martin’s Press

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