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Publisher's Summary

Henry Marsh has spent a lifetime operating on the surgical front line. There have been exhilarating highs and devastating lows, but his love for the practice of neurosurgery has never wavered. Prompted by his retirement from his full-time job in the NHS, and through his continuing work in Nepal and Ukraine, Henry has been forced to reflect more deeply about what 40 years spent handling the human brain has taught him.

Moving between encounters with patients in his London hospital to those he treats in the more extreme circumstances of his work abroad, Henry faces up to the overwhelming burden of responsibility that can come with trying to reduce human suffering. Unearthing memories of his early days as a medical student and the experiences that shaped him as a young surgeon, he explores the difficulties of a profession that deals in probabilities rather than certainties, and where the consequences of your decisions alter the lives not just of patients but also of those around them. The overpowering human urge to prolong life can often come at a great cost to those who are living it and to those who love them.

In this searing, provocative and deeply personal memoir, the best-selling author of Do No Harm finds new purpose in his own life as he approaches the end of his professional career and a fresh understanding of what matters to us all in the end.

Written and narrated by Dr. Henry Marsh.

©2017 Henry Marsh (P)2017 Orion Publishing Group

What members say

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Fantastic book, well read, honest insightful

Fantastic book, well read, honest, and insightful account of his career and how it impacted on his personal life. Would absolutely recommend.

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  • Trodez
  • 03-13-18

So good I listened twice

As a nurse,who trained in the same era. I found it interesting, stimulating and so comforting. I am not alone in my frustration and disgust at what has happened to our wonderful NHS, and to old England.
Well done ! A candid, honest and insightful book. Thanks

1 of 1 people found this review helpful

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    4 out of 5 stars
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  • Brenda Holliday
  • 03-07-18

Admissions. A life in brain surgery.

I so much admire the courage of Mr Marsh who has done so much to show that a group of people who have been put on a pedestal by patients and staff are in fact human like the rest if us. Fascinating though the description of his work is, I found myself wanting to know more about the progress of his work on the cottage. This book has been written by a deeply thoughtful and almost painfully honest person. So few of us have the courage to exam ourselves with total honesty and fund aspects of our lives and behaviour wanting.. Thank you Mr Marsh.

1 of 1 people found this review helpful

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  • IYER
  • 03-04-18

A personal contemplation

As the NHS in Britain lurches into yet another “crisis”, in what appears to be turning into an annual winter affair, reading comments by a retired doctor on the failings of recent management techniques that have added to the bureaucracy more than making life better for patients and medical practitioners seem aptly timed. But such criticisms are just a small part of neurosurgeon Henry Marsh’s sequel to “Do No Harm”, his first book that focused on the neurosurgeon’s craft and on the medical system in which he worked. “Admissions” is more a compilation of musings by Dr. Marsh, now retired, on post-retirement life, his experiences as a visiting doctor in developing countries, and an appraisal, of sorts, of his career.

Readers should know that “Admissions” is at its core the author’s very personal contemplation of his career and his especially post-retirement life, even though the blurb on the back cover overstates the case by describing the book as a “searing, provocative and deeply personal memoir”. At its best, apart from being a frank assessment of his own life and career, it also offers personal and quirky insights into unrelated areas such as gardening, carpentry and bee-keeping.

Dr Marsh does not like the bureaucracy of modern medical systems, which is what prompts him to retire as soon as he can and then spend his time, gratis, as a visiting doctor in Nepal and Ukraine. He is particularly critical of the current medical management thinking that places an emphasis on processes and checklists, something that has been encouraged by books such as “Black Box Thinking” which juxtapose the differences in the way the airline and medical industries react to failure, and suggest that there is a culture problem with the practice of medicine. That pilots don’t routinely need to decide what risks are worth taking (leave alone discuss those risks with passengers), that patients don’t choose to fall ill (unlike passengers who chose to fly), that passengers and their relatives don’t need constant reassurance, or the fact that when planes crash, the pilots usually also die, but when a patient dies, the doctor does not – all these are cited to suggest the fallaciousness of fashionably comparing two professions that are vastly different.
But he also talks later, looking back at his life, of the importance of learning and of self-criticism when things go wrong, and of how a doctor needs to change his mindset from necessary self –delusion about his own abilities (in order to help maintain patients’ confidence) to actually getting better from experience and unlearning this self-delusion since it will now make critical self-appraisals, crucial to getting better, harder.

Dr. Marsh has a knack for writing in an engaging and self-deprecating way (“It is better to leave too early than too late…but the problem is to know when that might be”), and this also leads to insightful observations about modern day Nepal ( less so about Ukraine, where he seems to have engaged less with the people). Along the way you get vignettes such as the practice among doctors to pay for each other’s services with wine, and reflections on carpentry, which is a favourite hobby, gardening, and the remodeling of an old house – which gets meaninglessly vandalized and then leads him to mull on the slow myelination of frontal lobes in teenagers’ brain as the culprit.

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  • Kevin Gillespie
  • 02-20-18

Fantastic

Fantastic that it is narrated by Henry himself, as he is able to emphasize where necessary, and makes the stories more engaging.

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  • Anonymous User
  • 09-25-17

very interesting.

narrator excellent.
story intriguing.
flow of book a little disjointed at times, but overall concept okay.
worthwhile listen.

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  • DEANVEGGY
  • 09-16-17

intensely interesting, and brutally honest

a privilege to sit in with henry on this. also loved the section on the cottage renovation and the meaning of life.

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  • Mr
  • 09-11-17

On Mr Marsh

Sobering, heartfelt and uplifting. Enjoyed even more as the previous as this book was voiced by marsh himself. I only hope that should I ever need help with my brain I find a man such as he, keep up the woodwork good sir and send me a jar of finest honey soon. An excellent book. Buy it !

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  • Amazon Customer
  • 08-27-17

Every manager in the NHS/politician should read this

Fantastic book - really insightful, interesting and really well written. I didn't love it as much and his first book but this is still brilliant. A must read!

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    5 out of 5 stars
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  • Gareth West Crosbie
  • 08-16-17

inspiring.

A beautiful and honestly written book. I'm so glad I listened to this, it is deep and thought provoking.

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  • Samantha Pearce
  • 08-15-17

2nd Attempt

I think Henry Marsh's first memoir is better, this is a bit scattergun. I would though living in the U.K. and NOT a fan of the NHS wished for a greater discussion of how a Surgeon's training & practice has changed during his lifetime as he is clearly seen much he dislikes.

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  • Paul
  • 06-20-17

Beautifully read, refreshingly honest, touchingly humane and always engaging.

Mr Marsh is clearly an extraordinary polymath with his hands, his mind and his heart. I love the way his story telling ranges from one continent to another, from culture to culture, patient to patient, agonising outcomes to miraculous cures, touching generosity to excoriating cringe-fests of past indiscretions and vanities.

It is his humanity, laid bare in heartwarming and surprising juxtaposition to his laudable achievements that makes his story so compelling.

Set next to his humanity is the joy of his insatiable curiosity and lust to create with his hands.... slashing weeds, sharpening the blade of a plane, lifting a steel beam into place with fewer tools than the Egyptians probably had at their disposal, or, planting a forest and building new windows. To feel the enthusiasm in his voice is a delight.

Oh, and I love his fulminating outbursts against The Managers and the regressive left. Love it!

Then, of course, are the all too serious existential issues that he discourses on.... something close to my heart given the instances I've twice been faced with regarding "switching off the machine". Thank you Mr Marsh for your candour and forthrightness.

I only have one beef..... I wish Mr Marsh had read his other book as well (Do No Harm).

Cheers,
Paul

2 of 2 people found this review helpful

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  • Chris K.
  • 03-21-18

Uncomfortably Relatable

a refreshingly honest, deeply sad account to relate to, inevitable, insurmountable, difficulties of capitalism in healthcare

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  • cameron.hoare
  • 06-15-17

a nice memoir. honest but all over the place.

an interesting memoir. well told, homest and insightful, but at parts sounded like a lonely man trying to avoid dementia

1 of 3 people found this review helpful