In ‘And Finally’, British Neurosurgeon and Author Henry Marsh Gets a Lesson in Empathy
As a physician whose patients include dying physicians, I have often been forced to wonder: Is it too serious an illness for a doctor to understand the trials and indignities that suffer in our medical industrial complex? Is it the lack of humanity that seems to be at the hands of advanced Western medicine?
The answer, as Henry Marsh reminds us in his poignant and thought-provoking new memoir, “And Finally,” is sometimes, yes.
When he learned of his diagnosis of advanced prostate cancer at age 71, Marsh, a neurosurgeon in London and author of two previous memoirs — “Do No Harm” and “Admission” — was shocked. In an instant, he has crossed over into another world: patience. (My term, not his.) As he comes to accept this new position, Marsh is haunted by the faces and ghosts of former patients: “Now that I was so worried and sad, feeling abandoned, So I realized how anxious and sad my patients must have been.
Marsh’s honesty is disarming, and it redeems him when he offers an explanation for his shortcomings as a caregiver. “As a doctor,” he writes, “you cannot function if you truly empathize. … You must practice a limited form of compassion, without losing your humanity in the process. Even when it was working, I thought I had achieved it, but now, looking back, and as a patient myself, I was full of doubt.”
It is this type of insight—the exploration of his fallibility, his shortcomings, and even his complicity in an unruly system—that makes Marsh’s writing so powerful and that allows him to transcend commonplace distortion. Nevertheless, some of his comments about medicine seem not to have been as much of a revelation to him as they seem: for example, his observation that “one of the worst aspects of being a patient is the waiting – Waiting” in the subdued outpatient waiting area, waiting for appointments, waiting for test and scan results.
Still, her book shows how illness unites us. Marsh is beset by fears and anxieties just like anyone else. “I find myself beset by philosophical and scientific questions that suddenly appear to be of great importance—questions that in the past I either took for granted or ignored,” he writes. His book is an attempt to understand the questions, not to come up with the answers. As in his earlier works, Marsh’s explorations are intimate, insightful, funny and deeply moving.
Marsh’s writing style is such that one feels like following him in the operating room, or in his wood shop, or as a retainer at his dinner table; In doing so, a scientist, a neuroscientist, a neurosurgeon, and a patient’s inner dialogue about feeling vulnerable are heard. He weaves in science, philosophy, history and personal anecdotes as he tackles issues such as the nature of consciousness and deciding when it is time to assign a difficult operation to a younger and perhaps more capable colleague. It turns out that prior to his cancer diagnosis, Marsh was wrestling with a parallel issue: “As I neared the age of seventy, my cancer was already present, but had not been detected. , It was hard to deny that my body was past its best date.” He had become more aware of his limitations, of the accumulation of minor injuries.”I don’t want to die – but then who does? But nor, to state the obvious, do I want to be old and shabby.
As an affectionate grandfather, Marsh is concerned about the future of our species. “The history of science is largely a history of the denial of human exclusivity – the Earth is not the center of the universe; Human beings are animals. The great zoologist J.Z. Young observed, we are resurrected apes, not fallen angels. Marsh “isn’t too bothered by the idea of the end of the human race,” he explains. “In the very long term it is inevitable after all. … But I am horrified by the suffering that will be involved in the collapse and end of the human race, and I am horrified by the suffering of my granddaughters and their potential descendants, and climate change, and all that will come in its wake.” Will bring, think about.
For the reader seeking insight into how to face the end of life, Marsh shares that she has seen many people die, “some good, and some bad.” Death can be slow, painless, painful or, if one is lucky, a peaceful fading away. “But dying is rarely easy, and most of us will now end our lives in hospital… in the care of strangers, with little dignity and no autonomy. Although scientific medicine has brought great and wonderful blessings, it It has also brought a curse – for many of us, dying has become a prolonged experience.”
Before he knew of his diagnosis, Marsh prepared a suicide kit that contained some legally obtained drugs that could have ended his life. But after his diagnosis, he worries: What if the kit doesn’t work? In desperation, he calls upon a doctor friend, extracting a promise that the friend will ensure the desired end. “‘Isn’t it a little premature?'” his friend asks. “Yeah… but I want to prepare myself for the worst.” The friend promises, and with that, Marsh’s worries subside.
The book ends with a focus on a photograph taken in 1929 of Marsh’s mother as a young girl with her siblings. “Looking into my mother’s young eyes, my own life now possibly nearing its end, I felt as if I could ever live in a block of time – past, present and future all combined into one whole.” Thankfully, Marsh is in the present, her cancer now in remission, and with this book she has left her work for future readers to savor and learn from.
source – washingtonpost