Book review of ‘And Finally,’ by Henry Marsh - The Washington Post

The answer, arsenic Henry Marsh reminds america successful his poignant and thought-provoking caller memoir “And Finally” is, sometimes, yes.

When helium learns of his diagnosis of precocious prostate crab astatine property 71, Marsh, a neurosurgeon successful London and the writer of 2 erstwhile memoirs — “Do No Harm” (2015) and “Admissions” (2017) — is shocked. In 1 moment, helium has crossed into different world, patienthood (my term, not his). As helium comes to judge this caller status, Marsh is haunted by the faces and ghosts of erstwhile patients: “Now that I was truthful anxious and unhappy, feeling abandoned, I realized however anxious and unhappy truthful galore of my patients indispensable person been.”

Marsh’s honesty is disarming, and it redeems him arsenic helium offers an mentation for his shortcomings arsenic a caregiver. “As a doctor,” helium writes, “you could not bash the enactment if you were genuinely empathic … you person to signifier a constricted signifier of compassion, without losing your humanity successful the process. While I was inactive working, I thought that I had achieved it, but now, looking back, and arsenic a diligent myself, I was afloat of doubt.”

It is these benignant of insights — exploring his fallibility, his shortcomings and adjacent his complicity successful an uncaring strategy — that marque Marsh’s penning truthful almighty and let him to transcend the accustomed pathography. Even so, immoderate of his observations astir medicine consciousness arsenic though they shouldn’t beryllium arsenic overmuch of a revelation to him arsenic they look to be: for instance, his reflection that “one of the worst aspects of being a diligent is waiting — waiting successful drab outpatient waiting areas, waiting for appointments, waiting for the results of tests and scans.”

Still, his publication shows however sickness unites us. Marsh is beset by fears and concerns overmuch similar anyone else’s. “I find myself besieged by philosophical and technological questions that abruptly look precise important — questions which successful the past I had either taken for granted oregon ignored,” helium writes. His publication is an effort to recognize the questions, if not to travel up with answers. As successful his earlier works, Marsh’s exploration is intimate, insightful, witty and profoundly moving.

Marsh’s penning benignant is specified that 1 has the feeling of trailing down him arsenic an acolyte successful the operating room, oregon successful his woodworking shop, oregon astatine his eating table; successful doing so, 1 overhears the musings of a savant, a neuroscientist, a neurosurgeon, and the interior dialog of a diligent feeling his vulnerability. He weaves successful science, philosophy, past and idiosyncratic anecdotes arsenic helium tackles everything from the quality of consciousness to deciding erstwhile it is clip to walk a hard cognition connected to a younger and possibly much susceptible colleague. It turns retired that preceding his crab diagnosis, Marsh had been wrestling with a parallel issue: “As I neared seventy years of age, my crab already contiguous but undiagnosed, it had go progressively hard to contradict that my assemblage was past its Best Before date.” He had go much conscious of his limitations, the accumulation of insignificant injuries. “I did not privation to dice — but past who does? But nor, to authorities the obvious, bash I privation to beryllium aged and decrepit.”

As a doting grandfather, Marsh frets astir the aboriginal of our species. “The past of subject is mostly the past of the refutation of quality exceptionalism — the world is not the halfway of the universe; quality beings are animals. As the large zoologist J.Z. Young observed, we are risen apes, not fallen angels.” Marsh is not “greatly troubled by the thought of the quality contention coming to an end,” helium explains. “In the precise agelong word this is inevitable aft all. … But I americium appalled by the suffering that the diminution and extremity of the quality contention volition astir apt involve, and I deliberation astir my granddaughters and their imaginable descendants, and clime change, and each that it volition bring successful its wake.”

For the scholar seeking penetration connected however to look life’s end, Marsh shares that helium has seen galore radical die, “some well, and immoderate badly.” Death tin beryllium slow, painless, achy or, if 1 is lucky, a peaceful fading away. “But lone seldom is dying easy, and astir of america present volition extremity our lives successful infirmary … successful the attraction of strangers, with small dignity and nary autonomy. Although technological medicine has brought large and fantastic blessings, it has besides brought a curse — dying, for galore of us, has go a prolonged experience.”

Well earlier helium was alert of his diagnosis, Marsh had assembled a termination kit consisting of a fewer legally obtained drugs that could extremity his life. But aft his diagnosis, helium worries: What if the kit doesn’t bash the job? In despair, helium calls a doc friend, extracting a committedness that the person volition guarantee the desired ending. “‘Isn’t this a spot premature?’” his person asks. “‘Yes … but I privation to hole myself for the worst.’” The person does promise, and with that, Marsh’s anxiousness diminishes.

The publication concludes with a meditation connected a photograph of Marsh’s parent arsenic a young miss successful 1929, posing with her siblings. “Looking into my mother’s young eyes, my ain beingness present perchance nearing its end, I felt arsenic adjacent arsenic I could ever perchance beryllium to surviving successful artifact clip — past, contiguous and aboriginal each combined successful 1 whole.” Thankfully, Marsh remains successful the present, his crab present successful remission, and with this publication helium has near readers of the aboriginal a enactment to savor and larn from.

Abraham Verghese is prof and vice chair, Department of Medicine, Stanford University. He is the writer of “Cutting for Stone.” His caller caller “The Covenant of Water” volition beryllium released successful May.

Matters of Life and Death

By Henry Marsh

St. Martin’s. 240 pages. $27.99.