(p. A17) One of the reasons patients find condescension from doctors especially loathsome is that it diminishes them — if you’re gravely ill, the last thing you need is further diminishment. But the desires of patients, Marsh notes, are often paradoxical. They also pine for supreme confidence in their physicians, surgeons especially, because they’ve left their futures — the very possibility of one at all, in some cases — in their doctors’ custody. “So we quickly learn to deceive,” Marsh writes, “to pretend to a greater level of competence and knowledge than we know to be the case, and try to shield our patients a little from the frightening reality they often face.”
Over time, Marsh writes, many doctors start to internalize the stories they tell themselves about their superior judgment and skill. But the best, he adds, unlearn their self-deceptions, and come to accept their fallibility and learn from their mistakes. “We always learn more from failure than from success,” he writes. “Success teaches us nothing.”
This was a prominent theme in Marsh’s last book, and readers may have a sense of déjà vu while reading this one. Like “Do No Harm,” “Admissions” is wandering and ruminative, an overland trek through the doctor’s anxieties and private shames. Once again, he recounts his miscalculations and surgical catastrophes, citing the French doctor René Leriche’s observation that all surgeons carry cemeteries within themselves of the patients whose lives they’ve lost. Once again, he rails against the constraints of an increasingly depersonalized British health care system, which mummifies its doctors in spools of red tape. Once again, he describes his operating theater in all of its Grand Guignol splendor, with brains swelling beyond their skulls and suction devices “slurping obscenely” as tumors evade his reach.
For the full review, see:
JENNIFER SENIOR. “Books of The Times; Surgical Catastrophes, Private Shames.” The New York Times (Sat., Oct. 7, 2017): A17.
(Note: the online version of the review has the date Oct. 5, 2017, and has the title “Books of The Times; A Surgeon Not Afraid to Face His Mistakes, In and Out of the Operating Room.)
The book under review, is:
Marsh, Henry. Admissions: Life as a Brain Surgeon. New York: Thomas Dunne Books/St. Martin’s Press, 2017.