The  brain cannot feel pain:  pain is a sensation created within the brain in response to  electrochemical signals to it from the nerve endings in the body. …Thought and feeling, and pain, are all physical processes going on within our brains. There is no reason why pain caused by injury to the body to which the brain is connected should be any more painful, or any more ‘real’, than pain generated by the brain itself without any external stimulus from the body…. The dualism of seeing  mind and  matter as separate entities is deeply ingrained in us, as is the belief in an immaterial #soul which will somehow outlive our bodies and brains.

Well-recognised brain surgeon Henry Marsh’s memoir Admissions is immensely readable while being thought provoking. It explores that fuzzy space which can put many an experienced medical professional whether to be true to their Hippocratic oath or let their patient slip away with dignity.

When a surgeon advises a patient that they should undergo surgery, he or she is implicitly saying that the risks of surgery are less than those of not having the operation. And yet nothing is certain in medicine and we have to balance one set of probabilities against another, and rarely, if ever, one certainty against another. This involves judgement as much as knowledge. 

The book also documents Henry Marsh’s experiences as a consultant surgeon in Nepal and Ukraine. Two countries where given the lack of medical facilities would result in patients arriving for consultation when it was far too late or were considered to be cases found only in textbook — an experience many doctors from the developed world remark upon about developing nations.

Henry Marsh’s  Admissions: Life in Brain Surgery was written after he retired from active surgery and was able to reflect upon his life’s achievements as well as explore the philosophical aspect of his actions as a brain surgeon. Many times it was like walking a tight rope, particularly in modern medical practice, where the costs and profits were constantly being factored into a new admission. It did not matter if the patient was critical or not. The costs incurred in treating a sick person were first calculated before moving ahead. This was a far cry from the days when he began practising as a surgeon. He never articulates it but there is a pall of gloom that hangs over the memoir especially when he ruefully shares his distress at the extraneous financial factors they have to take into account before getting to the actual work of treating a patient.

Admissions is a disquieting but an essential memoir that is impossible to finish reading for it leaves one much to think about and query life as never before.

Henry Marsh   Admissions: Life in Brain Surgery Weidenfeld & Nicolson, an imprint of Orion Publishing, Hachette India, 2017. Pb. pp. 272 Rs 599 

26 June 2017