Henry Marsh: The neurosurgeon on operations that go wrong, why he hates hospitals - and why he's leaving Britain

 

All doctors have failures; the problem with brain surgery is that failure is often very terrible and very spectacular The very nature of medicine is that things go wrong – and when an operation goes badly, the patient doesn't necessarily die; they can be left horribly disabled, and you have to confront and see that patient often for weeks after on the walk rounds, which is a peculiar torment. Doctors should be honest about the fact that what we do is often very imprecise. It's not a business, it's not a consumer process.

Brain surgery is not very difficult technically But in terms of the human decisions you have to make, it is extraordinarily difficult for both patient and doctor. People think it's all cut and dried, but it's not. It's about balancing risks: the risk of treatment against the risk of no treatment.

It is quite distressing at times that one has to treat the brain as a lump of flesh when in fact it is thought itself and you're dealing with humanity. In some ways, as I get older, I find it more disturbing. Increasingly, I see many older people with cerebral atrophy and Alzheimer's and brain rot, and I think, well, that will be me in 20 years' time.

Some of my patients' deaths still haunt me One of my patients knew there was something wrong with him, and after I told him he was fine, he had a heart attack. I felt so awful, and I still feel haunted by the way he looked at me, knowing something. All doctors deal with this, but they may be better at bottling it up than me.

I hate hospitals They're like prisons and there's a huge lack of insight into what a ghastly environment they are. My greatest achievement in medicine has been having a balcony garden installed outside the neurosurgical wards at St George's. It was very difficult to do, as management said I had to raise £130,000 to make it suicide-proof. It's decorated with garden furniture and trees and shrubs; the patients love it, the staff love it, and it transforms the experience of being in the hospital.

You've achieved most as a doctor if the patient gets on with their life and forgets you I tend to get more gratitude and praise from patients who still need me – they still need to keep me happy, so to speak.

The NHS has management but no leadership One of the main reasons I'm off to work abroad is that I feel like I'm back at school here – I'm treated by senior management as a sort of naughty schoolboy, and I'm just not psychologically suited to working in an environment like that.

I find the nannying attitude in hospitals very annoying I hate the pre-recorded voices in lifts telling me to wash my hands, and the endless bullying posters, telling patients what to do or not to do. We should treat patients as equals.

If I wasn't a surgeon, I'd be an architect I love making things and I do all my own building work, including central heating, plumbing – always have. The reason I went into neurosurgery is that I knew it would involve using both my brain and hands. I make furniture, I keep bees, I read a lot. I have a compulsive need to do things all the time; I'm a bit like a gyroscope: if I'm not spinning constantly, I tend to fall over.

Henry Marsh CBE, 64, is the senior consultant neurosurgeon at the Atkinson Morley Wing at St George's Hospital. He specialises in operating on the brain under local anaesthetic, and has also lectured widely on the subject of hospital architecture. His book, 'Do No Harm: Stories of Life, Death and Brain Surgery', is published by W&N on Thursday, priced £16.99

Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Photographer / Floorplanner / Domestic Energy Assessor

    £16000 - £25000 per annum: Recruitment Genius: A Photographer/ Floor planner /...

    Ashdown Group: Front-End Developer - Surrey - £40,000

    £30000 - £40000 per annum: Ashdown Group: Front-End Developer - Guildford/Craw...

    Recruitment Genius: Customer Service Assistant

    £13500 - £15000 per annum: Recruitment Genius: A Customer Service Assistant is...

    Recruitment Genius: Sales Executive - OTE £35,000

    £16000 - £35000 per annum: Recruitment Genius: An ambitious and motivated Sale...

    Day In a Page

    Not even the 'putrid throat' could stop the Ross Poldark swoon-fest'

    Not even the 'putrid throat' could stop the Ross Poldark swoon-fest'

    How a costume drama became a Sunday night staple
    Miliband promises no stamp duty for first-time buyers as he pushes Tories on housing

    Miliband promises no stamp duty for first-time buyers

    Labour leader pushes Tories on housing
    Aviation history is littered with grand failures - from the the Bristol Brabazon to Concorde - but what went wrong with the SuperJumbo?

    Aviation history is littered with grand failures

    But what went wrong with the SuperJumbo?
    Fear of Putin, Islamists and immigration is giving rise to a new generation of Soviet-style 'iron curtains' right across Europe

    Fortress Europe?

    Fear of Putin, Islamists and immigration is giving rise to a new generation of 'iron curtains'
    Never mind what you're wearing, it's what you're reclining on

    Never mind what you're wearing

    It's what you're reclining on that matters
    General Election 2015: Chuka Umunna on the benefits of immigration, humility – and his leader Ed Miliband

    Chuka Umunna: A virus of racism runs through Ukip

    The shadow business secretary on the benefits of immigration, humility – and his leader Ed Miliband
    Yemen crisis: This exotic war will soon become Europe's problem

    Yemen's exotic war will soon affect Europe

    Terrorism and boatloads of desperate migrants will be the outcome of the Saudi air campaign, says Patrick Cockburn
    Marginal Streets project aims to document voters in the run-up to the General Election

    Marginal Streets project documents voters

    Independent photographers Joseph Fox and Orlando Gili are uploading two portraits of constituents to their website for each day of the campaign
    Game of Thrones: Visit the real-life kingdom of Westeros to see where violent history ends and telly tourism begins

    The real-life kingdom of Westeros

    Is there something a little uncomfortable about Game of Thrones shooting in Northern Ireland?
    How to survive a social-media mauling, by the tough women of Twitter

    How to survive a Twitter mauling

    Mary Beard, Caroline Criado-Perez, Louise Mensch, Bunny La Roche and Courtney Barrasford reveal how to trounce the trolls
    Gallipoli centenary: At dawn, the young remember the young who perished in one of the First World War's bloodiest battles

    At dawn, the young remember the young

    A century ago, soldiers of the Empire – many no more than boys – spilt on to Gallipoli’s beaches. On this 100th Anzac Day, there are personal, poetic tributes to their sacrifice
    Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves

    Follow the money as never before

    Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves, reports Rupert Cornwell
    Samuel West interview: The actor and director on austerity, unionisation, and not mentioning his famous parents

    Samuel West interview

    The actor and director on austerity, unionisation, and not mentioning his famous parents
    General Election 2015: Imagine if the leading political parties were fashion labels

    Imagine if the leading political parties were fashion labels

    Fashion editor, Alexander Fury, on what the leaders' appearances tell us about them
    Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

    Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

    The architect of the HeForShe movement and head of UN Women on the world's failure to combat domestic violence