46 Quotes by Henry Marsh

We have achieved most as surgeons when our patients recover completely and forget us completely. All patients are immensely grateful at first after a successful operation but if the gratitude persists it usually means that they have not been cured of the underlying problem and that they fear that they may need us in the future. They feel that they must placate us, as though we were angry gods or at least the agents of an unpredictable fate.

Some of my operations are great triumphs and tremendous. But they’re only triumphs because there are also disasters.

Angor animi – the sense of being in the act of dying, differing from the fear of death or the desire for death.

Doctors need to be held accountable, since power corrupts. There must be complaints procedures and litigation, commissions of enquiry, punishment and compensation. At the same time if you do not hide or deny any mistakes when things go wrong, and if your patients and their families know that you are distressed by whatever happened, you might, if you are lucky, receive the precious gift of forgiveness.

When I tell a patient that I think I should do their operation under local anaesthetic they usually look a little shocked. In fact the brain cannot itself feel pain since pain is a phenomenon produced within the brain.

But death is not always a bad outcome, you know, and a quick death can be better than a slow one.

There is no evidence that the complete head shaves we did in the past, which made the patients look like convicts, had any effect on infection rates, which had been the ostensible reason for doing them. I suspect the real – albeit unconscious – reason was that dehumanizing the patients made it easier for the surgeons to operate.

I am reaching the end of my career this detachment has started to fade. I am less frightened by failure – I have come to accept it and feel less threatened by it and hopefully have learned from the mistakes I made in the past. I can dare to be a little less detached. Besides, with advancing age I can no longer deny that I am made of the same flesh and blood as my patients and that I am equally vulnerable.

I learned a long time ago in the outpatient clinic to make no distinction –as some condescending doctors still do –between ‘real’ or ‘psychological’ pain. All pain is produced in the brain, and the only way pain can vary, other than in its intensity, is how it is best treated, or more particularly in my clinic, whether surgery might help or not.