Changes

I'll confess that I started reading this book because it's on the shortlist for the 2014 Costa Biography Award. I started reading it in the expectation that it might be rather tedious and beyond my basic biology. I expected to have to spend time on Google trying to understand what I was reading - or skipping over anything which went above my head. I thought it would be a book I worked at over a few day days and felt virtuous when I finished it. I started reading it one evening and finished it at four o'clock the following morning and was rather cross when I turned the final page - I could have read much, much more on the subject.

What you read is a loosely-woven series of case histories, anecdotes and autobiography. Yes - each chapter has a heading of something you'd hope never to have the need to learn how to pronounce correctly, followed by a definition which was sufficient for even an ignoramus like me to understand roughly what we were talking about and then you have an explanation of function and importance followed by a story - or stories - telling of operations or even the refusal to operate, as knowing when not to interfere is probably as crucial as knowing that the scalpel is sharp. I came to understand the need for distance between the patient and the surgeon and why they have a ready acceptance that sometimes death is inevitable and that nothing should be done to interfere with nature.

The writing style is easy - rather like listening to an old friend reminiscing about what he does in the day job. He's open - very open - about the mistakes he has made, arguing that they're inevitable, sometimes catastrophic and frequently ruinously expensive to the NHS Trust concerned. He takes what he does seriously, but has leaned learned not to take himself too seriously, although it seems that it was not always the case. Brain surgery has unique burdens which don't always augur well for family life, and Marsh admits to feeling impatient at being kept waiting in a supermarket queue - until he considered the fact that those around him could well be his patients.

If you're due to see a neurosurgeon (or even have a bad headache...) it might not be the book for you, but otherwise , anyone with a functioning brain (in the literal sense of the phrase) should get a great deal out of it. I'd like to thank the publishers for sending a copy to the Bookbag.

If this book appeals then we think that you might also enjoy [[Direct Red by Gabriel Weston]]. Also on the Costa Awards shortlist is [[The Iceberg: A Memoir by Marion Coutts]] which comes from the opposite end of the brain surgeon/patient relationship. If you're interested in disease of the brain you might appreciate [[Brain on Fire: My Month of Madness by Susannah Cahalan]].