You’ve always done it this way.

It’s quick, to-the-point, and concise. If A, then B, and there’s no emotion needed, no waffling, no waste of time. Explanations, news-delivery, decisions made, it’s all the same: state the truth and then move on. It’s efficient, until — as in the new book “And Finally” by Henry Marsh — you’re standing on the receiving end of the words.

Many decades ago, when Henry Marsh was learning to be a neurosurgeon, there were processes he was taught and mannerisms he picked up from the physicians who schooled him. Through example, he learned efficiency, endurance, and how to talk to patients.

Now well past seventy and retired, Marsh has learned truths about these things the hard way.

Don’t, for instance, look at your own brain scans. You don’t want to know what’s in them, he says, especially if you’re over 60 because you probably are not the outlier you think you are. You’ve aged, your brain has shrunk, and that’s “just too frightening.”

Another thing: don’t put off the care you need.

At the end of the COVID lockdown in Great Britain, Marsh finally sought care for a problem he’d known about but had made excuses for: his prostate was giving him problems. That he halfway expected the diagnosis of cancer didn’t make it easier but knowing that prostate cancer is a common “disease of old men” eased his worries some.

Once doctor became patient, though, his eyes were opened. Now on the other side of things, Marsh was shocked to see, first-hand, the overly-efficient, businesslike way that patients are often treated. He could “see just… how little doctors understand about what their patients are going through.”

When he was still doing neurosurgery, Marsh says that only one patient was brave enough to tell him, face-to-face, what she thought of him. Most people, he realized, were just to stunned at their diagnoses to have the presence of mind to even ask questions.

And when he suddenly became a patient himself, he understood why…

That sound you just heard is that of patients everywhere yelling, “Heck, yes!” And yet, this book is not a manifesto, nor is it sad and depressing; in fact, there’s plenty of wry humor inside here, and hope, and a happy ending.

But long before you get to that point, there’s much to learn first.

“And Finally,” is a stream-of-consciousness meditative sigh of a book about getting older and the pure futility of fighting it, as well as an AHA! moment mixed with a very stern scolding for former colleagues who “can do better.” Author Henry Marsh muses with appealing randomness that runs from his former career to his obsession with beautiful wood and the half-finished projects he hopes to finish before he dies. He marvels and ponders and wonders if we realize how living a long life is “not necessarily a good thing.”

But this book is, and readers who think about such things will agree. “And Finally,” will speak to your mind in a way that’s rarely done.

“And Finally: Matters of Life and Death” by Henry Marsh
c.2023, St. Martin’s Press
$27.99
240 pages