Marsh, who is now sixty-five, is one of Britain’s foremost neurosurgeons. He is a senior consultant at St. George’s Hospital, in London, and he helped to pioneer a kind of surgery in which patients are kept awake, under local anesthesia, so that they can converse with their surgeons while they operate, allowing them to avoid damaging what neurosurgeons call “eloquent,” or useful, parts of the brain. Marsh has been the subject of two documentary films. Still, he writes, “As I approach the end of my career I feel an increasing obligation to bear witness to past mistakes I have made.” A few years ago, he prepared a lecture called “All My Worst Mistakes.” For months, he lay awake in the mornings, remembering the patients he had failed. “The more I thought about the past,” he recalls in his book, “the more mistakes rose to the surface, like poisonous methane stirred up from a stagnant pond.”
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