I read this book a few years ago and rediscovering it in a hidden corner of my book case was a bit like becoming suddenly reacquainted with a lovable old half-forgotten friend. Professional memoirs rarely come as honest and hard hitting as this and, as a consequence, the now retired brain surgeon Henry Marsh has a legion of celebrity admirers including Phil Hammond, Bill Bryson and Ian McEwan. It hardly needs me, therefore, to suggest Henry’s autobiography is a must read.

It is not surprising that we, the general public, invest doctors with superhuman qualities as a way of overcoming our fears. But of course even the most highly qualified medics are fallible, just like the rest of us. “Much of what happens in a hospital,” Henry disabuses us from the outset, “is a matter of luck, both good and bad. Success and failure are often out of a doctor’s control. Knowing when not to operate is just as important as knowing how to operate, and is a more difficult skill to acquire.”

To some extent then this is a meditation on double binds. “How can I be both honest and kind to a patient who is gravely ill?” this humble medic asks. “How can I give hope to the terminally ill when I am plagued by my private sense of inadequacy to make any meaningful intervention?” Unless the reader has a heart of stone the answers Henry provides to these questions will deeply move him. Here is an example. Tyrosine Kinase inhibitors are a category of drug used in the treatment of many cancers. But at the manufacturer’s cost of £40k per patient per year the NHS cannot afford to prescribe them. Henry attends as an expert at the NICE meeting where this decision is ratified and it baffles him. It leads him to consider how important the concept of hope is to someone who is terminally ill. “How everything changes once you have been diagnosed with a fatal illness,” he writes. “How you cling to hope, however false, however slight, and how reluctant most doctors are to deprive patients of that fragile beam of light in so much darkness.” These drugs are a psychological lifeline, he infers, and even if they just alleviate the worst symptoms for a while you cannot put an economical price on the hope they give cancer sufferers. It is in such an encounter with medical bureaucracy and the pharmaceutical industry that we experience Henry at his most frustrated and conflicted.

There is wisdom and self-deprecating compassion on virtually every page. “Ii is much easier to be compassionate towards people if you are not responsible for them,” he confesses ruefully. As he watches his beloved mother on her death bed he reflects on the conundrum of mortality and identity. “And now all those brain cells are dead,” he concludes, “and my mother, who in a sense was a complex electrochemical interaction of all those millions of neurons, is no more. In neuroscience it is called ‘the binding problem’ – the extraordinary fact that nobody can even begin to explain, that mere brute matter can give rise to consciousness and sensation. I had such a strong sensation as she lay dying that some deeper, ‘real’ person was still there behind the death mask.”

I suppose some readers may find the author’s musings on illness and dying excessively morbid but the man’s essential dedication and decency cannot be questioned. ‘Part Sherlock Holmes in diagnosis, part action man in theatre’, ‘exquisitely attuned to the transient bond between doctor and patient, and hilariously impatient of hospital management’ I felt that Henry Marsh deserved all the plaudits coming his way.