Soulful yet soulless: Henry Marsh’s ‘Admissions’

For me, Admissions illustrates a great tension that exists in medicine. The need to feel, to be sensitive, to be humane, versus the need to be impervious to tragedy and move on to the next case. In describing his work in three countries (UK, Nepal, Ukraine), and the many successes and failures inherent in neurosurgery,... Continue Reading →

The limits of kindness: a patient with ‘pseudo’ seizures

Twelve years ago. A hospital at night. 9PM, and the night shift has started. My raggedy handover list contains many jobs; patients to review, “sickies” to keep an eye on, a chest drain to perform. At 9.30PM the bleep goes off - ‘fast’ bleep. Not a full crash call, but I need to rush. The... Continue Reading →

A moment before dying

I have been told all about him, but I barely know him. He was admitted in extremis, but tests quickly confirmed that his disease had progressed too far. He cannot survive. We were not involved. All this - the initial diagnosis, the failed treatment, the progression - happened elsewhere. An ambulance brought him to us... Continue Reading →

An evening in the Dutch Centre: on euthanasia

‘Medicine didn’t work until 1850,’ says Dr Bert Keizer (72), who works in the Dutch Levenseindekliniek (End of Life Clinic). And truly effective, life-prolonging treatments only really developed after the 1950’s. In his opinion, modern doctors commonly ‘misbehave’ when faced with patients who are clearly near the end of life, but for whom there are... Continue Reading →

Would you? The RCP Assisted Dying survey

  Doctors in England are being asked to answer a survey on their attitudes to assisted dying (AD). The Daily Mirror led on it on their front page today (Monday 14th Jan). The Royal College of Physicians wants to be sure that it current oppositional stance is a true representation of members' views, and is prepared... Continue Reading →

Introduction to ‘From Every Angle’

  In this the 6th collection of posts from Illusions of Autonomy I have explored complex situations through the perceptions and voices of those involved. This exercise is creative, and was inspired by William Faulkner’s 1930 novel As I Lay Dying. In this he describes the final days of Addie Bundren in the voices of... Continue Reading →


  My first midnight ward round in the intensive care unit, and still pretty inexperienced. The patient in cubicle 4 was deteriorating. His oxygen requirement was maximal, the pressure settings on the ventilator had crept up. His lungs were stiffening, be it due to infection, fluid overload or a tense abdomen... I could not be... Continue Reading →

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