Henry Marsh

It was fear of suffering before dying, and of, you know, lingering on, being in a hospital bed. And I hate hospitals, always have done. I think they're horrible places, even though I spent most of my life working in them. No, it's really - death itself holds no fears for me at all, as far as - I love the famous 18th century philosopher David Hume, who on his deathbed was asked, aren't you terribly worried about what will happen after death? And he said, no, I'm no more worried about not existing after death than I'm worried about not existing before I was born. And that is my view about death. I don't believe in an afterlife. But I know, as a doctor, that dying can be very unpleasant.

For the last few weeks, I've been completely happy. I've got my next PSA in three weeks' time. It may well show my PSA is starting to go up, and the cancer's coming back. Totally to my surprise, I've acquired this sort of Buddhist Zen outlook. Well, the future doesn't exist. I'm well. I'm happy at the moment. I've had a wonderful, exciting life. I've made lots of mistakes. I've trampled on people - yak, yak, yak, as I discuss in my books. But at the moment, today, the sun is shining. I'm very well. It's not that I'm in denial, but I think, well, all right. It may be bad news in three weeks' time, but that's three weeks away. At the moment, I'm well.

A close, loving family and work position in society which is meaningful, which is about making the world a better place rather than getting a bigger - having a bigger bank account.

what’s the difference? If I die in two years’ time, what will I do between now and then which I don’t want to do now? The main reason for living longer now is for the sake of my family and my wife. And this is not rationalist bravado entirely. I’ve had a wonderful life. Yes, I’ve done a lot of things I shouldn’t have done. But you know, I’ve had a full, complete life, and there’s nothing more I can do to complete it. Dying when you’re younger is obviously a totally different situation. Or losing a child. I mean, that’s beyond words.

Sufficiently well to see Johnson and Truss and then two or three days later, she’s dead. I thought, that’s fantastic. That’s something to celebrate. That’s a great death.

I was terribly upset at the time, because I felt I had betrayed [my wife] Kate and my family by being so stupid. But I’ve accepted it.

I was looking at ageing in action, in black-and-white MRI pixels, death and dissolution foretold, and already partly achieved. My 70-year-old brain was shrunken and withered, a worn and sad version of what it once must have been. There were also ominous white spots in the white matter, signs of ischaemic damage, small-vessel disease, known in the trade as white matter hyperintensities – there are various names for them. They looked like some evil pox. Not to put too fine a point on it, my brain is starting to rot. I am starting to rot. It is the writing on the wall, a deadline.

I should have known that I might not like what my brain scan showed, just as I should have known that the symptoms of prostatism that were increasingly bothering me were just as likely to be caused by cancer as by the benign prostatic enlargement that happens in most men as they age. But I continued to think that illness happened to patients and not to doctors, even though I was now retired. Twenty months after I had my brain scanned, I was diagnosed with advanced prostate cancer. I had had typical symptoms for years, steadily getting worse, but it took me a long time before I could bring myself to ask for help. I thought I was being stoical when in reality I was being a coward. I simply couldn’t believe the diagnosis at first, so deeply ingrained was my denial.

When I now think of how the uncertainty about my own future, and the proximity of death, threw me into torment, careering wildly between hope and despair, I look back in wonder at how little I thought about the effect I had on my own patients after I had spoken to them. I did worry that if my tone of voice was too pessimistic the poor patient might spend what little time they had left feeling deeply depressed, simply waiting to die. So I tried to find a balance between telling them the truth and not depriving them of hope. After a patient died, I only occasionally heard back from the family, so I had little way of knowing whether the way I had spoken to them was appropriate or not.