This is the bbc hello, I'm kirsty young, welcome to desert on an discs where, every week I asked my guests to choose the eight tracks, the book and the luxury item that they want to take with them. If they were cast away on a desert island for rights reasons, the music on these podcast versions is shorter than in the original broadcast. You can find over two thousand more additions to listen to and download on a desert island discs website. my castaway today is the neurosurgeon henry marsh. In his decades dedicated to saving people's brains from the rabbit, of disease and injury, he

surely works in the most select and intimate area of medicine, plying his craft and do his best balance, detachments with compassion and hope with realism what he describes as the fierce and happy concentration of his work came to wider attention through his compelling best selling memoir do no harm where, along with his considerable a couple, once the anxieties and tragedies of his high flying career were laid starkly bear. He may well be the only eminent euro surgeon who is also spent time working as a hospital porter, and it was that, sir, as a young man, lifting and laying patients and swooping down walls and equipment that exposed him to what he scribes as the controlled and altruistic violence of the operating theatre. from their own in he was pretty much hooks. He says a brain surgeon life is, for boarding and can be profoundly rewarding, but it comes at a price. You will inevitably make mistakes and you

learn to live with the occasionally awful consequences. You must learn to be objective about what. see and yet not use your humanity in the process. Welcome Henry was to be a patient's. Then We usually have to imbue surgeons with a sort of superhuman quality it didn't do. stand almost the necessity that we have in that. Yes, I think so. I dont know what sort of doktor, out of being My son hadn't had to bring tumor when he his three months old, but I was it the receiving end bright of beginning by surgical crew, when I was training as general surgeon and I think they gave me a lot of insight, which other doctors often didn't get until a much older than what it's like to be receiving end, which is, of course one is frightened. One is terrified and particular your face. My major surgery.

a highly accomplished career as many people will know, and you bruce, I called it. A memoir do no harm in twenty fourteen, followed by a second book a few years later in that first book, as I described there briefly unity, you talk about many of of your operations and and to incredibly successful, but you also detail the ones that once some angle, yes and while some yes, some of them. Why feel the need to do that? My right as we learn this mom stakes and of great problem in medicine is particularly dangerous. Specialty, like nearer surgery, consequences of almost stakes, a terrible for our patience, is very difficult to admit them. Little into one self, so I suppose I dont think as conscious aware of it of a time when I was right in the book. I was trying to set an example as a senior surgeon, being more open and more honest, tell me about your first piece of music. We must work to be done here, we'll be begins burden. Look. Dunham is a great song with great lyrics to those make me laugh when I hear, but

see now being a new research. this brought roulette being the tightrope. Yes, you need frightfully good sense, a balanced woke in a tightrope yesterday. There are certain you need to go to your hands, but the real difficulty is not looking down. Is the context is, we had all work on a narrow strip on the ground, but if, as a hundred four drop below it is attended, spirits and what really, what makes near surgery difficult is not the technicalities of the operation which, actually, after five years of trading, is quite easy. It is the seriousness of things if they go wrong, it's o human context and the thought of the damage patient, the miserable family after the operation. That makes it difficult, but you have to keep your nerve despite this. That is yet at the same time remain human around thousand them.

People like super right I know some advice that would be king and that are not done henry. The saying goes. This surgeon has to have nerves of steel. The hut so the line and the hands of a woman so neat phrase. What what do you make of it the sort of traditional view, the surgeon. In fact, anger goes back to the seventeenth century, but is often attributed to a famous. General surgical, Lord moynihan, at the beginning of the last century. I disagree with it because they cause that that's easy bit. What special about surgery is,

Is your at cheap invading other people's bodies and dangerous way, and it's a psychological difficulty about nor the consequences. You write incredibly revealing me about that, and I want to quote directly I'm your book key written as I climb into the operating chair behind this is the patients head. I feel command evil night mounting his horse and setting in pursuit of a mythical beast and the view during the microscope is indeed a little magical. Can you describe it to me? The viewed unlikely scope Most of us would have looked through very good pair by not killers, where the world some are more real when magnified than with normal vision, and that that description is the upside at sea addictive element, operating, is the combination of excitement?

thanks. I mean we know that it is very hard to say, were excitement becomes fear and what makes surgery exciting is What is it fighting? You become a surgeon because its exciting, but what makes the exciting Is your anxiety, the patient should do well, there's a common dismissive idea of surgeons, a psychopath. Technically, that's not true, as if you were a psychopath, you wouldn't care very much about what happened to the patient. Not might well be and again, common stereotype of the surgeon is arrogant. old brusque dismissive, but this, in my opinion, doesn't reflect a psychopathic personality reflects rather mechanisms of eager defence. Is a psychologist, Because the nice you are to patients the more it hurts you when things go badly serve as a strong element of self preservation and in treating patients

golden detached way to enable you to do the work. If, if your very nice some friendly and charming with patience and then view you do dangerous surgery such as brain surgery. You're, gonna feel all the worse afterwards and yet the gain soul with complex balance, because when you, when I see a patient, you that you don't want to give them a technical information want help was well. You want to support them and most of us as patients. We want guidance and we thank you. I do that. We given the facts and then we decide does not true. If you have a rather complicated medical problem, you want. Your document should take, This is what needs to be done, some music henry mass. What's next, my musical god is beethoven or there are very broad musical tastes I went through a very unhappy of adverse episodes, being I'm every emotional, personal, probably totally unsuited to being a surgeon psychologically at me, and I had a spirit eyes very depressing. Anxious, none happy when, in fact, it also university- and I spent a short time in a cycle-

recalls that psycho, there is quite a long time afterwards, which I've under enormous unhelpful lenny, everybody is better off for a bit of psychotherapy when I came out of the hospital I played, and rather self consciously emotional way, this some part of that one of the late beethoven's drink or debts, which I bade Evan rate on this Cool defence, giving on recovery from the long illness to slay movements of deepest one. Thirty two deserve eversleigh few conjures up with an enormous sense of recovery of life darting again

that was part of a certain movement from it happens, string quartet number fifteen in a minor opus, one thirty two played by the hungarian string quartet there and We must have written this as you. Mulder you have come to the stand, just how completely I am my parents creation tell me more about that my mother was german. She was a political refugee from nazi germany. In effect, my father gone to journey, to learn german in nineteen thirty six years, a great internationalist he was secretary of the oxford university league of nations. that was always a very, very moral and politically more person, and you germany to learn german event a holler were handled came from then it wasn't. examined my mother was in lodgings because should refuse to join the duchess middle, though the women's equivalent of ITALY,

youth and said you couldn't get university level, since it was a conscientious objector and my father angles, moralists first person whom she could open the talk to invite her unhappiness about what was going on in germany, Jim and got into trouble the gestapo five having been visuals, reported fagging, expressing anti hitler views in the bookshop where she was training, the bookseller and more or less, in effect, my via the maritime, to get her out of germany's as you could get out of trouble there is it was no use. There certainly was a marriage, partly based on liberal booth, clear principles and freedom and democracy in everything else, but amended. suppose to an awful lot of books from very early age. And my mother was immensely musical, and I remember I was that seven or eight my mother gave me some of those ep extended play

Two discs, and one was the red army, clap, and I like that very much and as we can discuss. I have had a long relationship. Rover excentrically, not smart, with russia. As of ukraine in some ways, maybe it goes back to hear and killing consanguinity eight years, let's have units piece of music and we must be on your side. You mentioned it briefly. because this is a red army classing killing her. When I was a docks reading admission into politics, lawson economics, I did special paper soviet studies and either with fascinated by russian society something forbad reasons. What he's bad it was. The sword part begin my mother nazis to us all. Still variants did by totalitarian politics and problems, which I suppose gain from my mother. No, the problem of the individual. What you do in your individual conscience when you are living in the inner deeply unsympathetic society

ever thought agenda combining criminal knowledge, I probably would have ended up being with brain surgery. Various reasons I did by working off known in ukraine for the last twenty years

and was clean in spite of money on often performed there by the red star. Let me call us with your guinea values directed by antonia by shocking You mentioned, as you introduce that piece of music Henry marsh that you had worked on and off in ukraine of the last twenty, and he even six twenty six years. I wondered in to volunteer to save it is probably among the most admirable of human cloning he's. When do you think it began to originates in you? How young, where you I hate to it? charity. I didn't even lightwood volunteering. Yes, it's true a lot of the work done abroad is actually very difficult and growth is stressful, and I very relieved to get back home, but I do exist so interested in it. A yes is good.

the help, and one of the reasons I became a doctor. I have I almost pathological need feel useful, which is why I am finding being seminary quite difficult at times but all I know is it's a great privilege to be adopted, because just by work during your work, you are helping. People is also rather corrupting course is a bit of a moral luxuries. I doctors can easily become very pleased themselves. You do your job and you have people frightfully grateful to this usefulness. Is that. carpentry comes in. You like to be major thing, is making for less useful and that's useful as bruce. I didn't like the pompous words blemmyes. Xo deep, creative urge. I suppose you could call it. I get, I haven't been making things over time, whether trying to help patients or making things my workshop or whatever is I found a very hard sit still ass, mommy's economise,

What are you gonna hear this issue forth of the day? This is right: coup d. I work in many countries medically, as well as england, and money and medicine, and never never far apart and is one of the problems and needs of patients as patients were so vulnerable with a desperate and as in many countries, are based the being ripped off some doctors recently corrupted money in the great strength of the images and the anxious and not unique, and the scandinavian medical systems of fantastic, an unseemly funded is it is as a doctor. You have no peculiar interest in what your doing to the patient. You may have limited resources and ass light was his song, which

Let us bring those rights how can a poor man stand such times and live? You secured this open scholarship than to Oxford study, beefy issue in the autumn of nineteen. Seventy one you're around about twenty one you decided to quit. Your degree. Will I fell unhappily in love with a much older woman was all very embarrassing, provoked what use, because a nervous breakdown but my way of dealing with it was to run away. So how unhappy did you get?

I am happy, I'm pretty suicidal and I couldn't carry on but against business, because I e the girlfriend of a friend of mine, her father was a general surgeon in the mining time north of newcastle gold ashes, and I had this idea I want to go to work in a hospital. I think the idea was sort of somehow ridiculous, I'm so unhappy. I would again see people are really proper, here is a movie didn't away, but it was thought a physician, he'll thyself almost- and this was your time spent his but a poor allows right. I'm spend, as I say, you wouldn't happen on the edges. This. This surgeons, without knowing me purely on the same, serve his daughter, the hospital management, those young man he wants to work is a book. I got a job and I spent six months working as if it were writing very, very bad second rate purchase. I'm glad

have destroyed, and during that time I realized I did want to professional middle class career of drool. I didn't want to kill myself, but I wanted to professional middle class curve, my in choosing and having what surgeons at work who lives or general surgeon was beat, etc, I thought that's what I want to do, but as a lesson to the role free hospital, which, again I have an enormous debt of gratitude which is in medical school in england, I think which took people without sancy level. You didn't extreme the first and be missed the last year. They ran first and vehicles, and they had this collection of oats insults like me, who are desperate to push on top, took. They must fit in music and tells about your fists.

Juno, my trading great musician. I love most of us zones as this theme to a lot when, as a medical student on as working for my medical finals, because a happy time very carefully as happy marriage, my first wife, we lived in a very small flat, but off my parents, eyes in london and his great music. When you sit down for another. that was doing

I'm a trading and down to zero, and you said Henry marsh one of the reasons you chosen. That was because, for you that brought back memories of simple and happy times as early married years, they were to become a lot more complex. When you first born your son, William, fell very ill. He he was diagnosed with a brain tumor. What would your memories at that time? I was working as a whole. says, working very long hours and was one in two has on call every every overnight and every other weekend. And my wife said Williams Fontenelle? Should it be like the knife today? It's all right. And then those on those eyes working late, an enduring me to say that the animals and quite right and should go to the clinic- and they said his head- was too big news. Not miss developed hospital, and then he was a great on street next day and had a brain scan and it was diagnosed with a very serious brand. You killed him korea, places papilloma, very unusual place in the middle of the brain,

It was he was very ill and amid sedated him for the scan and student wake up, and I thought something was wrong. Last panicking I didn't seem a pediatric neurosurgery, although I've had she became on herself and it was a green light because I told the doctors do isn't something runs in everything's all right natural. When when is a consultant coming, they said what we don't know he's not It means I'm going on this sort of crazy

marriage running around the hostile trying to find this mythical, mythical consultant to say what they help help. Then I went into a few state. I could I went when I'd taken. I ran away. I couldn't stand it anymore and then about the consult, had turned up and had taken one look at william it'd immediately carried out emergency as I'd operating on the spot, and then we had to wait several days before a definitive operation, which was terrible. Sir, was awful time. I dont know what sort of doktor I would have been like the hand, tat experience, but I knew from very painful personal experience. What it was like to be a desperate, anxious, parent thing watching your child, the huge child is about to die and williams. Just to be clear, listeners were willing. Britain was succeeded. It was successful, let's have some music

It's your six when my marriage was ending eyes as perhaps another some deals, adult embarrassing and painful and miserable inner in retrospect, but I mean what's listening to her slow movement of issue but content, which is a bit of music. I know very well and first of all, it is these with bitter music in his hand, nuns. Secondly, it brings back to me how being madly in love is wonderful, but it's a sort of madness at the same time- and I looked back at anko, could I be so stupid and it is a wonderful and everything feels unified and whole and beautiful one becomes madly optimistic. It is an extraordinary pressed. It fades your time but pursue, but couldn't it doesn't phaedrus time,

in spite of the second movement from schubert string content in c major played by the amadeus corsairs joined their by calling on cello. You said that your father, in his mid nineties died in your words ten years too late. Swift is an admirably frank sing to stay at home responsible. Do you think, Our modern medics for. Encouraging us to consider the blend of life above quality of life from a great proponent of, but I advocate phrase assisted dying, the biggest you in many european countries, the moment it is a very big issue and I'm afraid we don't have. I'm really I'm afraid we know of the times, had loved and learn about it in some detail but but can use. What I mean, of course, Finally, the old andrew there is very difficult and the loss of aspects we don't have time to discuss it is it, but it's so much easier to treat them not to treat, is something I discuss and in one of the books where

If you have a patient of olaf's arable hemorrhage? If you operate, they'll, probably live a bill of fare disabled. If you dined operate now, probably die, nazis to tell them what will operate everyday operate. They're gonna die in the family, say one you better operate. If you sit down with the family say will actually if they do live their propaganda, bavaria, disabled, and then you tried discussed with a family. What that means. That is a long conversation that takes at least an hour is a frightening conversation, says the surgeon euros or maybe I'm wrong. Maybe they'll survive, maybe they'll be better than I expect. Service is built in ratchet to retreat and generate a large number of disabled people, the sake of maybe a small number will make a good recovery. The navy easy answers. We are reluctant to die. We will cling on till the last moment and there getting away from that a good time to take a break for

musical thing tell me about what we can do here. This is: u will set it to his boot, sound over chinese being honest about unremitting months playing scarlatti on the piano they're. Not not Scarlatti is scarlatti for was meant to be heard, and that's because when I moved house when I became a consultant in the old atkins, somalis, hospital and wimbledon, my wife and family removed from bottom to wimbledon and on neighbor was, is rather odd. Looking chap wearing so sheepskin driving coat and driven energy, a sports car parked in front of his high snuff is up scruffy person and it he turned act there

anglo pettish man who almost instantly became my best friend and we ve been best friends ever since knife, and always said he is a ruined as it is a man of an extraordinary large number of parts, but one is, he were designed recorders than this, in fact, is a is a recording scotty play by food song. We remain himself recorded.

scarlatti sonata in c major k. Ninety five played there by food, some europe, seeing his unspearing in acknowledging the limitations of medicine and the fella billowy at times of its practitioners. What? when you are speaking as you do often these days to young doctors embarking on a life in in euro surgical work. What do you say to them? What's your advice offer hope eyes is the answer. If I look back in my earlier career, I mean is partly me being ambitious, driven single combat self glorification and normal testosterone alpha male stuff, but also partly as a search culture time merchant, anxious to see one due on or near earth orbit assisi? If you said well, sir, don't quite know what to do. I did some terrible things and patient suffered a because I based it got stop, but rather than daring to us, my boss come in

Oh me, out, I carried on an act is peculiarly not just to me, but the way medicine was like four yes, I think that is a better than one one does try. I try within my department, I play a minor role as the old old fart, who wonders and occasionally from time to time, to create in that sphere. Where is shame in saying I don't know what to do is no in saying I'm hope is there an element of it? That is, I mean when you described ass. He did so brilliantly. This idea that it was an average is with that in a walking a tightrope. Unless thing was to not look time walking a tightrope is, of course, pretty much a young person's game is there. Is there an element of this what an advance in question and researching seal problem we face with dangerous surgery if used. don't operate. Are you being wise, arriving a coward and if you do operate, being brave, rising reckless and that balance change zen it changes partly with experience abroad because

wiser but, as you got only artist austrian levels, dropping Omen The only thing that cutting edge alone you you'll, stop taking risks. Maybe you should take. The solution to the problem is to work together with different surgeons, are different ages, sight, more collective approach. You are a very practical man. Clearly, I'm you you'll do pretty well on the island. What would be your plan depends what I'm allowed to take with me I will come to that in that case, let's just going to be a bit What are we gonna hear mood above the burma dish Her mother was german. She was very proud of the fact that she heard the saint Matthew performed in terms of cash in leipzig,

where it was originally performed? Here too, there are nine nineteen, thirty seven, but the why protect cometh can it be forbidden music, but I like it particularly because I don't have any religious faith. Never did. My parents are based very sincere but very relaxed christians. It was a very important part, but it seems to me when I think about sign ikea bomb additional. Forgive us lord! You can reach very similar ethical conclusions. The christian ones like having to have gone simply apply. The golden rule of do this. You would be done by and all of us the surgeons

can think of many occasions when we didn't do that. Sometimes you have to, and I mean all patients would I be operated upon by the senior doctor, and you can't do that. You will have delegated operations and sometimes there's offers again badly because I'd over estimated, my trainees abilities common calls it the halo effect, and it is one of the cotton to passes. So we all is sort of skeletons now covers and guilty secrets. The wish for giving us the need for forgiveness, I think, is very deeply rooted in people and you don't have to invoke a sort of fierce christian. God is a source for that rivals, like the words of athens asian creed. I remember having to recite once twice weaken investments.

Everyone knows the school of never have done this is we ought not to have done and not done these things. We should have done except her and me that that music sums it up,

your body from books and mess you that, under your shoal, accompanied by the collegial vocally directed by philip heavy baker. It's time then Henry for me to give you some books. Everyone gets the bible and the complete works of shakespeare. You gets take one other book along if your choosing, what's it going teach yourself ukrainian. Ah, one of many regrets on my biggest regrets in life is, I didn't really have a second language uncle schoolboy french. If I'm so embarrassed to speak in france, I can't and then member of my family doesn't speak reasonably good. Go german and international and european and am deeply ashamed of the vet. Any really speak english and because I spend so much time in ukraine and my colleague goals be reasonable, english. But I'd love to hear.

communicate directly with my many ukrainian friends. That's use them, you may know, you're allowed a luxury and wondering what you can? One has even enormously large two chests will have been swept up and the shipwreck which, as you, MR posted may on the desert island, Let me see your million said it would working tools as long as you promise that you won't make a boats to his area. Thats true this will escalate. Yes, will that sets rather difficult, then isn't it even that you use it's just for the delta and is so remote? There's may realistic prospect of a raft getting it was. I had a letter I get to trouble, you know, but all right I'll give you do. You have a garden shan't where you have visited works have huge right, so you can have that shared a shade, or I ok, ok, and what is shed flights. It does is yours and which the tax would you save trying to be king makes me smile every time. I hear it. It's yours henry

Thank you very much for letting your doesn't island discs. I hope you enjoy this addition of desert island discs. You find over Two thousand interviews with artists, musician scientists, sports stars comedians anwar at BBC, dot, co, uk slash, desert island discs and have a favour to ask if you could rate and review the desert discs podcast wherever you download your podcast, it really help other people find us thanks again for listen. This is the bbc.

This is a story about a man called Otto von vaster. He was austrian lawyer, husband, a father and a very senior, not it's a story of life and love and have a curious death. You could say it's a sort of mystery story. Auto vesta is not see you ve, never heard of because he escaped justice, unfilial sands and I'm going to take you on an unexpected journey to find out what actually happened to otto vesta. It's a journey that goes right to the heart of something

hold the rattling nazi escape route out of Europe that started in nineteen forty five along the way, we're going to meet an unlikely cost of nazis, fascists assassins, spy, sons of spies, lovers, murderers and an elderly man who lives alone in a castle steeped in family secrets. But I've come to know rather well subscribe, just search for intrigue. The ratline, wherever you get your pod costs.