Admissions is a bleaker book than Do No Harm. The mood is at times sad, lonely, angry, and even a bit bitter. Marsh has clearly had his fill of bureaucracy and government regulation: "Years of frustration and dismay at my steady loss of authority, at the erosion of trust and the sad decline of the medical profession, had suddenly exploded" (p48). He calls out the tension in medicine "between caring for patients and making money" (p72). He points to physician's complacency as the vilest of any medical transgression.

Yet despite the gloom, Marsh carves out a prominent place for hope in the practice of medicine. He believes our brains are hardwired for it. He recognizes that "patients want hope, as well as treatment" (p244), but cautions that decent doctors "will neither lie nor deprive the patient of hope" (pxv).

Marsh reflects on how things can go wrong in the medical field and the consequences of medical mistakes. He considers the necessary balance between confidence and humility, compassion and detachment. Medical knowledge alone is not enough. Proper judgement must accompany it. Even in retirement, Marsh remains a prudent and powerful voice about what it means and what it takes to be a good doctor.