The next morning we went on an excursion to the port of Durres and to Berat, a town in the mountains. Even though we had spent only three days together, it seemed as if we had known each other for years. Marsh explained the architecture of the brain to me, and the way it functioned. He explained how they reached tumors that were lodged deep in the brain, which is, very loosely speaking, crumpled up like a sheet of paper, and therefore full of folds and ravines that you can push aside and move through. There are also so-called silent areas, which could be cut without damaging any of the brain’s functions. He told me about times when things had gone wrong, and the patient had died on the operating table in front of him. “I have killed people,” he said.

He told me about difficult operations that had succeeded and about the euphoria they produced. He said that 50 percent of surgery was visual, what you saw, and 50 percent was tactile, what you could touch. He said that brain surgery was a craft. To become good at it, you had to practice and sometimes make mistakes, in a profession where mistakes were fatal and impermissible. If your child has a brain tumor, you want the best surgeon. But to become the best, which is merely a question of gaining experience, you must first have operated on children without having experience, and what do you tell the parents then? That their child is important to the future of the young and as-yet-untested neurosurgeon?

He talked for a while about the particularities of operating on children. The tissues are soft and beautiful, very different from those of older people. A child is as fresh and clean on the inside as on the outside. But the problem with blood loss is very great; they can lose a life-threatening amount of blood very quickly. And the desperate anxiety of the parents is a heavy burden to carry. But for the children themselves, it’s easy. If they’re not in pain, they’re happy. They don’t have any existential perspective. He talked about his father, who was a law professor at Oxford University, and about his mother, who came to Britain as a refugee from Nazi Germany before the war, and how they both helped form what is now Amnesty International. He talked about his youth, about how shy he was, how he sat at home reading books when everyone else went out, how he never went to nightclubs, never spent time with girls. He told me about a breakdown he had as a young man, when he fell into a deep depression and spent some time in the psychiatric ward of a hospital. He told me he wrote poetry at that time, inspired by Sylvia Plath. He told me that the medical profession he had chosen seemed safe to him, something to buoy him. He told me about his relationship to his siblings and to his own children. “I competed with my children,” he said, grimacing at the recollection. “Can you imagine? I always wanted to show them how clever I was. That’s one of the worst things you can do to children.” He told me how his first marriage ended, and what his present marriage was like.

He was entirely open but not confessional; it was more that all our conversations seemed to lead to more serious matters, almost regardless of where they began, perhaps because the situations that gave rise to them were so concentrated and involved life and death, and because the places where they occurred were closed to us in a way, amid an alien culture, and yet in another sense, so open: Sitting on a terrace on the seventh floor, surrounded by dark blue sea extending in all directions, glittering in the sunlight, a few tiny people wading through the green shallows, maybe 50 yards out, the slightly lighter blue sky arching above us. Standing in an old Orthodox stone church in the mountains, in front of a row of icons on the wall, in radiant colors, gold, red, blue, beneath a dome with three circular holes that the light sifted down through. Sitting in a car whizzing through the darkness of the Albanian countryside after a long day in the sun. Walking through the heart of Tirana one afternoon, in small, narrow streets that lay in deep silence, past dilapidated houses and walls, with improvised electrical wiring, makeshift home extensions and dirty children playing in back alleys, just a few hundred yards from the main boulevards. Several times, when he mentioned something private, I reminded him that I was going to write about him. “You do realize that I might write about what you just told me?” He just smiled and said that was his strategy: The more personal he got, the more likely it was that I would like him and therefore write favorably about him.

The only time I saw Marsh angry was on the morning before the second operation. He had planned on seeing the patient, only to be informed by Petrela that she was already in the operating room and was having her head cut open.

“Damn,” he said loudly, stamping his foot and striking out at the air with his hand.

“You could see her tomorrow morning, before the operation,” Petrela said.

“O.K., that’ll have to do,” Marsh said calmly, but his eyes were still angry. Instead, he and Petrela went to see how Hasanaj was doing. I came along. Petrela pushed the button by the elevator at the end of the corridor and told us that when the king died, or rather, the king’s son, his heir apparent, the body had been brought to this hospital, and when it was taken out again, they had used this elevator. The elevator stopped between two floors, with the dead king inside, and it took them two hours to restart it.