I have been completely enthralled by neurosurgeon Henry Marsh’s bestselling book Do No Harm: Stories of Life, Death and Brain Surgery. Brain surgeons are awe-inspiring, almost God-like people with razor sharp minds and nerves of steel, and Marsh is one of the very best. In this book he gives a fascinating insight into his job and with moving candour describes the triumphs as well as the disasters. You’ll never think about your brain in quite the same way…
‘Tight-rope walking’ is how Marsh describes his job, life changing decisions being part of the every day. Although extremely stressful, it’s also exceptionally rewarding, according to the author. And, interestingly, just as strong a motivator as the urge to save peoples’ lives is the thrill of the actual operation.
The book is full of fascinating facts. Did you know for example that many brain operations are carried out with the anesthetised patient sitting upright? Or that some brain surgery is undertaken with only local aesthetic? Eek!!
Marsh is honest about his feelings of self-importance, even superiority, although as he has aged ‘I can no longer deny that I am made of the same flesh and blood as my patients and that I am equally vulnerable’. It almost seems that feeling invincible is a must to handle the pressure these surgeons are under.
Behind this tough façade, Marsh shows us, there is guilt and sadness where operations went wrong; mistakes made years ago still haunt him. Walking through the corridors of a nursing home he writes:
The doors were all open and through the doorways I could see the motionless forms of the patients in their beds. Beside each door was an enamelled plaque with the patient’s name […] To my dismay I recognized at least five of the names as former patients of mine.
Bureaucracy and lack of funding in the NHS are major obstacles in Marsh’s job, lack of patient beds means that he ‘spends many hours lying on a sofa, staring gloomily at the clouds’ while he waits for beds to become available so that he can continue operating. An archaic computer system is not helping either.
Marsh brings up some of the grisly dilemmas him and his team are up against. Should they operate on a 96-year-old woman with a brain tumour or tell her she’s too old? Will the 40-year-old man who’s crashed on a bicycle have a life worth living after being operated or should they just let him die? What do you tell the family so they can make the right choice?
In cases like this we often end up operating because it’s easier than being honest and it means that we can avoid a painful conversation. You might think the operation has been a success because the patient leaves the hospital alive but if you saw them years later – as I often do – you would realize that the result of the operation was a human disaster.
I found myself totally captivated and, at times, moved to tears by this book. Marsh’s touching yet completely unsentimental story will definitively be worth your time.
DO NO HARM: Stories of Life, Death and Brain Surgery by Henry Marsh is published by Phoenix, 276 pages.