If we are ill and in hospital, fearing for our life, awaiting terrifying surgery, we have to trust the doctors treating us – at least, life is very difficult if we don’t. It is not surprising that we invest doctors with superhuman qualities as a way of overcoming our fears. (xi)
In common use brain surgeon is a synonym for a person able to deal with difficult problems with extreme accuracy based on profound knowledge. And brain surgeons do have great skill and are often at the peak of their medical career. We should also remember that …
Doctors are human like the rest of us. (xi)
Do No Harm is a celebration of the human approaches in this medical specialism.
Do No Harm: stories of life, death and brain surgery
Richard Marsh recently retired from his position in a leading London Hospital where he had been a brain surgeon. This is his account of his career, his memoirs told through a series of case studies, each focusing on a different medical condition. He is keen to point out the fallibility of people in his position and that mistakes do get made, with quite awful consequences. He also reveals the importance of having good skills at explaining and reassuring people, patients and their families. And for teaching those who will ultimately replace him.
There is a central mystery in the brain. It is just jelly-like stuff. This grey-white stuff enables us to be conscious, to make decisions, to learn, understand, even to perform brain surgery. Yet it is still just jelly-like stuff fed by networks of blood vessels. If you are of a feeble disposition look away from this quotation.
I often have to cut into the brain and it is something I hate doing. With a pair of diathermy forceps I coagulate the beautiful and intricate red blood vessels that lie on the brain’s shining surface. I cut into it with a small scalpel and make a hole through which I can push a fine sucker – as the brain has the consistency of jelly a sucker is the brain surgeon’s principal tool. I look down my operating microscope, feeling my way downwards through the soft white substance of the brain, searching for the tumour. The idea that my sucker is moving through thought itself, through emotion and reason that memories, dreams and reflection should consist of jelly, is simply too strange to understand. All I can see in front of me is matter. (1)
This is the opening of the first chapter, called Pineocytoma (an uncommon, slow-growing tumour of the pineal gland). Not all brain surgery is in pursuit of tumours; some is to attend to aneurysms, and some is actually spinal surgery.
And while each chapter looks at a different condition, the reader is never in doubt that these are people in whose brains Henry Marsh is moving his sucker. Some are in a very serious condition, others need preventative work, but all are people, who usually have families, and who are usually very frightened.
Meanwhile he also makes it clear that he is a member of a team, the theatre team and also the team of nursing staff. That these carefully built up working arrangements are endangered by management systems in hospitals and the recent financial and recruitment difficulties inflicted upon the NHS provokes incandescence in a doctor concerned above all with patients.
He tells a good tale, invaluable for those who must learn from him, and which makes for a very readable account of his work inside people’s heads. Here are some of the words reviewers have used to describe this book: elegant, frank, compassionate, profoundly moving, extraordinarily intimate, full of humanity …
It may well be that doctors do not have superhuman qualities, but Henry Marsh demonstrates some profoundly humanitarian one.
I picked up my copy in the Red Cross Shop in Chichester. It is one of the best reads for £1.75 I have had for some time.
Do No Harm: stories of life, death and brain surgery by Henry Marsh, published in2015 by Weidenfeld & Nicolson. 290pp
Winner of the PEN Ackerley Prize and the South Bank Sky Arts Award for Literature. Longlisted for the Samuel Johnson Prize for Non-Fiction.
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