English neurosurgeon Henry Marsh’s mesmerizing memoir “Do No Harm” is an unblinking look at a profession that demands life-or-death decisions on a daily basis.
‘Do No Harm: Stories of Life, Death, and Brain Surgery’
by Henry Marsh
St. Martin’s Press, 288 pp., $25.99
When most of us fail at some aspect of our jobs we may feel distress and face some kind of reprimand. When brain surgeons fail, the consequences can be catastrophic, ruining or ending the lives of their patients and devastating family members.
A surprising page-turner, “Do No Harm” is British neurosurgeon Henry Marsh’s mesmerizing memoir of his career highlights and low points, a fascinating blend of derring-do and humble pie. Marsh was featured in the Emmy Award-winning documentary “The English Surgeon.”
Part of the enormous appeal of the book is Marsh’s unstinting candor and self-critical lens. He frankly admits the blunders he has made in the operating room and the grave results that ensued. As a doctor in a national health care system, Marsh seems more free to take responsibility and own up to errors than a physician in the mistake-averse American medical profession, with its constant threat of malpractice litigation.
This, of course, makes for a better book.
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The most thrilling parts of his storytelling are descriptions of the surgeries. The explicit details are not for the squeamish.
In one extraordinary case, his patient, Melanie, was going blind from a tumor that was pressing on her optic nerve. She was also nine months pregnant. After Marsh successfully removed the tumor, the obstetrics team rushed in to deliver her baby by C-section, causing a rare festive mood in the normally somber neurological surgery theater. An exhilarating moment to be sure, but in his very next surgery, the second of three operations that day, a middle-aged woman hemorrhaged and died after an operation to remove part of a cancerous tumor, leaving the surgeon miserable as he gave family members the bad news.
Because his work involves the body’s most vital organ, he must routinely talk with patients about whether they will live or die.
Marsh’s prose is elegant and seasoned, with no false bravado. Modern surgical techniques are nearly miraculous, but the risks are ever present, especially when, Marsh confesses, brain surgeons sometimes need to learn by making mistakes. The margin for error is scalpel-thin; a tiny severing of a nerve or a misjudgment on how much of a tumor to remove can cause paralysis or death.
“We have achieved most as surgeons when our patients recover completely and forget us completely,” he writes. “…They are grateful, no doubt, but happy to put us and the horror of their illness behind them. Perhaps they never quite realized just how dangerous the operation had been and how lucky they were to have recovered so well. Whereas the surgeon, for a while, has known heaven, having come very close to hell.”
Neurosurgery is an extraordinary profession, and despite the dread and foreboding he often faces before most operations, Marsh also feels the awe that inspired him to become a neurosurgeon in the first place. “More than that, the operation involved the brain, the mysterious substrate of all thought and feeling, of all that was important in human life — a mystery, it seemed to me, as great as the stars at night and the universe around us.”
Marsh’s gift for words helps him share his sense of wonder with his readers.