Do No Harm: Stories of Life, Death and Brain Surgery
By: Michael McKenna
Author: Henry Marsh
Length: 304 pages
Publisher: Weidenfield & Nicolson (Paperback)
There are few professions where the difference between success and failure is as stark as in the field of neurosurgery. Do No Harm provides an intricate insight into the mind of a man encountering these highs and lows on a daily basis.
For anyone with an interest in the vast breadth of surgical applications and its associated technical complexity, Do No Harm makes for a fascinating read. Each of the 26 chapters in the book centres around a condition or disease encountered in the field of neurosurgery and are awash with exhilarating drama, insights into the chaos and confusion of a modern hospital and the challenges experienced both inside and outside the surgical theatre. Marsh manages to tailor his book to both a healthcare and non-healthcare audience, frequently using medical terminology but explaining everything as he goes along, ensuring that any reader can pick up this book and delve deep into his life.
Do No Harm also provides a fascinating look into the healthcare environment. Throughout his anecdotes, Marsh reveals the comradery of working with his surgical staff, registrars, anaesthetists, porters and everyone in between while negotiating interpersonal differences in opinion and optimising care. We catch glimpses of the difficulties encountered while working in the modern healthcare environment, and the massive technological and cultural changes that have occurred between when Marsh first started practising surgery and the present day.
What makes this book so riveting isn’t the range of cases experienced by Marsh over his 30 year-long career however; it’s the raw, unfiltered emotions he reveals having experienced on a day-to-day, patient-by-patient basis. The reader can’t help but empathise with Marsh as he opens up about his inner struggles: allaying the fears of patients and their families about the risks of surgeries while ensuring they remain realistic, finding the right balance between a professional detachment and a personal empathy, and dealing with patients where operations haven’t gone well. It becomes apparent throughout the book that the doctor-patient relationship is by no means a strictly professional one, as Marsh recounts celebrating victories and suffering losses side by side with his patients. It serves as an important reminder that often there are personal consequences of professional responsibilities and that doctors, who are often imbued with almost superhuman qualities, are still human at the end of the day.
One of the most striking examples of the emotional quality of this book regards one of the cases that lead to Dr. Marsh leaving the world of paediatric neurosurgery. It regarded a three year old child, who had been an only child born from IVF treatment, and who had been diagnosed with malignant ependymoma. Having operated twice only to see the boy suffer two recurrence, he made the decision not to operate again as the endeavour was pointless. He described the emotional grief of the parents in vivid detail: ‘The conversation with his parents was terrible: they wouldn’t accept what I said and they found a neurosurgeon elsewhere who operated three times over the next year and the boy still died…His parents then tried to sue me for negligence…Love, I reminded my trainees, can be very selfish’. The heart-breaking lessons learned from stories like this are shared by Marsh throughout the book and allow the reader to tap into years of wisdom acquired over the course of a neurosurgeons career.
Having read this book, I would recommend it to anyone with an interest in neurosurgery, surgery in general, or to those looking for a fascinating pragmatic insight into the life of a doctor. Remaining pragmatic right up until the very last page, Marsh offers a rare balanced insight into the healthcare environment, where the amazing successes that people often associate with the medical profession are counterbalanced with the hard days and situations doctors often find themselves in. Elegantly written and impossible to put down, Do No Harm will remain a staple in the field of medical memoirs for years to come.
About the Author
The youngest of four children, Henry Thomas Marsh grew up in Oxford and London. Initially studying Politics, Philosophy and Economics at the University of Oxford, Marsh decided to pursue a career in Medicine instead, graduating with First Class Honours from the Royal Free Medical School. Deciding to specialise in neurosurgery, Marsh advanced to the level of senior consultant neurosurgeon in St. George’s Hospital in South London before retiring in 2015. Marsh has been hailed as a pioneer of neurosurgical advances in the Ukraine and has been the subject of two major documentary films, ‘Your Life in their Hands’ and ‘The English Surgeon’. Marsh was appointed Commander of the Order of the British Empire (CBE) in 2010. Do No Harm is the first of his memoirs, published in 2014, which was followed in 2017 by a second set of memoirs titled ‘Admissions: A Life in Brain Surgery’.
‘Riveting…extraordinarily intimate, compassionate and sometimes frightening…[Marsh] writes with uncommon power and frankness. And while this book may unsettle readers…it will at the same time leave them with a searing appreciation of the wonders of the human body, and gratitude that there are surgeons like Henry Marsh using their hard-won expertise to save and repair lives’ – Michiko Kakutani, New York Times
‘When a book opens like this: “I often have to cut into the brain and it is something I hate doing” – you can’t let it go, you have to read on, don’t you?…I trust completely the skills of those who practice [brain surgery], and tend to forget the human element, which is failures misunderstandings, mistakes, luck and bad luck, but also the non-professional, everyday life that they have. Do No Harm by Henry Marsh reveals all of this, in the midst of life-threatening situations, and that’s one reason to read it: true honesty in an unexpected place. But there are plenty of others’ – Karl Ove Knausgaard, Financial Times