Do No Harm – Stories of Life, Death and Brain Surgery
Weidenfeld & Nicolson, 2014
What it’s about: A Summary
I don’t want to spoil the book by giving too much away in this summary. I would simply say that, if you are looking into a career in the medical profession, this book is an excellent resource.
Simply, Do No Harm is the memoirs of a senior neurosurgeon, from the beginning to near the end of his career. It encompasses the good, the bad and the ugly of his field and medicine as a whole.
I would not say that Henry Marsh is a good role model for budding doctors. I would instead say that he acts as a reminder to all that doctors are as human as the rest of us.
On the Author:
Henry Marsh is one of the UK’s foremost neurosurgeons. It should be noted that, although I felt that only a cursory amount of attention is paid to his work in Ukraine in the book, the film The English Surgeon details this in far more detail. If you find this book to your tastes, it is worth giving the film a watch.
“It is not surprising that we invest doctors with superhuman qualities as a way of overcoming our fears. If the operation succeeds the surgeon is a hero, but if it fails he is a villain.”
Henry Marsh is only human. In his memoirs he publishes truly honest, sometimes disturbingly honest, stories of his daily life and work. In it, he challenges the basis of the age-old Hippocratic oath “Do No Harm”, by reminding us that, in their humanity, doctors and even surgeons make mistakes more often than we care to admit. Even truly excellent ones! In fact, all fields of medicine and all treatments come with risks that cannot always be accounted for. Walking along the corridors of a nursing home, he recognises “at least five” of the residents as his own failures. And these failures are what populate the book from page 1. “The idea that neurosurgery is some kind of calm and rational appliance of science… is utter crap.”
In fact, Marsh provides a window into his world in a very honest sense. Neurosurgeons must, on a daily basis, make life-changing, or life-saving, decisions that could lead to immense success or utter failure. It is with this dilemma that Marsh presents us.
In the course of the book, we also can see the sacrifices made in the pursuit of becoming an excellent neurosurgeon. The career served to shape Marsh’s character, such that he feels a certain entitlement as a result of his importance at work. One particularly memorable example of this is the moment in the book where, after performing a protracted operation, he expresses frustration at the menial world outside the hospital by imagining asking the person in front of him in a supermarket queue “What did you do today?” It is this frank self-awareness of how pompous he sounds that makes Marsh somehow so relatable.
Marsh, conversely, approaches the subject of being treated as a patient by his colleagues, and seeing his close family treated as well. It is through this intense vulnerability that he understands the plight of his patients. Through the connection Marsh makes to his patients, we can see the powerful exhilaration in performing a successful procedure to save a life. It is the wonder that Marsh feels that we also feel, even starting as a trainee first working on the brain, “a mystery… as great as the stars at night and the universe around us.”
And yet, the book still feels like a cautionary tale of the old ways of medicine: strict hierarchies where the senior doctor’s word was law. The world Marsh trained in, whose values are so ingrained in his practice, is gradually fading away, turning him into an “impotent and angry victim of government targets”. And it is being replaced with fresh bureaucracy, new management structures, corporate training programmes and regulation of junior doctors’ working hours. We can all certainly relate to the bizarre frustration he feels at current juniors being free of the excessively-long hours he endured as a trainee, but he also describes with understandable anguish administrative staff brought in purely to police government policies and agency staff that do not know the whereabouts of their patients.
It is with these thoughts that the book ends. It is an appropriate finish to a book that encompasses the daily thoughts, successes and failures of a human being who is also a surgeon. And really that, in itself is poignant in this new era of personalised medicine: in the same way that doctors must view patients as human beings, we must acknowledge that doctors, too, are people with their own hopes, desires and full lives.
A note from the author: As my posts sometimes touch on emotive subjects, comments are disabled after 14 days. This is because, at this stage, I feel that ongoing discussions tend to stagnate.