A collective of bibliophiles talking about books. Book Fox (vulpes libris): small bibliovorous mammal of overactive imagination and uncommonly large bookshop expenses. Habitat: anywhere the rustle of pages can be heard.
I do not, it would be fair to say, have much grounding in medicine. I got deeply average marks in my Standard Grade Physics and Chemistry, and didn’t even touch Biology. Come the time to do Highers I avoided the sciences altogether for the vastly more comforting realms of English, History, and French. I get squeamish at the sight of blood (even on telly) and I’m slightly hazy on the rules about taking paracetamol and ibuprofen at the same time. Whenever the marketing and sales people at W&N sat down one day to think about exactly who would be reading Do No Harm by respected neurosurgeon Henry Marsh, I would imagine “thirty-something humanities type who can barely tell her tibs from her fibs but who passed it in a bookshop and thought the cover was pretty” was not their top BIC code.
Yet that is exactly what happened. The cover is gorgeous, and while we all know we shouldn’t be judging our books on them, it was precisely that which made me look twice. On further inspection it struck me as the brain surgery equivalent of last year’s exceptionally (and deservedly) well reviewed The Examined Life by psychoanalyst Stefan Gross, which was a collection of stories from his own long career. So it is with Do No Harm, and I will say now I could barely put it down.
Henry Marsh read PPE at Oxford before changing routes and studying medicine. He became a Fellow of the Royal College of Surgeons in 1984 and was appointed Consultant Neurosurgeon at a London hospital in 1987, where he still works full time. It has been a long and distinguished career, and I have decided that should anyone ever need to drill into my skull and fiddle about with the “jelly-like” consistency of my brain, I would like it to be him.
Each chapter is based around a certain type of affliction, from benign tumours to awful malignancies, spinal cord issues (I had no idea these came under the remit of neurosurgery), and head injuries. While we do read about some of the technicalities of the procedures themselves, like seated operating positions, heads clamped to tables, working within brain spaces mere millimetres big, and brain surgery while the patient is awake, the most captivating aspects are the human stories. Not just the patients, but Marsh himself. We read about his slightly circuitous route to neurosurgery, his terror when his own infant son had to undergo brain surgery at just three months old, and – most astonishingly – his own surgical mistakes. The cliched view of surgeons is that they believe themselves infallible, god-like. I’ve seen numerous articles about half of them being theoretical psychopaths. What Marsh’s book does very well is explore the dichotomy between his need to be supremely confident, yet sufficiently fearful, in theatre, yet willing and able to hold up his hands when something goes wrong. Indeed, there are stories in his book where we see him speaking to anguished family members and advising them to sue him because he made a catastrophic error.
“I do not know why, since the operation had seemed to proceed uneventfully, but she awoke from the operation paralysed down the right side of her body. I had probably tried to take out too much of the brain tumour. I must have been too sure of myself. I had been insufficiently fearful. I longed for this next operation to go well – for there to be a happy ending so that I could feel at peace with myself once again.”
Some of the tales here are incredibly sad, especially those involving terminally ill children and teenagers. Yet, there are moments of immense hope and happiness. One such story involved a 28-year-old woman, 37 weeks pregnant, who had to undergo surgery to remove a benign tumour that was pressing on her optical nerves and quickly inducing blindness. A c-section would take place within the same operation, and of course, the risks were immense. But all went perfectly: a young woman regained her sight, had a beautiful, healthy child, and half the operating room were in tears of joy. In fact, I feel a bit sniffly just remembering the story now.
We are privy to Marsh’s frustrations with the current NHS culture and the leagues of managers and paperwork he must deal with. I believe he feels strongly about the good of the NHS but that, perhaps, money is being spent in the wrong ways. It’s not that there isn’t enough of it, it’s that it’s being wasted on bureaucracy. He has excoriating words for American Republicans who believe that the NHS has “death panels”.
Do No Harm is a fascinating and deeply moving book, and one in which the author is admirably honest about his own failings as well as his immense skills. And the cover is gorgeous.
Henry Marsh, Do No Harm: Stories of Life, Death, and Brain Surgery (London: Weidenfeld & Nicholson, 2014). ISBN 9780297869870, RRP £16.99