Do No Harm: Stories of Life, Death and Brain Surgery - as seen on 'life-changing' BBC documentary Confessions of a Brain Surgeon

by Henry Marsh

The brain is a mass of blood vessels and I must try to avoid tearing the many veins and minute arteries both to prevent bleeding from obscuring the view and also for fear of damaging the blood supply to the brain. Sometimes, if the dissection is particularly difficult and intense, or dangerous, I will pause for a while, rest my hands on the arm-rests, and look at the brain I am operating on. Are the thoughts that I am thinking as I look at this solid lump of fatty protein covered in blood vessels really made out of the same stuff? And the answer always comes back – they are – and the thought itself is too crazy, too incomprehensible, and I get on with the operation.

If patients were thinking rationally they would ask their surgeon how many operations he or she has performed of the sort for which their consent is being sought, but in my experience this scarcely ever happens. It is frightening to think that your surgeon might not be up to scratch and it is much easier just to trust him. As patients we are deeply reluctant to offend a surgeon who is about to operate on us.

With slowly progressive cancers it can be very difficult to know when to stop. The patients and their families become unrealistic and start to think that they can go on being treated forever, that the end will never come, that death can be forever postponed. They cling to life.