Do No Harm: Stories of Life, Death, and Brain Surgery

by Henry Marsh

Years ago, I would have stormed off in a rage, demanding that something be done, but my anger has come to be replaced by fatalistic despair as I have been forced to recognize my complete impotence as just another doctor faced by yet another new computer program in a huge, modern hospital.

Most neurosurgeons become increasingly conservative as they get older – meaning that they advise surgery in fewer patients than when they were younger. I certainly have – but not just because I am more experienced than in the past and more realistic about the limitations of surgery. It is also because I have become more willing to accept that it can be better to let somebody die rather than to operate when there is only a very small chance of the person returning to an independent life.

as I walked away down the dark hospital corridor, at the way we cling so tightly to life and how there would be so much less suffering if we did not. Life without hope is hopelessly difficult but at the end hope can so easily make fools of us all.

Dying is rarely easy, whatever we might wish to think. Our bodies will not let us off the hook of life without a struggle. You don’t just speak a few meaningful last words to your tearful family and then breathe your last. If you don’t die violently, choking or coughing, or in a coma, you must gradually be worn away, the flesh shrivelling off your bones, your skin and eyes turning deep yellow if your liver is failing, your voice weakening, until, near the end, you haven’t even the strength to open your eyes, and you lie motionless on your death bed, the only movement your gasping breath. Gradually you become unrecognizable – at least you lose all the details that made your face characteristically your own, and the contours of your face are worn away down to the anonymous outlines of your underlying skull. You now look like the many old people, with drawn and dehydrated faces, identical in their hospital gowns, to whose bedside I would be summoned in the early hours when I worked as a junior doctor, down the long and empty hospital corridors, to certify death. Your face becomes that of Everyman, close to death, a face we all know, if only from the funeral art of Christian churches.