Rebecca's Reviews > Do No Harm: Stories of Life, Death and Brain Surgery

“Terrible job, neurosurgery. Don’t do it.” Lucky for us, Henry Marsh reports back from the frontlines of brain surgery so we don’t have to. He’s nearing retirement age after a career divided between a London hospital and medical missions to Ukraine. The punchy chapters are named after conditions he has treated or observed. Rarely, he has been a patient himself (detached retinas, a broken leg), or observed a family member’s illness – his son’s brain tumor, his second wife’s epilepsy, and his mother’s terminal cancer.

Marsh comes across as having a hot temper, exhibiting extreme frustration with NHS bureaucracy. At the same time, he gets very emotional over his patients declining and dying, and experiences profound guilt over operations that go wrong or were ultimately unnecessary. He realizes the God-like power he holds over people’s quality of life: “We [surgeons] sit there, alive and well and happy in our work, and with sardonic amusement and Olympian detachment we examine these abstract cases on which to operate.”

It was particularly interesting for me to see the view from the other side of the operating table because two chapters have personal significance for me: “Oligodendroglioma” was my late brother-in-law’s diagnosis, and the account of a near-disastrous clipping surgery in “Aneurysm” showed me why my mother has been so reluctant to have it performed.

In my favorite passages, Marsh reflects on the mind-blowing fact that the few pounds of tissue stored in our heads could be the site of our consciousness, our creativity, our personhood – everything we traditionally count as the soul:

I am looking directly into the center of the brain, a secret and mysterious area where all the most vital functions that keep us conscious and alive are to be found. Above me, like the great arches of a cathedral roof, are the deep veins of the brain – the Internal Cerebral Veins and beyond them the basal veins of Rosenthal and the in the midline the Great Vein of Galen, dark blue and glittering in the light of the microscope. This is anatomy that inspires awe in neurosurgeons.

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.

This book might not be for you if you are squeamish about surgical details, but if you can get past that I submit to you that, like Atul Gawande’s Being Mortal, this is one that everyone should read.