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

Do No Harm by Henry Marsh
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it was amazing
bookshelves: memoirs, science-tech, illness-and-death

“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.
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Reading Progress

October 18, 2014 – Shelved
October 18, 2014 – Shelved as: to-read
September 6, 2015 – Started Reading
September 6, 2015 – Shelved as: memoirs
September 6, 2015 – Shelved as: science-tech
September 6, 2015 – Shelved as: illness-and-death
September 24, 2015 – Finished Reading

Comments Showing 1-15 of 15 (15 new)

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Jeanette Just finished this one and it was excellent.

Rebecca I saw you rated it just 10 minutes before me - how's that for a coincidence?! :) Absolutely fantastic book, one of the best I've read this year.

message 3: by Jo (new) - rated it 4 stars

Jo Weston It's outstanding. I only gave it four stars, but on reflection that might have been a bit mean. Suspect it may be my read of the year, certainly it will be a contender. Book Club reconvenes next week after our summer break and this is what we will be talking about, I cannot wait to see what the others thought.

Jeanette He is not unemotional, but has controlled his emotion. Imagine the onus of carrying that consequence as he does daily!

Rebecca He struck me as having quite a temper (not surprising considering all the bureaucracy he has to deal with), but also being sensitive to what his patients are going through.

My brother-in-law died of brain cancer earlier in the year, so there was some personal resonance for me here. My sister is now reading the book, and finding it an emotional experience for the memories it's bringing up. Good to see things from the other side, though -- to know that surgeons have a hard time seeing the people they've operated on decline and pass.

Jeanette We have history, as well. My Mother had pituitary tumor and was Univ. of Chicago teaching case for more than 30 years. She refused surgery and went all the way to end stage acromegaly. She always appreciated a doctor with some sensitivity too. Her experiences as specimen in photographic record and medical school contacts left her nearly none. She could do it BECAUSE she knew who she was, not just a "case" who no longer looked female.

Rebecca WOW -- what a story.

message 8: by Lilo (new) - added it

Lilo This book sounds like a must-read.

Rebecca Absolutely. It gets my highest recommendation. Especially since you enjoyed the Gawande.

Carolinemawer Thanks so much for this thoughtful review, Rebecca. As Jeanette says - the huge onus of carrying the consequences. Personally, I can't imagine that!

Marianne Villanueva I was just beginning the aneurysm chapter when I read your review. Put spoiler warning! Each chapter is a stand-alone whodunit. But that only shows how Marsh is able to get readers so vested in his material that we're all holding our breaths.

Jeanette This comment or two coming up reminded me that I want to read his other book. Marsh is an incredible person and a spectacular doctor.

Marianne Villanueva My sister died in New York at 34, mother of three small children, and ever since then I've been reading books by doctors. They are some of the best writers I have ever read.

Rebecca Jeanette wrote: "This comment or two coming up reminded me that I want to read his other book. Marsh is an incredible person and a spectacular doctor."

The new one is not quite as good, but still well worth reading.

Rebecca Marianne wrote: "My sister died in New York at 34, mother of three small children, and ever since then I've been reading books by doctors. They are some of the best writers I have ever read."

I'm sorry to hear that, Marianne. (I'm 34 now!) I would agree with you that doctors can be excellent writers, too. Atul Gawande and Siddhartha Mukherjee especially.

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