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

During the long flights from South America to Japan, I finished the book, Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh. Dr. Marsh is an experienced British neurosurgeon. He is an excellent writer with an rebellious attitude and I really was immersed in his world.

I learned a lot of about the life of a brain/spinal surgeon and it is a tough life. He deals a lot with death and illness, and I know it should be common sense, but when one thinks of doctors, one thinks of high salaries and respect in the community. With that however, comes much responsibility and the idea of going into work and someone’s life depends on your performance that day is awe inspiring. It is a demanding career choice, especially doing delicate operations on the brain and spinal cord.

He went through a lot in his over 30 years of practice. Dr. Marsh has come to some revelations through this and he has some interesting reflections on death, illness and medical care. As with other books I have read about death and illness, much of it is just bad luck. I have only known one person with a brain tumor, a teaching colleague of mine when I was in Australia. I was new to the school and didn’t really know him, but he was on and off at the school while he battled the cancer, eventually ending in his retirement and death. So tragic as he left behind a wife and children. Marsh recalls many emotional stories of people dealing with brain tumors. One story of a bicycle rider reminds me to always wear a helmet!

Marsh is a really Brit, and for those Americans who have spent a lot of time around them, you’ll know what I mean. I had to laugh out loud when he wrote what he learned from his American residents that he trained at his hospital. “…I love their optimism, their faith that any problem can be solved if enough hard work and money is thrown at it, and the way in which success if admired and respected and not a cause of jealousy.” I admire the honesty of the Brits.

It is truly awesome to be able to cut into and work on the human brain. His descriptions of the procedures are amazing. The operating microscopes and technology that allows doctors to cut through the skull and repair the mass of jelly which is the brain is incredible. 25% of our blood from the heart goes to the brain which makes it even more complicated and dangerous. He liked his job because “it seemed to involve excitement and job security, a combination of manual and mental skills and power and social status as well.” He sees medicine as a form of craft, neither art nor science.

Many of the cases are really depressing. When patients are terminally ill, it is difficult to accept it and to decide how to proceed. As he asks, “will I be so brave and dignified when my time comes?” I too wonder about my death. He reckons the perfect death is to die in one own’s home, after a long life, quite quickly, looked after by her own children, surrounded by family and free of pain”

He refers to Daniel Kahneman’s book, “Thinking, Fast and Slow” and writes that errors of judgement and the propensity to make mistakes are built in to the design of the human brain and gives him comfort in thinking about the mistakes he has made in his career.

He really hates the British public health system and the way modern hospitals are managed. There seems to be a shortage of beds in the UK and I am glad I have private health care, which he also uses. I hope I can afford to keep private health care as I get older.

I am not sure if I would like a job that deals with death and disease all the time. I think I would be good at it however, except for my fine motor skills, which are not great.

Some of the other quotes and vocabulary words I got from the book are as follows:

“…as I become more and more experienced it seems that luck becomes ever more important.”

“…the long working hours and the self-importance it produced in me would lead to the end of our marriage 25 years later.”

“to treat some of the keynote lectures at conferences with a degree of skepticism”

pineal gland – a cone-shaped gland under the brain that releases melatonin, regulating sleep and circadian rhythms. This is known as the “third eye” and some quacks believe the gland can be managed through meditation or other means.

aneurysm – the wall of the artery gets weak and bulges out

pithy – adjective meaning concise and forcibly expressive language

ignominious – causing public shame or disgrace

paroxysms – sudden violent attacks

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