Do no Harm, Henry Marsh | Review #1
Stories of Life, Death, and Brain Surgery
Who is Henry Marsh ?
Henry Marsh is an English neurosurgeon born in the 5th March 1950. He’s mainly known for being a pioneer of the neurosurgical advances in Ukraine.
Do No Harm was published in 2014, followed by his second memoir Admissions: A life in brain surgery in 2017.
Quick Review
This book is about the joy and struggles in a neurosurgeon’s daily life.
On one hand, succeeding a surgery fills your heart with a deep sense of accomplishment ; on the other hand, the tiniest mistake might lead to the patient’s death (or he/she may be severely disabled for the rest of his/her life).
In his book, Henry Marsh gives an insight of his anxiety and suffering as a neurosurgeon, but also his passion and the satisfaction saving one’s life procure. This is what makes this book so valuable to me. You do not understand or imagine what some surgeons might go through every day unless you’ve experienced it or talked to one of them personally. The author’s honesty lets you have a glimpse of what it feels to the patients and their families and to be the one saying the bad news to them.
Moreover, something said in the book also reflects different ideas an other surgeon told me :
Surgeons are no longer considered as “gods”. Patients now come with their own diagnosis made up thanks to the internet. As a result, the truth towards the surgeon has also been impacted ; nowadays, doctors sometimes have to really convince their patients.
Doctors have to show empathy but at the same time, they shouldn’t get too much involved in their patients’ feelings. Finding the balance between empathy and sympathy isn’t always easy.
For aspiring doctors : Interventional radiotherapy may interest you. It is a fast-growing field. Nowadays, as Henry Marsh said, many aneurysms in brain arteries are no longer a neurosurgeon’s exclusivity.
Simply written but moving, Do No Harm enhances your empathy, both towards doctors and nurses working in hospitals but also (and mostly !) towards the patients and their families.
One thing to remember for aspiring neurosurgeons
Sometimes, it is better not to remove a brain tumor entirely. Even if it will grow back again, removing it entirely might lead to some brain damage. Obviously, it depends on the case, but good to keep that in mind. At times, we have to know when to stop.
Every surgeon carries within himself a small cemetery, where from time to time he goes to pray - a place of bitterness and regret, where he must look for an explanation for his failures. (René Leriche, La philosophie de la chirurgie, 1951)
Quick brain anatomy
Henry Marsh often mentions the risks of a neurosurgery. One of them being the loss of language.
Briefly :
The brain can be segmented in different regions (called “Brodmann areas”), each one has a number. Both areas responsible for speaking and understanding language are located in the left hemisphere.
Broca’s area (44 + 45) : speaking
Wernicke’s area (22 + 37 + 39 + 40) : understanding. It is located between the visual areas (17 + 18 + 19) and the auditory areas (41 + 42). Makes sense.
The different areas are interconnected with a myriad of fibres but enough lol, that was just a quick crash anatomy for medical nerds like me :).
Have a nice week !
Philippe