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


Henry Marsh


Wiedenfeld & Nicholson






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Recommended by one of our MyBrain Practitioners and billed on the front cover as "startling and moving...enthralling" by a Guardian reviewer, I was intrigued to read this book.

Henry Marsh writes in an easy, almost conversational style, giving an insight into the fascinating life as a brain surgeon through a series of true stories of the various treatments offered to his patients. I was struck particularly by the honesty and candour he injects into these stories, about his vulnerabilities, his imperfections and the inevitable human error that sometimes occurs. He talks about the hope and trust that patients and their families have in their surgeons, almost believing them to be superhuman heroes and the weight of responsibility that feels for the doctor.

I like the way that each chapter tells of a different challenge with each patient, from benign tumours pressing on optic nerves causing blindness, to strokes, traffic accidents and more, yet there is the common theme of a man committed to doing his best for each. He finds his work hugely rewarding but describes that reward as coming with a price - where mistakes are inevitable and you must learn to live with sometimes dreadful consequences. He shines a light on an area all surgeons battle with, the struggle to find a balance between the necessary detachment and compassion for his patients. His way (as it should be) is to always tell the truth to his patients which often meant he had to answer "I don't know" to the question "will I get better?". His telling of a conversation with a man whose initial low grade astrocytoma of the right temporal lobe eventually became a high grade glioblastoma which would be fatal is particularly moving. Only a few of the low grade tumours, if small enough, can be completely removed by surgery and most patients must learn to live with a slow death sentence. Moore reveals how difficult it is to explain that diagnosis to a patient and how to balance realism with optimism. His patient David had come to terms with his short time left and told Moore that he had organised everything that needed to be done. The chapter (12) ends with Moore shaking David's hand and telling him "It's been an honour to look after you", then afterwards asking himself if he could be so brave and dignified when his time comes.

Throughout all this Moore demonstrates a healthy sense of humour and self-deprecation not least with his teams of junior doctors who he sometimes also finds exasperating. He admits to worrying about allowing them to learn in the operating theatre and mistakes being made at their hand rather than his own, always wanting to give the best to each patient.

The stories tell of Moore's career journey as he builds his experience of intricate surgery throughout the years, and even as medical knowledge and research progresses, he tells the reader that in reality he never completely knows what he is going to see or discover in each operation. It is a book that reminds us that the world of neuroscience is in its infancy, and one where the ongoing discoveries surely will never end. The subject of the book inevitably makes it sometimes difficult to read and we are reminded about the hand we are all dealt and how that hand can be so cruel and so random. At the same time it is gripping and a fascinating read, informative, yet human and humbling. I highly recommend it.