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

by Henry Marsh

Overview

Named a Notable Book of the Year by The New York Times Book Review and The Washington Post

What is it like to be a brain surgeon? How does it feel to hold someone’s life in your hands, to cut into the stuff that creates thought, feeling and reason? How do you live with the consequences of performing a potentially lifesaving operation when it all goes wrong?

With astonishing compassion and candor, leading neurosurgeon Henry Marsh reveals the fierce joy of operating, the profoundly moving triumphs, the harrowing disasters, the haunting regrets and the moments of black humor that characterize a brain surgeon’s life. Do No Harm provides unforgettable insight into the countless human dramas that take place in a busy modern hospital. Above all, it is a lesson in the need for hope when faced with life’s most difficult decisions.

Product Details

ISBN-13:	9781250090133
Publisher:	Picador
Publication date:	06/07/2016
Pages:	320
Sales rank:	76,480
Product dimensions:	5.40(w) x 8.20(h) x 1.00(d)

About the Author

HENRY MARSH studied medicine at the Royal Free Hospital in London, became a Fellow of the Royal College of Surgeons in 1984 and was appointed Consultant Neurosurgeon at Atkinson Morley's/St George's Hospital in London in 1987. He has been the subject of two documentary films, Your Life in Their Hands, which won the Royal Television Society Gold Medal, and The English Surgeon, which won an Emmy, and is the author of the New York Times bestselling memoir Do No Harm and NBCC finalist Admissions. He was made a CBE in 2010.

Table of Contents

Preface ix

1 Pineocytoma 1

2 Aneurysm 12

3 Haemangioblastoma 35

4 Melodrama 48

5 Tic douloureux 62

6 Angor animi 74

7 Meningioma 86

8 Choroid plexus papilloma 107

9 Leucotomy 111

10 Trauma 121

11 Ependymoma 133

12 Glioblastoma 144

13 Infarct 154

14 Neurotmesis 165

15 Medulloblastoma 176

16 Pituitary adenoma 181

17 Empyema 186

18 Carcinoma 192

19 Akinetic mutism 200

20 Hubris 207

21 Photopsia 215

22 Astrocytoma 231

23 Tyrosine kinase 241

24 Oligodendroglioma 250

25 Anaesthesia dolorosa 259

Acknowledgements 277

Editorial Reviews

Neurosurgery has met its Boswell in Henry Marsh. Painfully honest about the mistakes that can 'wreck' a brain, exquisitely attuned to the tense and transient bond between doctor and patient, and hilariously impatient of hospital management, Marsh draws us deep into medicine's most difficult art and lifts our spirits. It's a superb achievement.” —Ian McEwan

“His love for brain surgery and his patients shines through, but the specialty—shrouded in secrecy and mystique when he entered it—has now firmly had the rug pulled out from under it. We should thank Henry Marsh for that.” —The Times

“When a book opens like this: ‘I often have to cut into the brain and it is something I hate doing' – you can't let it go, you have to read on, don't you? Brain surgery, that's the most remote thing for me, I don't know anything about it, and as it is with everything I'm ignorant of, I trust completely the skills of those who practice it, and tend to forget the human element, which is failures, misunderstandings, mistakes, luck and bad luck, but also the non-professional, everyday life that they have. Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh reveals all of this, in the midst of life-threatening situations, and that's one reason to read it; true honesty in an unexpected place. But there are plenty of others – for instance, the mechanical, material side of being, that we also are wire and strings that can be fixed, not unlike cars and washing machines, really.” —Karl Ove Knausgaard, Financial Times

“"Do No Harm is a penetrating, in-the-trenches look at the life of a modern day neurosurgeon. With rare and unflinching honesty, Henry Marsh describes not only the soaring triumphs but the shattering tragedies that are so much a part of every surgeon's life. A remarkable achievement."” —Michael J. Collins, author of Hot Lights, Cold Steel

“A soul-baring account of a practical-minded neurosurgeon who does not suffer fools or believe in souls, who favors ‘statistical outlier' over ‘miracle,' and who admits that a surgeon's ultimate achievement is marked by patients who ‘recover completely and forget us completely.' Readers, however, will not soon forget Dr. Marsh.” —Katrina Firlik, author of Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside

“"Do No Harm is a fascinating look into the reality of life as a neurosurgeon. The personal patient stories are gripping, providing the public with an incredibly candid look into the imperfections and perfections of a dedicated neurosurgeon. In Do No Harm, Dr. Marsh takes the reader into deep into a world of life, death, and everything in between. Despite it all, Dr. Marsh's commitment to his patients and his profession never wavers. You will not be able to put this book down."” —Paul Ruggieri M.D., surgeon and author of Confessions of a Surgeon and The Cost of Cutting

“"Do No Harm dares to reveal the raw and tender humanity behind brain surgery. Each story invites readers into the private thoughts of a neurosurgeon and astonishes them with the counterintuitive compassion required in the operating room."” —Michael Paul Mason, author of Head Cases

“"Henry Marsh peels back the meninges to reveal the glistening, harrowing, and utterly compelling world of neurosurgery. Top-notch medical writing." —Danielle Ofri, MD, PhD, author of What Doctors Feel: How Emotions Affect the Practice of Medicine "The outstanding feature of Do No Harm is the author's completely candid description of the highs and lows of a neurosurgical career. … For its unusual and admirable candor, wisdom and humor, Do No Harm is a smashing good read from which the most experienced and the most junior neurosurgeons have much to learn." ” —AANS Neurosurgeon

“This thoughtful doctor provides a highly personal and fascinating look inside the elite world of neurosurgery, appraising both its amazing successes as well as its sobering failures.” —Publishers Weekly (Starred Review)

“Like the work of his fellow physicians Jerome Groopman and Atul Gawande, Do No Harm offers insight into the life of doctors and the quandaries they face as we throw our outsize hopes into their fallible hands.” —The Washington Post

“Riveting. ... [Marsh] gives us an extraordinarily intimate, compassionate and sometimes frightening understanding of his vocation.” —The New York Times

“The Knausgaard of neurosurgery. ... Marsh writes like a novelist.” —The New Yorker

“A surprising page-turner, Do No Harm is British neurosurgeon Henry Marsh's mesmerizing memoir of his career highlights and low points, a fascinating blend of derring-do and humble pie. ... Marsh's prose is elegant and seasoned, with no false bravado. ... Marsh's gift for words helps him share his sense of wonder with his readers.” —Seattle Times

“There's no denying the vicarious thrill of peeking over a neurosurgeon's shoulder in the operating theater, and Dr. Marsh delivers plenty of hospital drama. Yet what sticks with you are the moments when the lens flips and the field of view widens, and you realize that, in learning about the minutiae of neurosurgery, you're gaining insight into life itself.” —The Wall Street Journal

“One of the best books ever about a life in medicine, Do No Harm boldly and gracefully exposes the vulnerability and painful privilege of being a physician.” —Booklist (starred review)

From the Publisher

"Henry Marsh peels back the meninges to reveal the glistening, harrowing, and utterly compelling world of neurosurgery. Top-notch medical writing." --Danielle Ofri, MD, PhD, author of What Doctors Feel: How Emotions Affect the Practice of Medicine "The outstanding feature of Do No Harm is the author's completely candid description of the highs and lows of a neurosurgical career. … For its unusual and admirable candor, wisdom and humor, Do No Harm is a smashing good read from which the most experienced and the most junior neurosurgeons have much to learn."

AANS Neurosurgeon

"Do No Harm dares to reveal the raw and tender humanity behind brain surgery. Each story invites readers into the private thoughts of a neurosurgeon and astonishes them with the counterintuitive compassion required in the operating room."

author of Head Cases Michael Paul Mason

"Do No Harm is a fascinating look into the reality of life as a neurosurgeon. The personal patient stories are gripping, providing the public with an incredibly candid look into the imperfections and perfections of a dedicated neurosurgeon. In Do No Harm, Dr. Marsh takes the reader into deep into a world of life, death, and everything in between. Despite it all, Dr. Marsh's commitment to his patients and his profession never wavers. You will not be able to put this book down."

surgeon and author of Confessions of a Surgeon and Paul Ruggieri M.D.

A soul-baring account of a practical-minded neurosurgeon who does not suffer fools or believe in souls, who favors 'statistical outlier' over 'miracle,' and who admits that a surgeon's ultimate achievement is marked by patients who 'recover completely and forget us completely.' Readers, however, will not soon forget Dr. Marsh.

author of Another Day in the Frontal Lobe: A B Katrina Firlik

"Do No Harm is a penetrating, in-the-trenches look at the life of a modern day neurosurgeon. With rare and unflinching honesty, Henry Marsh describes not only the soaring triumphs but the shattering tragedies that are so much a part of every surgeon's life. A remarkable achievement."

Michael J. Collins

When a book opens like this: 'I often have to cut into the brain and it is something I hate doing' - you can't let it go, you have to read on, don't you? Brain surgery, that's the most remote thing for me, I don't know anything about it, and as it is with everything I'm ignorant of, I trust completely the skills of those who practice it, and tend to forget the human element, which is failures, misunderstandings, mistakes, luck and bad luck, but also the non-professional, everyday life that they have. Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh reveals all of this, in the midst of life-threatening situations, and that's one reason to read it; true honesty in an unexpected place. But there are plenty of others - for instance, the mechanical, material side of being, that we also are wire and strings that can be fixed, not unlike cars and washing machines, really.

Financial Times Karl Ove Knausgaard

His love for brain surgery and his patients shines through, but the specialty--shrouded in secrecy and mystique when he entered it--has now firmly had the rug pulled out from under it. We should thank Henry Marsh for that.

The Times

Neurosurgery has met its Boswell in Henry Marsh. Painfully honest about the mistakes that can 'wreck' a brain, exquisitely attuned to the tense and transient bond between doctor and patient, and hilariously impatient of hospital management, Marsh draws us deep into medicine's most difficult art and lifts our spirits. It's a superb achievement.

Ian McEwan

…[a] frank and absorbing narrative of [Marsh's] life in neurosurgery…

The New York Times Book Review - Jerome Groopman

…in this unflinching book…[Dr. Marsh] gives us an extraordinarily intimate, compassionate and sometimes frightening understanding of his vocation. He writes with uncommon power and frankness. And while his book may unsettle readers—so many things can go wrong with the brain, so many things can go awry in a hospital—it will at the same time leave them with a searing appreciation of the wonders of the human body, and gratitude that there are surgeons like Dr. Marsh using their hard-won expertise to save and repair lives.

The New York Times - Michiko Kakutani

★ 03/09/2015
In this memoir of a long career, English neurosurgeon Marsh reveals both a “weary and knowing skepticism” and a striking determination to help the desperately ill despite the uncertainties. “The operating is the easy part, you know,” he writes of one neurosurgeon’s advice to him; “the difficulties are all to do with the decision-making.” Marsh’s remarkable, unblinking honesty shines through in each of the starkly different cases he describes, including a little boy with a progressive cancer whose family came to believe he could “go on being treated forever”; the death “without regret” of his own mother from metastasized breast cancer; and the devastating outcome of a difficult operation on an 11-year-old Ukrainian girl with a large but benign brain tumor that was slowly killing her. Surprisingly humble and introspective, Marsh can be hard on himself: “It’s not the successes I remember, or so I like to think, but the failures.” The stubborn bureaucracy of Britain’s healthcare system merits its own harsh meditation, though Marsh tempers his deep distrust of the system with compassion. This thoughtful doctor provides a highly personal and fascinating look inside the elite world of neurosurgery, appraising both its amazing successes as well as its sobering failures. Agent: Julian Alexander, Lucas Alexander Whitley Ltd. (U.K.). (June)

Publishers Weekly

Prominent neurosurgeon Henry Marsh recounts stories of patients whose cases, with both positive and negative outcomes, have had a lasting impact on him professionally and personally. Jim Barclay's authoritative British-accented narration is befitting for the purveyor of delicate and exacting medical procedures. Barclay's tone does tend toward a sort of exasperation or haughtiness. Whether this is due to his narration style or is an exaggerated portrayal of the author's frustrations on the page is not evident. Nonetheless, the book is an informative look at the joys and trials of a practicing brain surgeon. S.E.G. © AudioFile 2015, Portland, Maine

AUGUST 2015 - AudioFile

★ 2015-03-02
A British neurosurgeon delivers fascinating, often harrowing stories of several dozen cases intermixed with compelling digressions into his travels, personal life, and philosophy. In 25 chapters, each built around a neurosurgical operation (infections and strokes but mostly tumors), the author provides vivid accounts of patients before and after surgery as well as encounters with Britain's National Health Service, which is far skimpier than America's system (even hospital beds are in short supply). The quality of medicine, however, is first-class. American neurosurgical trainees serve in his hospital, and Marsh admires but does not share the gung-ho optimism of America's "death is optional" surgeons. While happy to recount dramatic cures, he admits that these are not routine in a neurosurgeon's practice and that aggressive surgery often leaves patients with catastrophic brain damage. Few American surgeons, worried about being sued (a legitimate concern), would dare write, "I am more experienced than in the past and more realistic about the limitations of surgery….I have become more willing to accept that it can be better to let someone die rather than operate when there is only a very small chance of the person returning to an independent life." Far more than the average doctor-memoirist, Marsh does not conceal his feelings, whether dealing with patients, colleagues, assistants, or superiors, and he spares no one when matters turn out badly. Readers will share his emotions, including contempt for a penny-pinching, meddling government. Unlike American doctor/government haters, there is no sour right-wing ideology or any impression that he is defending an obscenely high income. Nor does he trumpet his compassion; that is never in doubt. Beautifully written and deeply moving—one of the best physician memoirs in recent memory.

Kirkus Reviews