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

Oui, another medical book. Sorry-not-sorry. But in all seriousness, this one offers a wholly different experience than other trending doctors’ books. It is no commentary on the wide world of providing healthcare, like two of Gawande’s publications. Nor is it a deeply philosophical exploration of certain diseases, like Sacks’ most successful collections. It is simply a raw, honest account of Marsh’s experiences, written in the register of a letter to a curious friend.

Do No Harm offers a refreshing vantage point from the perspective of a reputable neurosurgeon, a specialist who faces the especially daunting task of cutting into the very matter of our thoughts and emotions. Whilst the title may be a main principle of medical ethics (the fancy term is non-maleficence), the prose rarely enters the theoretical domain. Rather, Marsh chooses to focus on his concrete attempts to uphold it and his occasional failures to do so. So do not be hesitant because you anticipate heavy, abstract discussions, as those are almost completely absent.

Although Mr Marsh comes across in certain passages as possessing characteristics a typical patient would be unnerved to find in her surgeon (a susceptibility to temperamental outbursts, instances of hubris), the unflinching candour with which he recounts his experiences and fallibilities instead inspires empathy and understanding. After all, the book promises a riveting exploration of a profession dangerously familiar with death, and the heartbreaking disasters described are the reality of the medical industry.

As a first year medical student, his anecdotes vividly reminded me of the inevitability of my future mistakes or encounters with pure bad luck. Some of these may, in Marsh’s own words, “wreck” my patients. But instead of instilling a fatalistic attitude, Marsh inspires readers to strive ever more determinedly. I clearly recall a case in which, against the expectations of the Trust, he even encouraged a patient to sue, because his ultimate priority is unfalteringly his patients’ well-being.

Literarily, Marsh has a slight tendency to use repetitive language and excessively elaborate analogies. But once you become engrossed in his deeply personal accounts (as you quickly will), these minor annoyances are no longer noticeable. In fact, his sometimes fanciful imagery underlines the careful consideration and wonder with which he views his craft, even after all these years. In addition, unlike many medical publications aimed at laymen, Do No Harm is not organised around central themes. Some readers may find this style unstructured, but not knowing what revelations to expect when I began each new chapter made the reading experience more reminiscent of the twists and turns of a novel.

To conclude, Do No Harm is a thoroughly unpretentious book, addressing even the most devastating consequences without frills or excuses. Sometimes shocking, often moving, and always memorable, appreciators of the unique thrill and terror of treating the brain will not be disappointed.

Rating: 3.5/5

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