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

Book #4, read summer 2018

Do No Harm: Stories of Life, Death, and Brain Surgery (Henry Marsh)

I vaguely remember reading a positive review of Marsh’s writing in some other publication years ago, but I didn’t pick up Do No Harm at the time. Instead, I stumbled back onto it a month or two after my father’s glioblastoma diagnosis and tumor “debulking” (the open-skull surgery where they remove what they can of these tentacled tumors — not all of it, and it’s not curative).

Do No Harm was pretty hard for me to read at this time. I noticed as I opened it up that there would (of course) be a chapter on glioblastoma, and that was extra hard to read. No glioblastoma portion of any book is especially uplifting, but it was extra bad here (spoiler alert). Marsh once counseled a not-old glioblastoma diagnosee to accept the debulking surgery in order to prolong her life a bit and make some memories with her family, even though her eventual demise due to the tumor would remain assured. Although Marsh made no apparent mistake during the procedure, she never woke up.

So obviously I am really, really glad that I didn’t manage to begin reading Do No Harm before dad had had his procedure. Waiting for hours to hear that his surgery had gone smoothly was bad enough already. I remember standing numbly in a noodle shop trying to get my toddler some lunch, wondering if my dad’s head was still open on the surgeon’s table hundreds of miles away at that moment. I remember getting finally getting the call — no bad surprises but no good ones either, everything was just about like they’d expect in there, rotten necrotic tumor core and all. Ugh.

Incidentally, Do No Harm also manages to shed some light on what the inner workings of the NHS are really like. Though Marsh is good at his job with long-running positive job performance, he faces weird new hurdles to actually practicing his craft, at seemingly every turn. Some of these policies, like curbing overtime and making residents’ hours less crazy, sound great on paper, but they have unintended and far-reaching consequences. Still, I guess plenty of uninsured brain tumor patients or those in the third world would much prefer the opportunity to join a queue to see Marsh over their current care circumstances.

Do No Harm, with its vivid, fascinating descriptions of the essential structures deep in your “reptile brain” (and what can go wrong with them) will make you feel fragile. It reveals that our medical saviors are fragile in their own ways, too. I would have preferred never to feel this fragile, but it was thrust upon me back in May. Since there’s no un-opening that can of worms, all there’s left to do is explore what there is to it.

Read Do No Harm if: you’re not squeamish and you don’t know anyone currently facing a brain or other major surgery.

Don’t read Do No Harm if: you’re pretty black & white and prefer to retain a completely positive (or completely negative) view of doctors.