Here’s an unusual reviewer’s recommendation: Don’t read this book. Neurosurgeon Henry Marsh’s “Do No Harm” is just too shocking. It will make you fear for yourself and your loved ones and those you care about.
Mr Marsh is now one of the most eminent brain surgeons in the UK. He has been a consultant in neurosurgery at St George’s Hospital, London, since 1987. Now he leads the team there. Mr Marsh writes elegantly in this memoir and spares no sensitivities, including his own. His frankness about mistakes when a patient’s brain has been open before him on an operating table is astonishing.
Take this example:
A school teacher in his late fifties came to see him in the hospital. The patient was tall, bespectacled, walked with a stick and was a little stooped. His brain scans were put up on the wall on a viewing box (technology of the day). Henry writes he was “startled by the sheer size of the tumour growing from the base of his skull.” All the brainstem and the cranial nerves — nerves for hearing, movement, swallowing and talking — were stretched over a sinister hump-backed mass.
Henry advised the teacher, his wife and son that if the tumour was not removed the man’s condition would slowly deteriorate. He explained the risks of the surgery: possible deafness, stroke, paralysis, death.
“The three of them sat in silence for a while.” The family elected to go ahead with surgery. They chose one of the top neurosurgeons in the country, Professor M. Henry was qualified, but inexperienced at the time.
A few days later Professor M called. “Ah, Henry,” he said. The teacher was starting to have difficulties that would sooner or later kill him, the Professor said. “It’s a young man’s operation. You should do it.”
Henry writes, “It’s one of the painful truths about neurosurgery that you only get good at doing really difficult cases if you get lots of practice, but that means making lots of mistakes at first and leaving a trail of injured patients behind you.”
The teacher’s operation went perfectly in the early stages. “We slowly removed more and more of the tumour, and by midnight, after fifteen hours of operating, it looked as though most of it was out and the cranial nerves were not damaged.”
The young Mr Marsh “started to feel I was joining the ranks of the really big neurosurgeons.” He writes that he should have stopped at that point and left the last piece of tumour behind in the teacher’s brain. He had been swayed, however, by eminent neurosurgeons at conferences who had detailed their successes in such operations getting all of tumours out.
Henry proceeded trying to remove the last bit of tumour. “I tore a small perforating branch off the basilar artery. A narrow jet of bright red arterial blood started to pump upwards. I knew at once this was a catastrophe.” The blood loss was trivial but the damage to the brainstem terrible.
The teacher never woke up.
Seven years later, visiting another patient in a nursing home, Henry realised a figure curled in a fetal position in a coma on his bed was the same teacher.
Published last year, Henry’s book, “Do No Harm”, has been something of a sensation. Reviewers’ favourite word about it seems to be “searing”. That’s right.
If you’re sensitive, nervous about what the future may hold — especially if you’ve got kids — don’t read it.