Welcome back to the Synapse Project Book Review Series! Today, we’re joined with Sruthi Ramaraju, and her beautiful review on Henry Marsh’s Do No Harm, a book about one of the top neurosurgeons in Britain. Sruthi placed in the top 5 at the 2017 English Brain Bee, a national neuroscience competition for secondary school students in England. She loves to read medical literature and enjoys writing fiction and non-fiction. If you are interested in contributing to this book review series, contact Megumi Sano at firstname.lastname@example.org.
It is not surprising that Hippocrates started off with “First, do no harm.” As ridiculously self-evident as it seems, Henry Marsh’s book beautifully shows how difficult that very obvious statement can, in some cases, be to uphold. Do No Harm is provides a very candid and no-nonsense account of the triumphs and downfalls that a neurosurgeon faces from day to day, both professionally and personally.
What I liked the most about the book is the undercurrent of humility borne out of mistakes- how, despite his successes, experience and evident proficiency, he so frankly admits to how some of his blunders had been fatal or had left his patients with lifelong disability. It serves as a powerful reminder that as error-free as medicine constantly strives to be, it is ultimately still in the hands— both literally and metaphorically— of humans, even the most capable and accomplished of whom are still susceptible to making incorrect decisions and to accidentally let the scalpel slip a little too far.
Scalpel and scrubs aside, Marsh masterfully conveys how, despite how it is portrayed in popular culture, a surgeon’s job is far from cold and detached; indeed, as he reinforces throughout, the emotional aspect plays an integral role in shaping how good a surgeon later becomes. He powerfully shows how, although there is only person in the operating theatre, he deals additionally with the responsibility towards the relatives of the patient and his trainees as well as the hospital as a whole. Rather than beautify his job, he shows us the pressures of being wholly in control of a person’s cognition, movement and life and the responsibility that comes along with it. And yet, despite how grimly demanding the job can be, Marsh’s evident wonder and appreciation of the brain shine through, from his elucidations of the various medical condition he mentions right through the descriptions of the physiology of the brain as he operates on each condition in turn. Whilst he doesn’t simplify the concepts enough to patronise the reader, he still explains medical concepts in a concise yet engaging manner that is both accessible and gripping.
Although difficult to find much fault with, there were some parts of the book which came off as a little pretentious and pompous— particularly when Marsh talks of how he feels as though he shouldn’t have to wait in queues in shops, or shouldn’t have to give his name to hospital staff upon breaking his leg. But all in all, in the face of the monumental stress of his job, his respect and care for his patients overshadow this.
Marsh also skilfully explores wider issues and how they all play a role in his job, including the bureaucracy and changing climate of the NHS, the role of pharmaceutical companies in delivering healthcare and how the increase in private practise is affecting patient health. At times frustrated, at times darkly satirical, he provides a comprehensive view of healthcare in general, besides his role as one of the people in it.
Do No Harm does an admirable job in that its purpose is not to glamourise neurosurgery, but instead to demonstrate the fallibility and very human problems that the person behind the scalpel faces.
— Sruthi Ramaraju