Review: Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh

5 stars for Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh.

Henry Marsh is leading English neurosurgeon. He retires from full-time practice in 2015. Do No Harm is a brutally honest account of his life's work, his 40-year career as a brain surgeon.

As with any human, neurosurgeon Marsh makes his share of mistakes in his life. The stories in this book are about his attempts, and occasional failures, to find a balance between the necessary detachment and compassion that a surgical career requires, a balance between hope and realism.

Having read this memoir, I understand better the difficulties that doctors face. But I also view doctors in a different light now.


Publisher: Weidenfeld & Nicolson
Publication date: 13 Mar 2014

*** Favourite quote 1 ***

‘Every surgeon carries within himself a small cemetery, where from time to time he goes to pray – a place of bitterness and regret, where he must look for an explanation for his failures.’

~ René Leriche
La philosophie de la chirurgie, 1951

*** Favourite quote 2 ***

Doctors are human, just like the rest of us.

Much of what happens in hospitals is a matter of luck, both good and bad; success and failure are often out of the doctor’s control. Knowing when not to operate is just as important as knowing how to operate, and is a more difficult skill to acquire.

*** Favourite quote 3 ***

A famous English surgeon once remarked that a surgeon has to have nerves of steel, the heart of a lion and the hands of a woman.

*** Favourite quote 4 ***

Most neurosurgeons become increasingly conservative as they get older – meaning that they advise surgery in fewer patients than when they were younger.

I certainly have – but not just because I am more experienced than in the past and more realistic about the limitations of surgery.

It is also because I have become more willing to accept that it can be better to let somebody die rather than to operate when there is only a very small chance of the person returning to an independent life.

*** Favourite quote 5 ***

Surgeons must always tell the truth but rarely, if ever, deprive patients of all hope. It can be very difficult to find the balance between optimism and realism.

There are degrees of malignancy with tumours and you never know what will happen to the individual patient in front of you – there are always a few long-term survivors – not miracles but statistical outliers.

*** Favourite quote 6 ***

Dying is rarely easy, whatever we might wish to think.

Our bodies will not let us off the hook of life without a struggle.

You don’t just speak a few meaningful last words to your tearful family and then breathe your last.

If you don’t die violently, choking or coughing, or in a coma, you must gradually be worn away, the flesh shrivelling off your bones, your skin and eyes turning deep yellow if your liver is failing, your voice weakening, until, near the end, you haven’t even the strength to open your eyes, and you lie motionless on your death bed, the only movement your gasping breath.

Gradually you become unrecognizable – at least you lose all the details that made your face characteristically your own, and the contours of your face are worn away down to the anonymous outlines of your underlying skull.

*** Favourite quote 7 ***

In neuroscience it is called ‘the binding problem’ – the extraordinary fact, which nobody can even begin to explain, that mere brute matter can give rise to consciousness and sensation.

*** Favourite quote 8 ***

This is life, and we all have to die sooner or later. It is when I do not know for certain whether I can help or not, or should help or not, that things become so difficult.

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

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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?

In neurosurgery, more than in any other branch of medicine, the doctor's oath to "do no harm" holds a bitter irony. Operations on the brain carry grave risks. Every day, leading neurosurgeon Henry Marsh must make agonizing decisions, often in the face of great urgency and uncertainty.

If you believe that brain surgery is a precise and exquisite craft, practiced by calm and detached doctors, this gripping, brutally honest account will make you think again. With astonishing compassion and candor, 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.

*Blurb from Goodreads*

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