Understanding operations through the eyes of a neurosurgeon

A medical memoir about brain surgery, life in the NHS and difficult decisions.

‘Do no harm’ by Henry Marsh

In his memoir ‘Do no harm’, neurosurgeon Henry Marsh tells a colleague: “There are two great benefits to medicine as a career… one is that one acquires an endless fund of anecdotes, some funny, many terrible.” Marsh uses these anecdotes to reveal how his love affair with neurosurgery began and to illustrate the difficulty of making decisions about whether a patient should live or die by one’s own hand. Through his tales, we get glimpses into life in the NHS, the psyche of an experienced doctor and the contents of our own heads.

The narrative is infused with Marsh’s ardent fascination for the human brain. “The idea that my sucker [a tool used to remove tumours] is moving through thought itself, through emotion and reason, that memories, dreams and reflections should consist of jelly, is simply too strange to understand,” he writes.

Marsh’s self-confessed pomposity, evident throughout, can be grating and does not warm the reader to him. A small handful of the success stories seem to have little purpose other than to inform us of what an excellent surgeon he is. However, his arrogance is juxtaposed with self-awareness — he is keen to remind us that doctors are fallible, his decisions are not always correct and he is open about his flaws.

In one poignant story, he describes a man who he “wrecked” — during the operation, Marsh attempted to remove too much of the patient’s tumour and tore an artery. As a result, the patient never woke up “and that was why, seven years later, I saw him curled into a sad ball, on a bed in the nursing home”.

Despite the heavy subject matter, the book still manages to be a light read, similar in style to other medical memoirs such as ‘Confessions of a GP’ by Benjamin Daniels. Those who have wondered what neurosurgery involves and how doctors make decisions will gain valuable insight — but this book is best avoided by individuals about to undergo an operation.


‘Do no harm’ by Henry Marsh. Pp 278 £8.99. London: Weidenfeld & Nicolson; 2014. ISBN 978 1 7802 2592 0

Last updated
The Pharmaceutical Journal, PJ, 18 July 2015, Vol 295, No 7871;295(7871):DOI:10.1211/PJ.2015.20068739

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