Do No Harm

Stories of Life, Death, and Brain Surgery

By: Henry Marsh

Narrated by: Jim Barclay

Length: 9 hrs and 33 mins

Publisher's Summary

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

©2015 Henry Marsh (P)2015 HighBridge, a division of Recorded Books

Critic Reviews

"Neurosurgery has met its Boswell in Henry Marsh. Painfully honest about the mistakes that can 'wreck' a brain, exquisitely attuned to the tense and transient bond between doctor and patient, and hilariously impatient of hospital management, Marsh draws us deep into medicine's most difficult art and lifts our spirits. It's a superb achievement." (Ian McEwan)

"His love for brain surgery and his patients shines through, but the specialty - shrouded in secrecy and mystique when he entered it - has now firmly had the rug pulled out from under it. We should thank Henry Marsh for that." ( The Times)

"When a book opens like this: 'I often have to cut into the brain and it is something I hate doing' - you can't let it go, you have to read on, don't you? Brain surgery, that's the most remote thing for me, I don't know anything about it, and as it is with everything I'm ignorant of, I trust completely the skills of those who practice it, and tend to forget the human element, which is failures, misunderstandings, mistakes, luck and bad luck, but also the non-professional, everyday life that they have. Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh reveals all of this, in the midst of life-threatening situations, and that's one reason to read it; true honesty in an unexpected place. But there are plenty of others - for instance, the mechanical, material side of being, that we also are wire and strings that can be fixed, not unlike cars and washing machines, really." (Karl Ove Knausgaard, Financial Times)

Neurosurgical struggles between hope & reality

Do No Harm provides interesting, educational, terrifying, and honest insights into neurosurgery, the patients that undergo the surgery, Britain's National Health Service, and the author himself. Each chapter deals with a different condition - pineocytoma, meningioma, anaesthesia dolorosa, hubris - in which Mr. Marsh recounts his successes, failures, thoughts, and feelings.

His prose is beautiful when describing the brain and his view through the counterbalanced surgical microscope, which “leans out over the patient’s head like an inquisitive, thoughtful crane.” The internal cerebral veins are like “the great arches of a cathedral roof”. Marsh writes about his anxiety, how and how much he should convey to his patients, the unusual route of how he became a neurosurgeon, his frustrations, and all the things that make him human first, neurosurgeon second. When speaking with patients, he struggles to find the balance between “hope and reality,” “optimism and realism,” “detachment and compassion.” This book details those struggles in fine form, and Jim Barclay provides absolutely perfect narration.

Great storytelling wrapped in a medical package!

I am a neuropsychologist, so this topic naturally caught the attention of my geeky brain. However, I think almost anyone would enjoy this book, especially if they have ever had to navigate their way through the healthcare system to treat a significant illness (neurological in nature or not). Dr. March is not just a neurosurgeon, he is a poet, philosopher, self-deprecating comedian, and a grand spinner of stories! Finally, the narrator fits the text so well that it is hard to imagine anyone else reading this book. This is a book that I am almost certain to listen to again in the future. Well done, Dr. March!!

Uneven

Would you recommend Do No Harm to your friends? Why or why not?

This audiobook features the reflections of Dr. Henry Marsh, a British Neurosurgeon with over thirty years of practice, primarily in brain surgery. His writing is straightforward and surprisingly honest – he’s not hesitant to admit mistakes in judgment, instances he has erred, and the unfavorable outcomes that haunt him (and the reader). Do No Harm is most gripping when it focuses on the surgeries and the patients – there is a surprising amount of detail and suspense in these parts. Unfortunately, these are interspersed with many less interesting bits – the inadequacies of the British health care system, hospital bureaucracies, and incompetent colleagues to name a few - where Marsh’s recollections come across as rants. This isn’t helped by the narration whose tone is more often than not equal parts frustration and irritation and which I found distracting. Do No Harm offers an interesting glimpse into the day to day world of a neurourgeon and probably should be required reading by any medical intern thinking of making this their career. For the layperson, however, I wish it had confined itself solely to the operating room.

I just love this book

I know "Mr. Marsh" isn't bound to entertain me, but he sure did. Plus he educated me.

As a professional technical writer and reader, I found this book had all the elements I enjoy. It was honest. Simple. Straightforward. Thoughtful. Candid. Humorous. Emotional. Analytical. Sympathetic.

I sometimes wondered how he could be so honest about his failures. Wasn't there some risk of being attacked or prosecuted – even if he wasn't really naming names and times and dates?

I have come to realize that there is no such thing as magic. But I still like to believe in magic when it comes to the medicine that's treating me. Mr. Marsh gives a good mix of the real and the unreal, the spiritual and physical, confidence and failure.

One note: I was a little put off by the narrator. I'm not sure why. He has that sort of pompous English accent that we Americans are so familiar with. Why I found it offputting I'm not sure, but he spoke in a clear voice, and he was well recorded, his cadence and delivery were extremely competent. I can't make many sound adjustments on my iPhone, so I was very happy with the voice recording after all.

I highly recommend this book.

A Totally Absorbing Read I Finished in 2 Days!

". . . Life, Death, and Brain Surgery"--that summarizes this book perfectly. It kept me totally occupied, absorbed, and distracted while trying to recuperate from a cold. Thus, I was able to finish it in 2 days. I found Marsh's patient stories fascinating. He talked about the frustrations and rewards of doing brain surgery, doctors' inevitable mistakes (his own), his trips to Kiev to do surgery, the failings of the NHS in Britain, and the difficulty of training students to do brain surgery. Some of the most interesting sections, to me, were where he discussed his own illnesses and particularly his mother's death, which he felt was the most nearly perfect death any of us could wish for.

I felt his honesty was very refreshing. Could a US doc be so honest in talking about mistakes? Probably not, with our over-intrusive legal system, watching, waiting, ever-ready to pounce. Do I wish the government would take over medical care in this country (US)? Most definitely not after reading Marsh's trials and tribulations with the NHS. Somehow, we always think the grass is greener but it seldom is.

The most important message I took away from this wonderful book was, pray you do not ever need brain surgery! It is just too darned risky. And, if by chance it is unavoidable, pray some more, this time for a doctor like Henry Marsh. AND, oh yes, do ask how many times your surgeon performed this particular operation!

Highly recommended.

The daily life of a brain surgeon in UK's NIH

Where does Do No Harm rank among all the audiobooks you’ve listened to so far?

Very highly, especially if you enjoy non-fiction biography and science.

Who was your favorite character and why?

There's only one primary character and it's the neurosurgeon himself. I heard about this book based on an interview with the author on NPR. He chose not to narrate, though he could have. I was immediately struck in the NPR interview by how very bright the neurosurgeon seemed. He spoke simply, but obviously about subjects of great importance. He also seems to know himself very well--big portions of the book are effectively his own mea culpas for mistakes he made with patients which led to the patients' deaths or paralysis, etc. Because brain cancers tend to have such poor prognoses, there is also the exploration of death and how people prepare for it.

Have you listened to any of Jim Barclay’s other performances before? How does this one compare?

This was my first time listening to this narrator, but I would listen to him again. I felt he did a great job with the text and likely sounds much like the author would have. I particularly enjoyed it when the narrator grew agitated, as the author obviously was, about the problems with the bureaucracy in the NIH in England. I kind of giggled at those portions.

Did you have an extreme reaction to this book? Did it make you laugh or cry?

There were a few passages where I teared up or cried when patients did not make it or something sad happened, but I would not describe it overall as a tear-jerker. There were a few absurd moments when I did laugh.

Any additional comments?

The audiobook was less scientific than I expected. This is more along the lines of an autobiography of a doctor than a science book. For instance, I can't say I know a lot more about brain surgery than I did prior to listening. I am sort of a "medical hobbyist" and while I probably could go back and write down specific conditions or operations and memorize the terms, that is likely the only way I would necessarily be smarter about brain surgery. My thoughts on brain cancer are effectively the same before and after listening to the audiobook.

This audiobook would likely be of interest for many professionals in positions of high stress, high responsibility, etc. because the author details his own struggles with these issues and the need to perform highly while still forgiving oneself for mistakes in order to carry on.

One Grumpy Old Brain Surgeon

I bought this book in the print version for my son, a 3rd year medical student with aspirations of becoming a neurosurgeon, and now I am sort of wishing I hadn't. While there are certainly many fascinating stories of the medical crises a neurosurgeon regularly confronts, a good ⅓ to ½ of the book consists of Dr. Marsh's railing against all the confounded, new-fangled nonsense he has to put up with, including the NHS, computers, hospital administrators, residents with limited work hours, etc., etc., etc.

I'm not denying that modern doctors must all experience frustration to a greater or lesser extent in having to deal with bureaucracy and paperwork instead of practicing medicine, but I had not expected this to be such a large portion of the book. Dr. Marsh offers no real solutions to these issues except for opining that it was so much better in the good old days. Narration is great, capturing Dr. Marsh's curmudgeonly character quite perfectly.

Heady stuff (har har)

I like books about the workings of the brain, including this one. As a memoir, it had less of the instructional and more of personal perspective. Different from what I usually read, but enlightening to discover the struggles with bureaucracy and with maintaining compassion that brain surgeons endure.

Candid look at neurosurgery in UK

Henry March was a senior consultant neurosurgeon in an NHS hospital in London. l loved his rants about management, bed shortages, and impossible rules regarding so called health and safety. Equally fascinating were the anecdotes regarding the various brain tumors. My DIL died of a glioblastoma that started as an astrocytoma. She was in her early 30s.

Marsh is brutally honest in describing his mistakes, especially those caused by hubris or cognitive errors. Doctors including surgeons are fallible. I am happy he realized that. He also knows which cases are better off without surgery. I know too many pompous and arrogant surgeons; some think they are a god.

Marsh has an incredible way of describing the architecture of the brain. He paints a beautiful picture. Amazing!

I struggled to understand the NHS and the hierarchy in the British medical education system. If you are an American, you might want to research that first. I highly recommend this book.

The life of a neurosurgeon

This is a book that documents the daily life of a neurosurgeon. What I liked about it is that it gave me what I expected. I had always wondered how doctors handled the stresses of uncertainty that decide the life or death of their patients and how they view their failures and successes. The book does these question, and many more, more than justice. The story Dr. Marsh tells in this book is honest and never-boring.