Do No Harm is written by one of Britain’s most eminent neurosurgeons, Henry Marsh, and it is a beautifully eloquent and candid account of his 30-year career as a brain surgeon. Marsh writes with honesty about many of his patients and the operations he has performed, including the triumphs of his successes and the awful consequences of his failures. When operating on the brain, he says:
“All I can see in front of me is matter. Yet I know if I stray into the wrong area, into what neurosurgeons call eloquent brain, I will be faced by a damaged and disabled patient when I go round to the Recovery Ward after the operation…”
I loved the way Marsh writes about himself with such humility, candour and insight – he tells us of his self-doubt, his uncertainty about the successful outcome of certain operations, the exquisite vulnerability of the patients who trust him, literally with their lives, and he tells us of the focussed joy he experiences when operating on the brain.
The details of the operations are fascinating and never once did I find my eyes glazing over because of obscure medical terms. He exposes the machinations of the NHS in England and the excruciating hindrances of bureaucracy, often with a wry sense of humour. I thoroughly enjoyed the book and was engrossed in the process of cutting into the human brain. Perhaps I should have been a neurosurgeon? I now intend getting hold of both documentaries that have been made about Henry Marsh: Your Life in Their Hands and The English Surgeon. I have also watched a BBC Newsnight interview with him: BBC interview with Henry Marsh
The second book I have read about the brain recently was the compulsively readable account by Sarah Cahalan of her descent into insanity, called Brain on Fire. At age 24, Cahalan, a successful journalist for the New York Post, slowly started becoming what appeared to be psychotic, interspersed with epileptic fits and odd jerking physical movements. No doctor could find out what was wrong with her and she slowly deteriorated as treatments for misdiagnosis after misdiagnosis failed (including ‘partying too much’ and schizoaffective disorder).
Blessed with a determined and, I have to add, wealthy family who would not commit her to a psychiatric institution, Cahalan was eventually diagnosed by several physicians – the main one being a Dr Najjir – as having a very rare autoimmune disease of the brain called Anti-NMDA Receptor Encephalitis. With the correct treatment she slowly recovered and was able to resume her ‘normal’ life, including going back to work. One of her first assignments was to write an article about her disease, which then grew into this book. She admits in the introduction that she is an ‘unreliable witness’:
Because of the nature of my illness and its effect on my brain, I remember only flashes of actual events, and brief but vivid hallucinations, from the months in which this story takes place. The vast majority of that time remains blank or capriciously hazy.
As a result, she used her journalistic skills to piece together the vast amount of evidence available, ranging from medical records, interviews with doctors, her own journal, her father’s journal, and video footage. I found this a fascinating process, as her account is peppered with different viewpoints. Her memoir has resulted in people all over the world contacting her about the disease because either they have had it or a family member. Unfortunately not everyone recovers as well as Cahalan did. Despite her full recovery, though, towards the end of the book, she admits:
…with every memory I recapture, I know there are hundreds, thousands even, I cannot conjure up. No matter how many doctors I speak with, no matter how many interviews I conduct or how many notebooks I scavenge, there will be many experiences, bits of my life that have vanished.
I was so intrigued by the this book that I read it over a weekend.