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.
You know you’ve read a lot of medical nonfiction when you think, “This is an alright book by a neurosurgeon discussing the intricacies of brain surgery, but I’ve read better.” (For the record I like When the Air Hits Your Brain by Frank T. Vertosick Jr. more.)
Marsh hits all the expected beats and themes – surgery that goes well despite all odds, surgery that doesn’t go well despite all efforts, kids you don’t want to see die, adults who face death with dignity. The cases are engaging and the writing solid.
But I’m not sure I get along with Marsh as a person. He’s nearing the end of his career, which is good in that we can see how hospital conditions and doctor training have changed over time. These changes, though, are often framed in terms of the good ol’ days and how they compare with the bad ol’ now. For example, an anesthetist refused to do a big surgery at 4 pm because she didn’t have childcare for the evening.
“But we can’t cancel it,” I protested. “She was cancelled once already!”
“Well I’m not doing it.” …
For a few moments I was struck dumb. I thought of how until a few years ago a problem like this would never have arisen… I envy the way in which the generation who trained me could relieve the intense stress of their work by losing their temper, at times quite outrageously, without fear of being had up for bullying and harassment.
Oh, I’m sorry that asshole-ry is no longer tolerated. Geesh. This doesn’t take away from the amazing work Marsh has done in his life, including humanitarian work in rural Ukraine, but neurosurgeon as god thing turns me off.
In sum the book is good but there’s better out there – check out Vertosick’s first.