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Book Review: Do no harm: Stories of life, death and brain surgery

Article  in  Neurology India · September 2016

DOI: 10.4103/0028-3886.190245

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Book Review
Do no harm: Stories of life, death and
brain surgery
Authors : Henry Marsh
Edition : 1st Edition
Publisher : St. Martin’s Press
Pages : 288
“Do No Harm” is a reader’s delight in which a neurosurgeon
candidly acknowledges the fine bond between himself and
his patients. The title is an obvious take on the Hippocratic
adage “Primum non nocere.” This nonfictional work is a
personal memoir pertaining to the patients of various
neurosurgical ailments, mostly representating the ones that
we often encounter in our practice. The author aptly accepts
the fact that some of the surgeries are performed to satisfy
a surgeon’s ego rather than for other indications.
The book starts with a French saying that “Every surgeon
carries within himself a small ‘cemetery,’ in which from time-
to-time he goes to pray—a place of bitterness and regret,
that he is compelled to explore while seeking an explanation
for his failures.” The book brings a smile on the faces of the
readers when statements like “neurosurgeons look at a brain
scan showing a pineal tumour with both fear and excitement,
like mountaineers looking up at a great peak that they hope
to climb,” are read. This book is brutally honest about the
emotions, behaviour, personality, and professional life of a
neurosurgeon. Unlike most of the other memoirs, this book is
a testament to the work done by one of the most successful
and finest neurosurgeons of the United Kingdom, whose
advice to his younger colleagues is a reiteration of an old
saying, “Knowing when not to operate is just as important
as knowing how to operate, and is a more difficult skill to
acquire.”
This book is a pictorial and poetic depiction of the life of
a neurosurgeon right from the time of his residency to his
being the chairperson.
1112 © 2016 Neurology India | Published by Wolters Kluwer - Medknow
Fascinated by an aneurysm surgery in the early years of
his medical training, Henry Marsh chose the tough and
selfless life of a neurosurgeon. In the 25 chapters of the
book, each named after a surgical ailment, the author
takes the reader on a guided tour of Neurosurgery from
the eyes of a failed lover, an egoistic yet careful person,
a wise statesman, and an empathic young neurosurgeon.
The wisdom gained from experience and introspection has
guided the author to choose the idea of a “good death
and equanimity over a life filled with sorrow.”
In the middle of the book, the author compares himself
with the character of Jack Nicholson, in the movie “Five Easy
Pieces,” when he joins a medical school as a hospital porter,
after failing in love, to nurse his broken heart. He witnesses
a pineal region surgery in sitting posture and describes it
as being no less than a horror film. Neurosurgery, being
strange and often brutal but also delicate, miraculous and
full of surprises, seduced Marsh. This seduction culminated
in transforming him into a wise but anxious neurosurgeon.
In the final chapters of the book, he frankly admits his
scepticism about the restricted working hours for residents,
the growing tendency of consumerism among patients, and
the rising bureaucratic influences in the medical system.
I recommend this book as a practical guide for young minds
to remind them to remain 'cautiously courageous.' The book
will also provide an introspective journey to most of the
neurosurgeons who are nearing the end of their career. In fact,
every neurosurgeon at any stage of his/her career will find his own
story in this book but emnating from the pen of Henry Marsh.
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Book Review

Manjul Tripathi, Kanchan K. Mukherjee
Department of Neurosurgery, Postgraduate Institute of Medical
Education and Research, Chandigarh, India
E‑mail: drmanjultripathi@gmail.com
This is an open access article distributed under the terms of the Creative
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How to cite this article: Tripathi M, Mukherjee KK. Do no harm: Stories

of life, death and brain surgery. Neurol India 2016;64:1112-3.

Neurology India / September 2016 / Volume 64 / Issue 5 1113

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