And Brain Surgery - Do No Harm - Stories of Life

The first few chapters had me choosing something else to read as a brain sweep so that I'd be able to sleep! Later chapters were less frightening, or I had toughened up, and I could read as I wanted to - voraciously. It's well-written, brilliantly titled, accessible to the layman and puts the human back into doctor/surgeon.

Informative but repetitive... Good luck to Dr. Marsh in his retired years; the guy really had a very rough life... Some people deserve more than our unbound gratitude as they choose the "less traveled path" to help some other human beings deal with the horrific side of unimagined disease...

This is an interesting book if you want a look into the experiences of neurosurgery. However, the author portrays himself in a manner suggesting an over-inflated sense of his own importance. That isn't to say that neurosurgeons are not important or that they rightfully stand as among the more gifted surgeons. But the nature of the prose and the author's reflections give the impression that he considers those around him not to be his human equal. I don't know if he is actually like that, but I find that element of the writing to get in the way of some interesting , tragic and at time, miraculous moments.

Interesting read from a doctor across the pond. Not sure if I would want to know all the details if I were facing brain surgery. Author does a good job in making his profession seem "real" to someone not in the medical profession. So very strange to me to hear this doctor referred to as "Mr." so unlike our country. Not light entertainment but an informative read.

A beautiful treatise on the desperation of being in medicine in a world of bureaucracy. It is not defeatist or pessimistic to remember your failures. If anything it makes you more human. I applaud Mr. Marsh's perspective and recommend this book to anyone, fellow physicians especially.

I enjouyed this book, although the arrogance of the author was a bit much at times. Loved the stories and the medicine, though, and the reality of everyday medicine. Not much is ever said about the aftereffects of brain surgery, and I appreciated this aspect of the book.

For a book ostensibly about poking around in people's heads with a sharp instrument it was strangely compelling. I learned a little about the unpleasant things that can grow there and how they are removed, and a great deal about humility, self awareness and the impact of errors. In fact, the surgical mistakes and their drastic effect on the patient were a dominant theme in this quietly well-written book.

Organized in chapters, each focussing on detailed accounts of various medical procedures, descriptions of the mechanics of operation procedure as well as the physical hospital conditions, beaurocratic workings, interactions of medical staff w patient and family
Confessional, honest, insightful

As a physician myself and the same age as Mr Marsh, I can fully agree with his writings. The intrusion into medicine by third parties with no interest in patient care have made the quality decrease and the cost only go up!

A very good read whether you have a medical back ground or not. Surprisingly honest with just the right amount of dry humour. It puts into perspective the pathetic complaints that nurses receive from patients - so all nurses out there read this!

Even with absolutely NO medical background at all, I could understand what the book was about. I loved it, and what an amazing thing for the Doctor to do...... write about some of his failures. My hat of to you, Sir......

After reading reviews of this book, as well as a personal recommendation from a friend, I anxiously looked forward to reading it myself. Unfortunately, it left me wanting something more or different. The author is a good writer and he seems like a good human being. But I wouldn't let him operate on me and I was left wondering how much of this book is true and how much was written for effect. I know many neurosurgeons but I've never met one like him. As a group they are an extremely confident bunch. Dr. Marsh, on the other hand, seems full of self doubt and questions. While that may be admirable and perhaps makes him seem more transparent, I find it hard to believe that he successfully functioned in the world of neurosurgery like that. So at the end of the book, I didn't trust his voice which made the book much less enjoyable.

This is a pretty good book, but not literature in the best sense. Henry Marsh does interesting exploratory and rescue work in that mushy organ known as the brain. Mr. Patient: know this! One slip and you're out..skilful cutting and probing, and you're back in the game. How one learns to do this without pushing patients over the edge is a mystery to me! There are dozens of different kinds of cancer, not to mention aneurisms and other nasties that seek to end our lives, but Marsh soldiers on, brave and wise and, thank the Lord, exprienced. Very interesting...

While the author is honest, and seems like a very nice man, this book is depressing and gave me nightmares about brains.
What is also depressing and disheartening is his commentary on the state of the British Health System. It is exasperating
and makes the whole thing look like a circus. Which is probably his intention. I hope it helps in some way to improve things, but I
doubt it
I did make myself finish the book, but cannot say I enjoyed it. I purchased it because my father was a surgeon whom I admired
much, and I was curious. I would say this subject has a limited audience

I found this book somewhat enjoyable at times and others seemed to drag on without substance. I am not a neurosurgeon, however I am a High-functioning TBI survivor, and have spent the last 10 years researching everything about Brain Injury. I thought this book would go further into details and talk about the last minute decisions and miricle cases. I do not feel my time was wasted, however I wished it could have been better.

This little book is a gem for anyone who is interested to know more about brain surgery. It is very readable for the layman. The chapters ( each one a different case) are short and each one is fascinating whether a happy or sad ending.

This is a very enjoyable read. Mr Marsh is frank and forthright , and pulls no punches when he recounts his stories. Not only is he remarkably empathetic, I love the way he calls a spade a spade when discussing the shortcomings of the NHS. He is insightful and innovative I do hope he will continue to share his wisdom !

Though this book is not for light reading, it is a well written account of Henry Marsh's slant on the challenges & satisfactions of practicing neurosurgery.

I particularly liked his clear, no holds barred approach to telling it "as it is"

I would recommend this book to anyone who is interested to find out more about life in this challenging profession. Some background medical knowledge would probably be an advantage.

Some interesting cases. I enjoyed the book but Marsh is no Gawande. Marsh is open and honest about his mistakes which is very much to his credit. I would have appreciated less of Marsh's view of his career, mistakes and triumphs, and more about the field of neuroscience/neurosurgery.

This book was entertaining for the most part, but I was looking for some deeper meaning. In the end, it seemed to simply be war stories about operating on human brains. Granted, that process is incredible in and of itself, but I found no real insight into this most complicated of human organs. I appreciated Dr. Marsh's internal conflicts and can understand them, but after a while I became bored with them.

I thoroughly enjoyed this book. An unpretentious, honest and engaging look inside an exceptionally unusual and interesting profession. The stories are varied, the chapters are short, the prose is nothing but the necessary, precisely and neatly executed - just like in his day job, I imagine. Great read. Can't think of anyone who wouldn't find it interesting. Going to miss it on the loo in the mornings.

Having heard Teri Gross' Fresh Air interview with the author, I couldn't wait to get this book that she had characterized as so beautifully written. The content is undisputably riveting and Henry Marsh's humanity shines through. Unfortunately, there was little cohesiveness either within or across chapters, and his sentences rambled on. Not the most pleasant read for this reason.

Interesting read but it focused more on his failures rather than successes. Maybe he wrote it as some sort of catharsis. Overall, I liked it. Easy, quick read with good explanations of the technical details.

This book is disarmingly honest in revealing the highs and lows in the career of an exceptional neurosurgeon. God-like status often proves difficult for surgeons to handle, both within their professional careers and in private lives, and Henry Marsh does an outstanding job in examining many of the issues through the use of finely crafted case-histories. His difficulties in working within the evolving UK health system, where new levels of management and administration degrade the ability of front-line medical to achieve the outputs expected of them, is sobering and thought provoking.
I thoroughly recommend this book to anyone with an interest in, and some knowledge of, the the life sciences.

Brain surgeons may well be the rock stars of medicine, but not because of their erudition and warm ways. Certainly, though, they can be granted some level of sanctity for their perilous craft. But statistics will always prevail, heedless of merit or medical degree. Even avoidable outcomes can become unavoidable given the right - or wrong - conditional variables.

Sometimes, "salvageable" is the best declaration that neurosurgeons such as Henry Marsh can make of a potential patient. If his operation fails, the patient is "wrecked". The terminology may be crass, but Marsh does not prettify anything in his book Do No Harm. It is straight talk about brain surgery as just another venue where luck reigns. No one WANTS to kill their patients because of a stupid mistake on their part. But it will happen. No manufacturer deliberately designs medical equipment that can fail. But it will. Sometimes the surgeon making the mistake is going to be Marsh. And sometimes the unlucky patient is going to be you.

The directive to "Do no harm" is about intention and deliberate action. Marsh's intentions in writing Do No Harm are indisputably good. If you have any doubt, watch the 2009 documentary that features his work in the Ukraine. It is available for streaming and/or purchase here on the store, and well worth paying to see, if necessary. The English Surgeon

I had just finished Melinek's Working Stiff when I started Marsh's book. Hers is far superior with respect to writing style and content. Marsh comes across as egocentric (surprise!) and many of his highly touted errors were really someone else's fault. The writing is stilted and not particularly interesting. If I needed brain surgery, I would find someone else. On the other hand, if I needed an autopsy, Melinek would be my first choice!

Not the most enlightening book. I'm not real sure why he wrote the book other then to make money and absolve himself oh screw ups. Did like that he would decline surgery when he knew it wouldn't help. Not as cocky as most neurosurgeons

I love reading books about healthcare, but I found myself getting quite irritated while reading this one. At one point, Dr. Marsh refers to one of his patients, who had attempted suicide, as a “pathetic, dying bulk”. He also often seems to become irritated about having to comfort his patients. Dr. Marsh came across as extraordinarily arrogant, and he seemed to lack the compassion and bedside manner that makes a great doctor. I would not recommend this work.

The only downfall is that the items never come together always in separate bags making it very costly for the arrival. I am not sure who to contact regarding my future packages. I do need them to arrive all together. The piping tips easy to use....love them! Thank you.

This book is a memoir of Henry Marsh, a senior consultant neurosurgeon in London, UK. In a series of episodic chapters, he writes very candidly about the challenges, heartbreak and occasional triumph that neurosurgeons (and indeed many medical professionals) face every day. Each chapter is compelling, whether following individual patients and their sometimes life-or-death surgeries, recalling his years of extensive medical training, or searching for some sort of hope within stories of disease. His recounting of his own family's illnesses is very raw and touching. His bitterness against the institutionalization of medicine is counterbalanced by the very 'British' dry wit and irony, which in many cases is very funny.

The book is clearly written in a style that does not talk down to the reader, despite discussing sometimes very complicated or technical medical problems. Fans of neurological disease (such as the works of Oliver Sacks and Frank Vertosick) or medical stories in general will enjoy and appreciate it. Highly recommended.

I've read a number of books written by neuroscientists before, but this is the first one written by a neurosurgeon. Rather than an examination of brain chemistry and human behavior, this is a fascinating nuts-and-bolts look at how a surgeon can fix... or not fix... dreadful, and sometimes dreadfully painful, brain abnormalities.

I salute the author for ripping away the secrecy which many doctors, especially surgeons, use to shroud their careers so they can maintain their "supremacy" over us plebeian non-surgeons. Mr. Marsh does an excellent job explaining the different types of tumors and the life-threatening dangers an operation can pose, and while he celebrates some of his successes, he doesn't gloss over the other, more tragic outcomes. He comes across as a brilliant doctor who genuinely cares about his patients and has learned from his mistakes.

Another interesting aspect of the book is the behind-the-scenes look at the British healthcare system. His frustration at having to deal with inane and seemingly meaningless administrative rule changes, "improved" computerization, and governmental rulings that have more to do with saving money than saving patients will resonate with anyone who's ever worked in the healthcare industry, no matter the country.

Four and a half stars, rounded up to five.

What is it like to be a senior neurosurgeon?

Marsh allows us a peek into his soul, not through a microscope or MRI scan but through these fascinating memoirs. His description of bodily details which most of us would find gory makes them sound like exquisite art exhibits or magnificent scenes in nature. More harshly but no less poetically he describes his own emotions, particularly when matters go wrong. Throughout he alludes to but never quite puts his finger on the elusive bridge between cerebrum and psyche.

Usually before writing a review I refrain from reading others' reviews lest I be prejudiced by them. But as hundreds of fine reviews of this bestseller are already available on the Internet, I choose here to only highlight aspects of this book that seem to have escaped the attention of other reviewers.

Of the twenty-five chapters, the titles of twenty are names of neurological pathology followed by a brief definition. Three refer to emotional states. One title has a definition in both neurology and psychology. That adds up to twenty-four.

Only one carries the title of ostensibly a medical treatment: Leucotomy, or as it is called in the US, lobotomy. In this chapter Marsh reminisces about his brief job as a nursing assistant on a long-term psycho-geriatric ward while still a student. Not only the title contrasts this chapter to the others but also his attitude. While elsewhere he describes his patients with the utmost of respect even when they have been reduced to a pathetic state of helplessness, here he describes them as “babbling, demented incontinent old men” (sic) and his respect is reserved for the nurses who work with them. And while in the other chapters he blames himself for causing such damage, here he in no way acknowledges that the mess these men are in is iatrogenic, whether or not caused by Marsh. He describes how the operation is done but fails to condemn it. Instead he writes, “Fortunately it was rendered obsolete by the development of phenothiazine drugs such as Largactile.” Fortunate for whom? The phenothiazines were the first neuroleptics, later falsely relabeled antipsychotics, which indeed render lobotomy obsolete as with these drugs psychiatrists can reduce their patients to “babbling, demented incontinent old men” and women without soiling their hands. Marsh admits to having committed such operations but is happy to have abandoned them. “The psychiatrists told me that the operation really did work,” he cites doubtfully, then prematurely aborts his skepticism by skipping to a description of a person with mysophobia who, before treatment, is not too babbling, demented or incontinent “to sign the consent form that allowed me to burn a few holes in his brain.” Rather than relating the tragic results as he does in other chapters, he has his train of thought interrupted by a nurse, never to return to the subject again. (Perhaps he never did do lobotomies himself but only inserted them into the book for what he perceives as their entertainment or educational value?)

That kind of cop-out is not typical of this publication. Marsh is otherwise not wary of withering criticism of himself nor of the medical establishment:

Examples:
I thought the word 'technology' would mean interesting things like microscopes and operating instruments but it turned out, to my dismay, to mean drugs.
Many of the hospitals are involved in trials for the big drug companies and I was told that the same patient might be put into several different trials since the doctors get paid for every patient they enter. If that is true … the results are therefore meaningless.
[In patient files] the recent relevant results have rarely been filed, and if they have been filed, have been filed in such a way that it is usually very difficult to find them. I can learn … about my patient's birth history, and perhaps gynaecological, dermatological or cardiological conditions, but rarely find information such as when I had operated on the patient, or the analysis of the tumour I removed. I have learnt that it is usually much quicker to ask the patient instead.
I thought of the presentations I had heard over the years at international conferences by the great names of neurology and the breathtaking results they claimed … although rarely, if ever, with a word about any bad results they might have had along the way.

In addition, this book contains some great quotable passages which deserve to become aphorisms that make Marsh immortal. Here are a few examples:

We invest doctors with superhuman qualities ... If the operation succeeds, the surgeon is a hero, but if it fails, he is a villain.
Doctors [are] reluctant to criticize each other in public [except if they] hate each other.
They do the rounds of the hospital departments when they are appointed and then one never sees them again, unless one is in trouble... This is called management.
Doctors need to be held accountable, since power corrupts.
The real utility of the drug is to give dying patients hope.

Though Marsh's surgery sometimes stumbles, his stories are a smashing success.

Copyright © MeTZelf

There are many accounts of the practice of medicine written by various doctors out there, and I've read many of them. Often times, when I tell others that I've read them, I'm asked "Why would you read that?" The reason I'm asked that is because I, too, am a doctor, so I think I am uniquely qualified to judge Mr. (Dr.) Marsh's book.

The book is wonderful. It's an interesting discussion of different brain tumors and other conditions a neurosurgeon would treat, and how this particular neurosurgeon managed patients with a variety of problems. It's about the relationships he's formed with some of these patients and how his work has affected his personal life. Most importantly, it shows just how serious brain disorders such as tumors and hemorrhages can be, and takes away some of the mysticism associated with these conditions.

The most striking part of the book, and for me the most enjoyable, is the humility with which Dr. Marsh practices his craft. When one thinks of a surgeon (and I've known many of them), the vision is often one of arrogance, aloofness, hubris, and superiority - put simply, some surgeons just carry themselves that way. Dr. Marsh doesn't seem to be like this stereotype; rather, he seems humble, sensitive, caring, and selfless and clearly interested in the best outcome for his patients, even if that outcome is a shortened (but high quality) life. As I read this book, I found his humility refreshing and his honesty enjoyable. What's interesting is that people always think of the family doctor or pediatrician as the type of physician who shows caring, who hold your hand, who gets you through the tough diagnosis. Once you read this book, you will see that there are some surgeons - like Dr. Marsh - who do this as well.

The other thing which I think is very interesting is how Dr. Marsh describes the pressure of performing brain surgery. I've always thought that the reason that some surgeons have tempers is because of stress, but when you consider it from Dr. Marsh's point of view, it's no wonder that surgeons can sometimes be seen that way. The term 'operating under pressure' applies very well to Dr. Marsh's work described in this book.

This is a short and interesting book that I'd strongly recommend reading.

This a great book. Well-written and sincere. The book is composed by a series of anecdotes and short memories, most about the medical profession, but a few others about Dr. Marsh’s personal life. Dr. Marsh combines his great story-telling abilities, with his wisdom, truthfulness and capacity for introspection.

While reading this book I remembered a beautiful poem by Wislawa Szymborska, In Praise of Feeling Bad about Yourself:

The buzzard never says it is to blame.
The panther wouldn't know what scruples mean.
When the piranha strikes, it feels no shame.
If snakes had hands, they'd claim their hands were clean.
[…]
Though hearts of killer whales may weigh a ton,
in every other way they're light.
On this third planet of the sun
among the signs of bestiality
a clear conscience is Number One.

Dr. Marsh doesn’t have a clear conscience. He knows well that for a neurosurgeon the long and difficult path toward technical competence is dotted by innocent victims. Unlike other doctors, he doesn’t take this fact lightly. He feels bad about himself: self-deprecation becomes part of his routine. In one of the most telling anecdotes of this book, he leaves his hospital on a Sunday afternoon after a busy day and goes to a grocery store near his house. He finds a big line at the cash register. He gets exasperated. “What have you done today?”, he mumbles arrogantly to the other shoppers. But then he realizes that his power over other people’s lives was mutating into a disregard for their humanity. This book can be read, indeed, as Dr. Marsh’s fight to resist the dehumanizing forces of modern medicine.

As his career advances, Dr. Marsh learns that the most difficult part of his job doesn’t take place inside the operating room. Making decisions in the office tends to be much more complicated. He regrets much more his past actions than his inactions. If neurosurgeons followed their patients over time, they would be much more reticent, he writes. Talking to dying patients is also very difficult. And, in light of the book, there is litlle learning and reflecting about it.

Dr. Marsh puts forward a subtle criticism of his profession. Experience and wisdom, he suggests, do not always come together. Experienced and competent physicians are not always wise and humane doctors, and vice versa. Dr. Marsh is both a wise and experienced surgeon. He is also a good and honest writer. These virtues are reasons enough to read this great book.

A memoir of Henry Marsh's time as a top brain surgeon. An absolutely fascinating look at what goes on in the operating theatre, and the life changing outcomes of his surgery (mostly positive). Fortunately, for me, the book is very low on gore, and very high on interesting detail. It is quite suitable for those with no medical knowledge.

Each case is a chapter in itself, making it perfect for short bursts of listening. Along with the intricate operations, Henry Marsh describes his relationships with his patients and their families, the training of brain surgeons and his frustrations with some NHS management decisions.

The narration was so good, I checked to see if it was the author himself. When "The End" was announced I thought it was a new chapter header, and was very disappointed to find the book was finished!

A book with as much tension, drama and excitement as a thriller. Highly recommended.

"Brain surgery" has always been right up there with "rocket science" as an exemplar of really, really tough things to do, and brain surgeons in the popular view are medical magicians. Henry Marsh's memoir of the real life of a real brain surgeon makes it very clear that brain surgeons are fallible human beings, not magicians or knights in shining armor. Without in the least condescending to the reader, he talks about what it is that he actually does, the physical reality of operating on the human brain. But he also talks about the psychic reality. He shares his wonder at the fact that the physical brain is inextricable from the mind and heart and the other things that make us human. He shares the bitterness of knowing that surgery sometimes won't help, and sometimes fails. And he shares stories of his own mistakes. This book taught more about doctors than about operations -- most critically, that doctors are people, as much as we want to turn them into minor deities who can resolve all our ills. Before closing, I should say that this book is brilliantly written, in a clear and lucid style, with an underling gentleness that makes one wish there were more doctors like Henry Marsh

If you're a hypochondriac, steer clear. Otherwise, steel yourself and have a look-see at surgery from the other side (assuming you're not a neurosurgeon reading this). Henry Marsh is a British brain surgeon and a writer with a clear, straightforward style -- not only his diction, but his personality. With each chapter named after a different (and terrible) thing that can go wrong with these miracle devices we call our brains and our bodies, he delivers anecdote after anecdote of actual cases he's experienced over the years, some ending happily, many not. What's refreshing is his human voice. Being seen as savior or demon (often depending on outcome of surgery) is no easy way to make a living, as readers will see.

Still, Marsh is not one to hide behind his vaunted profession and overly-romanticize it. In fact, he admits that errors happen. Things go wrong, even during routine operations. In one frightening case, he let a junior surgeon begin a rather straightforward procedure and an error causing permanent disablement occurred. Rather than falsify records as many doctors do (and easily can, considering the patient is out and you're only surrounded by members of your team, the medical brethren), Marsh owned up to it. In his view, hospitals deserved to be sued in some cases -- a man like this should at least win a settlement to help with the obvious ordeal lying ahead. Still, settlements or not, mistakes don't stop guilt from hounding doctors. At least doctors who care.

Despite all of the gloom and doom, there's an education to be had in this book. You can learn a lot about the brain's function and effects on other parts of the body. All pain is signaled by the brain. Hemispheres matter. Location and size of tumors matter. Some tumors are "sticky" and become problematic because they adhere too much to the brain. Others, more luckily, almost "pop" out with little coaxing -- like Teflon, even. One never knows until one goes into the brain, which on more than one occasion sounds as much the "last frontier" as outer space, especially when reading Marsh's graphic descriptions of the "landscape" in there.

Here's an excerpt showing Marsh's typical tone and overall humanity: "My outpatient clinic is an odd combination of the trivial and the deadly serious. It is here that I see patients weeks or months after I have operated on them, new referrals or long-term follow-ups. They are wearing their own clothes and I meet them as equals. They are not yet in-patients who have to submit to the depersonalizing rituals of being admitted to the hospital, to be tagged like captive birds or criminals and to be put into bed like children in hospital gowns. I refuse to have anybody else in the room -- no students, no junior doctors or nurses -- only the patients and their families."

The type of doctor you could put your faith in? I should say so. An education not only on the brain but on dying? That, too. The doctors know what's going down, and you will, too, once you read all of these cases. Sometimes no operation is the answer. Sometimes hope is your enemy -- bound only to prolong your suffering when palliative measures would be so much more humane.

Overall, a compelling document. Moments of humor, dark and not, rails against bureaucracy and government, and snapshots of people like you and me... always hoping the best from life, sometimes receiving the worst from it. In a word: fate.

These tales from the operating room by Henry Marsh, eminent British neurosurgeon, open a door to a world most of us will never see: the inept management of the NHS, the world of the neurosurgical operating room and, more intriguingly, the world of the brain itself. By reputation – and in his own estimation – Marsh is a skilled technician, a masterful brain surgeon, though he doesn’t hide his personal faults or his medical errors. When neurosurgeons make mistakes, well, the consequences are often catastrophic (he “wrecks” them), if not fatal. In some cases fatal would be a mercy. But he has his numerous triumphs as well.
However, his stories rarely have a conclusion or anything approaching closure; we never hear the patient’s long-term story (except for those who die on the table or shortly after). So many stories end with, “she went back to her local hospital and I never saw her again.” So when Marsh says a surgery was successful, he means the patient didn’t die or wasn’t obviously wrecked. Whether they had long-term success is unknown in most cases, although there are a few cases where the patient lives long enough to have a recurrence and turns once more to Marsh for help.
This is perhaps a cause of the primary fault of the book, the lack of any meaningful meta-narrative. What do all of these stories mean? What did Marsh learn about humanity in all its frailty and resilience? Marsh’s book ends up being an existential narrative describing what the problem was, what he said and did, and what the immediate outcome was. Perhaps that’s Marsh’s pessimistic point. People get tumors or aneurysms or injuries, or they don’t. They live or they die. They recover or they’re wrecked. They come into his surgery, then leave never to be seen again, their ephemeral existence serving only to hone his skills for the next case. Perhaps he sees no lesson to be learned. If he sees it that way, I’m disappointed that he does, but if I ever need brain surgery, I’d like him to do it.

Once I finished Do No Harm, I wanted immediately to read it again. Not because it was difficult to read or because I had missed things. It is such a rich book, simple to read, quite riveting (I read it in one sitting). Yet I felt a such a sense of awe, curiosity about the patients, Henry Marsh's experience and the layered complexity such a simple read created in my thoughts that i wanted to read it again.

A review on another site that Mr. Marsh (English surgeons aren't called Doctor for some reason) had not matured enough to recognize his arrogance. This is so wrong. Every time I read about some moment of his arrogance -- locking the door to the neurosurgeons' lounge, mentally complaining about having to stand in line at the supermarket, being admitted at the emergency room of his practicing hospital for a broken leg and not being recognized as the hospital's neurosurgery consultant; doing a surgery at a different hospital with no neurosurgeon on staff and having the staff treat him all to casually rather than as a Brain God -- each of these accounts were to me written with great irony, the author's awareness of his shortcomings, and (maybe only in hindsight) humility. If that doesn't show maturity and growth I don't know what does.

This is a marvelously engrossing,must-read book worth more than one read. Also worth watching is the Emmy-Award winning documentary, The English Surgeon,about Mr. Marsh's 15- year relationship with hospitals and doctors in the Ukraine.

Although a man of colossal ego, Dr. Marsh is able to discuss his failures as well as his successes as a neurosurgeon. The nature of the surgery is such that even the best leave a trail of destruction in their wake and come to realize that the most important decision is whether to do the surgery at all. Marsh gives a vivid description of what brain surgery is like, as well as all the pedestrian troubles that go with the glamour of the profession.

He is a bit less insightful when it comes to his criticisms of management and discussion of larger issues of health policy.

Very well written and absorbing.

This was a real eye-opener of a book. I have often wondered how things are from the surgeons point of view when it comes to operations and now I have a much better understanding.

Dr Marsh is certainly honest when it comes to his career, the highs and the lows of it. How one mistake or an error in judgement, can change a persons life forever. I love that he mentions that young surgeons are sometimes too impatient and are not thinking about the whole picture when it comes to surgeries and he admits that he was one of those impatient surgeons once himself. With age comes wisdom and that is a good thing.

Fascinating reading, it really was.

Have you ever wondered what your doctor thinks of you and or your situation? What are their feelings like? How do they deal with frustration and loss and ineptitude of themselves, others and the system around them? From a neurosurgeon's perspective, those questions are all answered here. There have been books written before about life as a surgeon with case notes, most prominently from Atul Gawande who is generally without peer. Marsh does well in comparison to Gawande. If you like one, I believe you will like the other.

Marsh spends usually around 8-10 pages on different scenarios categorized by the type of disease that patient is presenting with. He describes the disease in just the right amount of text and goes on to describe the patient in a way that personalizes them. He has vivid recollections of his conversations which in the beginning of the book are inspiring, but toward the end of the book become downright sad.

This book is very philosophical and extremely well-written. I was actually shocked at what a great writer Marsh is or what a great editor he has. Perhaps both. I cannot imagine one not being touched or moved emotionally by this book, but it is real life. People get brain cancer and die-all many times within very short periods of time. Marsh discusses what his conversations look like with those patients and what his follow-up is like. He is clearly haunted by his failures and those patients he has lost much more than gleeful about his successes.

I have a unique perspective in to this book in that I am a medical device representative and have supported many brain surgery procedures in the past at more than 100 different hospitals in the US. I have also supported 100's of other types of procedures in the Operating room. The lesson I would encourage to all of you that read this review is that all surgeons are not the same. All physicians are not the same. Some are significantly better at what they do than others and having seen so many procedures at times things can be frightening, but watching how physicians deal with problems can also be encouraging. At your job are you the best at what you do with your company? The worst? Or somewhere in between? Physicians are no different.

Marsh cared greatly about what happened to his patients, but his job was to give them the best care possible regardless. Ultimately, he had to move on and claims to not remember the successes, but the failures. More than likely he is just like the rest of us, which is why this book is so brilliant. Bravo Dr. Marsh.

My wife recommended this book to me. It was written by a neurosurgeon, Henry Marsh, to whom she was referred with back pain. We both met him in his outpatient clinic, and he impressed us – partly because he said that no surgery would be required. When Mr Marsh’s book was published and was shortlisted for a 2014 Costa Award, my wife naturally wanted to read it.

The book is subtitled “Stories of Life, Death and Brain Surgery”, and I found it to be a very engaging read. The subject matter: brain surgery is quite mysterious, but Mr Marsh explains procedures so that the main points are quite understandable without being technically obscure. His writing flows pleasantly, and sincerely; one never feels that he is the least bit condescending. In fact, he lays bare the mistakes he has made in surgery, and reveals the anguish he has felt. Successful, life-saving procedures are dealt with matter-of-factly. With twenty-five chapters, each dealing with a different condition, one feels well-exposed to brain surgery. Mr Marsh tells the reader of his development from nursing aide to med school, through the doctors’ hierarchy to consultant, and includes vignettes of the teaching of junior doctors. The book is not from a doctor’s perspective only; he reveals the thinking and the feelings of patients, too. The hospital setting is covered: nurses are caring but over-worked; managers are bureaucratic, unsympathetic and stubborn. Stories from his voluntary practice in Ukraine are included, as well, and these provide a strong contrast to the state of the art and the clinical and management culture in the UK.

One can’t help but feel, as one reads the book: Why in the world would anyone want to be a neurosurgeon, given the complex opportunities for failure? Mr Marsh doesn’t answer this question directly, but I think his view would be that the euphoria that one can feel from saving a life or advancing the technology more than offsets the anguish one feels from a mistake that leaves a patient paralysed. Given, therefore, that a neurosurgeon has control over the life and death of his (or her) patients, Isn’t it tempting for a neurosurgeon to feel like a god? Again, Mr Marsh does not answer directly. He seems to say that any pretence at being a god is destroyed in the humility of the learning process.

Do No Harm was one of five books shortlisted in the biography category of a Costa Book Award in 2014. The winning book was H is for Hawk by Helen Macdonald about her struggle to train a goshawk. On the face of it, one would think that Marsh’s book would have a leg up: after all, a book about the ramifications of life-saving surgery sounds more important than the difficulty of training a very wild animal. Perhaps a clue can be found in what the Costa judges said about H is for Hawk: “A unique and beautiful book with a searing emotional honesty, and descriptive language that is unparalleled in modern literature.” I haven’t read H is for Hawk, but what I think the judges are saying is that Helen Macdonald’s writing is what won the prize for her. Still, I would recommend putting Do No Harm at the top of your reading list.

This is a very candid, interesting, and powerful book on the life of a neurosurgeon. I highly recommend it--with limitations. Let me explain. My older sister has had numerous brain surgeries throughout her life so when I saw this book I was interested in it for personal reasons. I also thought my sister may enjoy reading it. I let her have the book first for a couple weeks and when I asked her about it she said it was very good. However, when I picked it up from her she said she had only read the first chapter which surprised me. She then commented that if she had read this before any of her surgeries she may not have gone through them.

When I started reading the book I understood my sister's words and I almost had to stop reading it as well because even though the perspective is from the neurosurgeon's view it brought back too many memories of the fear and pain associated with having a loved one undergo a brain operation. These are memories I would rather not remember or relive. Fortunately, feeling obligated to write a fair review I continued reading and overall I am happy that I did. This is an excellent book. It is educational, inspiring, candid, and intriguing. It is also very truthful and honest regarding the risks and dangers of brain surgery and therefore it may not be for everyone.

The human body is a fascinating creation and the brain is probably the most fascinating (and frightening when something is amiss). I applaud Henry Marsh's writing and surgery skills.
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Updated 3/31/15: I've finished the book and I would have to rate it as one of the best books I have read!

Henry Marsh has been a consultant neurosurgeon in England for twenty-seven years. He, his wife, and child have had serious health problems, so he understands how it feels to be vulnerable and frightened. He has done his best for countless patients suffering from conditions ranging from the benign and treatable to the malignant and inoperable. In "Do No Harm," Dr. Marsh looks back at his long and eventful career. Being a neurosurgeon has taught him harsh lessons about life, death, and his own limitations.

How does it feel to hold someone's brain in one's hands? It is gratifying, exhilarating, and terrifying. There is little margin for error when you poke around near the centers of speech, comprehension, sight, respiration, and movement. If Marsh makes a serious blunder, he may be responsible for crippling or killing someone. What a burden to have on one's conscience! Yet, if he were too fearful and overly cautious, he could not function effectively in the operating room. A healthy dose of humility, along with the hubris that all neurosurgeons possess, is the balance one needs to do this job well.

This work of non-fiction is divided into twenty-five chapters, in which Marsh talks compellingly about patients with brain tumors, aneurysms, head trauma, strokes, and other diseases and injuries. He is candid with sick people and their families who want to know the truth, but tries not to rob them of hope. Equally refreshing, if Marsh slips up during surgery, he is remorseful, admits what he did, and tries not to repeat his mistake.

"Do No Harm" is somber, occasionally amusing, and enlightening. Marsh clearly outlines various ailments and explains possible treatment options. He discusses the importance of informed consent; suggests that it is sometimes best to do nothing; and never discounts the role of luck in medical outcomes. He writes conversationally, clearly, and compassionately about a complex subject, and emphasizes "the need for honesty and kindness from doctors." Dr. Marsh considers it to be "such a privilege--although a very painful one--to be a neurosurgeon."

This is an absolutely superb, even essential book by a British surgeon. Three years ago I wrote the following Review for a documentary about Mr. Henry Marsh:

"Format: DVD

"My wife (who has had three operations on an inoperable brain tumor) and I found this a fascinating, moving documentary when we watched it on PBS last night. Both surgeons impressed us with their humanity and with the terrible difficulty they face in delivering bad news to patients and in practicising world class medicine in the Ukraine. A remarkable irony: the featured operation was done in a former KGB building; the KGB had hasseled the Ukrainian surgeon for several years for providing unauthorized medical services.

"The comments on the PBS website devoted to this film reflect a wide range of deep emotions that many viewers felt as they watched and reflected on this documentary. The film maker's description of Mr. Marsh is right on the money in my opinion: "He is firstly an artist and then a surgeon. He's willing to look at surgery and surgeons. He's prepared to be vulnerable ... He's the very opposite of the arrogant, repressed surgical model."

"Incidentally, the correct way to address a member or fellow of The Royal College of Surgeons is to use the title Mr, Miss, Mrs, or Ms (not Dr). This system (which applies only to surgeons, not physicians) has its origins in the 16th century, when surgeons were barber-surgeons and did not have a medical degree (or indeed any formal qualification), unlike physicians, who held a University medical degree.

"The documentary honored (honoured?) this usage, and my wife and I honor both physicians. A wonderful film from our favorite television station.

"PBS has put together a wonderful website devoted to this film (link in first comment)."

The English Surgeon.

This wonderful book enhances that documentary in plain, down to earth, moving language. If you can only view one, choose the documentary. But I urge everyone to view or read both.

Robert C. Ross
March 2015

This memoir is amazing, one the best I've ever experienced. Dr. Marsh is a gifted storyteller, and his stories are powerful. From this book, an open-minded reader with a basic grasp of biomedicine can learn a lot about the mind and work of neurosurgeons, with much of that applying to other surgeons and physicians as well. We also learn about some of the pitfalls of the UK's national health care system. I highly recommend complementing this book by watching online videos of neurosurgeries.

Here are some of the key things I learned:

- Neurosurgery is very demanding. It requires an accurate and detailed grasp of very complex 3D neuroanatomy, precise tactile ability, stamina, balance of confidence and humility, extensive background clinical knowledge, good judgment, ability to deal with failure, and ability to talk to patients and their families.

- Neurosurgical failures can be immediate, glaring, and devastating for patients, their families, and neurosurgeons. This is very high-stakes work.

- It's not entirely inappropriate to put neurosurgeons on at least a small pedestal. No, they're not gods and are evidently fallible, but let's grant that neurosurgery is deservedly viewed as an elite profession.

- I think it can also be argued that neurosurgery is a rather narrow hands-on specialty, and less 'intellectual' than many other areas of medicine. I can imagine someone getting bored with it if they don't truly love it. Before this book, I could have imagined enjoying life as a neurosurgeon; after this book, I don't think so.

PS - The audio version of this book is narrated is exceptionally well, and many may prefer it over the print book.

If you like books that help you get inside the head (pun intended) of others in the world - which to me, is the magic of books - you should enjoy Henry Marsh's memoir Do No Harm. If you're familiar with the work of Atul Gawande, it has some general similarities in the reflective look at medicine and the many profound topics that cannot be separated from its practice.

The mysteries of neurosurgery, medicine and life make this fascinating. Dr. Marsh observes carefully, thinks deeply and has a very human and humble perspective on his work and on the deep issues it touches. The book reflects his work and thought, in that in some ways medicine is a job, and one has to focus on the task at hand. But soon much else comes into the discussion. This interview quote may give you a sense for Marsh's perspective: "Death can be a good outcome compared to the quality of life some are left with. We neurosurgeons do wonderful, but terrible things."

Or perhaps the quote Marsh uses to introduce the book: "Every surgeon carries within himself a small cemetery ... a place of bitterness and regret, where he must look for an explanation for his failures." Marsh has not left the uncomfortable events of his career out of this memoir.

The biggest caution I'd make is that if this subject matter is very close to home for you or a loved one, you might consider whether this is the book to read. Everyone else it appeals to though, read it now.

Do No Harm: Stories of Life, Death, and Brain Surgery is the memoir of neurosurgeon Dr. Henry Marsh, with a no-holds-barred approach that I found refreshing. As he recalls some of his cases, Dr. Marsh also includes more personal details about his life. Although fascinating, I found the book to be a little repetitive and not laid out in a linear fashion.

I did find interesting, however, that Dr. Marsh admits to his mistakes and does not profess to know everything about his chosen profession. I thought his musings about his Ukraine trips to be quite fascinating and wished that he went into more detail. Overall, Do No Harm was a good blend between the personal and professional life of a seasoned neurosurgeon and I look forward to reading more about Dr. Henry Marsh in the future.

Henry Marsh is a successful British neurosurgeon who has filled his book with tales of, mostly, imperfect outcomes. He makes mistakes, he can't guarantee outcomes in delicate brain surgery, he has to deal with patients fairly and clearly. We go behind the scenes at hospitals in London and in Ukraine - and no matter how much Marsh complains about the National Health Service you're definitely better off there than in Ukraine. His stories are riveting, and he is frank about the limits of his skills and of medicine. He doesn't get at wider issues as much as the leading masters of the genre like Oliver Sacks or Lewis Thomas, but he does well.

Marsh is a deft writer with interesting things to say. For an American audience there is too much about the idiocies of the NHS; I'd rather read about neurological matters than about bureaucratic absurdities. Everybody with a job has seen plenty of those. Also, while I'm sure their computer systems are the worst in the known universe, I wish Marsh would just man up and stop whining about passwords. Just write them down if you have to, or use a password manager. If you can't remember your password and lose time, it's your fault, not the computer system's.

All that aside, this is a thoroughly enjoyable and interesting and instructive book. If you have a brain and are interested in it, or if you like medical stories, this is for you.

A fascinating book. I love the way he lights into the incompetent bumpkins that manage the British National Health Service. I was surprised at the constant and severe shortage of beds in his hospital. Apparently British hospitals still use large rooms with twenty beds or more. They have not yet achieved the American system of no more than two patients per room. We need Florence Nightingale to come back and kick their ass.

Neurosurgery is a strange profession because, on many occasions, you are crippling a desperate patient who has come to you for help and expecting his condition to be improved. Somehow you have to live with that. Henry Marsh is only 65 years old but he looks 95 years old. Clearly Brain Surgery is a very cognitively stressful occupation and not good for one's mental health. Surprisingly, he is planning to retire soon. The surgeon who saved my life from colon cancer turned 90 years old this year and he is still operating.

Marsh was obligated by his parents to waste the best and most creative years of his life studying Latin, Greek, Politics, Philosophy and Economics and other such ridiculous nonsense subjects (Thank God they did not include Art History). He is fortunate they did not send him to that infamous school whose name begins with E. He describes some of the degrading jobs he held as a student including wiping the bottoms of bedridden, semi-conscious elderly patients. He has worked very hard to attain the skill level he now has.

Marsh has a kind heart and has devoted much of his time to helping the poor people in Ukraine who come to him, when he visits, to have large tumors removed from their brain. He does this for no financial compensation.

The most impressive thing about this book is the complete and utter candor with which he expresses his most intimate feelings and thoughts. He holds back nothing. He mentions his divorce from his first wife and describes the medical problems of his second wife. He does not mention children so I assume he has none.

If you are British and you have severe mental problems, requiring surgery, caused by the massive inflow of immigrants through the Chunnel then I urge you to read this book. In that way, when the anesthetic wears off and you find you cannot move your right leg, you will know that Henry is sincere when he says "Sorry 'bout that!"

“Do no harm” is paraphrased in the Hippocratic Oath that medical students are all exposed to first thing. It’s the common principal in all medicine, but is especially stressed in neurosurgery, where the possibility for harm is so high. Henry Marsh has been a top neurosurgeon in Great Britain for many years and shares his stories of the trade here.

Each chapter is named for and explores the treatment of a different neurological problem; meningioma, pituitary adenoma, infarct. Each chapter features a different patient; we see how the patient came to Marsh, how the operation went, and sometimes we see how they fared. Not always; sometimes they are whisked way back to the hospital that referred them, rather them leaving them under the care of the surgeon. So there are times that the author had no idea how they ultimately turned out.

The descriptions of the problems and the way they are treated fascinated me, but beware if you are squeamish- the author describes things pretty vividly. But his book is not just about operations; it’s also about his own life, the about the NHS system in England. The system limits not just patient care but the hours doctors can work, which can make arranging long operations difficult. New doctors don’t have time enough to learn all they should. Marsh describes taking this out on nurses, anesthesiologists, clerks, and more- while an empathic, caring, man with patients, he seems to have been an ass to those he worked with at times- and admits it.

I couldn’t put this book down. It was like reading a series of exciting stories, watching Marsh’s expertise and character grow. And I love a good medical description.

Wonderful treatment of a fascinating topic

Brain surgery should hold a certain fascination for anyone remotely interested in medicine or the strange workings of the human brain with all of its wonderfully complexity and extreme fragility. One could not hope for a better guide in such an exploration than Henry Marsh who writes beautifully on both the mundane (bureaucratic hassles of modern medicine) and the profound (the fine line between a brilliant success and a tragic outcome when operating on the brain where the margins of error are literally microscopically small). Marsh is alternatively arrogant and humble, curmudgeonly and deeply sensitive/ sympathetic about his own skills and limitations. Most of all, he is deeply self-aware, uncompromisingly self-critical and honest in his treatment of his profession and his successes and failures in this most difficult profession.

Rather than try to write a comprehensive or definitive treatise on neurosurgery, Marsh uses stories to give the reader a feel for this specialized branch medicine - its successes, failures, limitations, and the people who work in it. It works well - alternatively funny, intellectually engaging, uplifting, and sad. At the end, one comes away thankful for not having had to face the need for neurosurgery and equally thankful that there are surgeons like Marsh for those who do.

Ever wanted to see inside the brain? Did you ever want to touch that gelatinous mess and feel warm blood squirting all over your starched shirt, knowing that the next squiggly thing you sever, solder, extricate or drop will be the difference between life, death or some excruciating in-between coma-like existence for the anesthetized human container beneath your hands? Well then, this book is definitely for you -- and me too, it turns out.

I was absorbed from the first chapter. The author gently welcomes the reader into the foreign land of neurosurgery, whose citizens are of a decidedly unique temperament. Organized around chapters focusing on a specific condition or patient experience, Marsh writes clearly and without fuss, providing insider chatter (I especially enjoyed the commentary about hospital administrators and the dialogue from the daily brain scan reviews with juniors), just the right amount of biological explanation, along with exceptional descriptions of surgical procedures and brain conditions (hence the opening two sentences of this review).

But what is most intriguing is Marsh's honest reflection on a life spent curing and occasionally destroying brains, and the effects of his decisions and actions on the lives of the humans attached to them. It turns out that while these brain docs seem rather god-like, they make mistakes, some unavoidable, others less so. (Patients, beware; read this book.) This is no big surprise, but the descriptions in this book of some of those bad outcomes are poignantly raw. After several decades, the emotional price of a noble career in neurosurgery can be high.

Marsh delivers a fine piece of writing, and adds to a growing body of medical memoirs that bravely, finally, help to break down the damaging, and entirely unnecessary, wall separating patient from physician. We are all just human brains inside a body, after all.

This very well written memoir is a series of vignettes drawn from the career of a senior British neurosurgeon, Henry Marsh. Mr. Marsh (in Britain, surgeons are dubbed Mr.) is particularly interested in the psychological consequences of surgical practice. A good deal of this book is devoted to some of Marsh's errors and Marsh's introspection about the more difficult aspects of his practice, such as delivering bad news to patients' families. This could be self-indulgent, but is not, in good part due to Marsh's restrained and precise writing style. All of these episodes are interesting and quite a few are powerful. Other themes in the book are limitations of our current treatment approaches to many problems and Marsh's considerable dissatisfaction, often conveyed with considerable wit, with "reforms" of the British National Health Service. This book will be interesting to a broad audience but will have particular resonance for physicians, as Marsh really captures some of the most challenging aspects of clinical practice.

I was especially interested in this title as my husband had surgery for a benign meningioma last year. I don't know that I wish it had been available before the operation, but reading it now proved validating and poignant and infuriating all at once. Marsh organizes the book around types of tumors and the patients who had them, which I found academically interesting. But what matters more to me are the descriptions of the real behind-the-scenes concerns and fears of the doctors, as my view had shown only off-the-charts confidence and positivity; the confirmation that staff find petty bureaucracies and inefficient systems just as maddening as the patients and their families; the reality of surgeries gone awry, unexpected complications, and unintended consequences. For the record: I would have given this book five stars had I read it a year ago, as it's interesting, organized, and well-written. Anyone interested in medicine, patient care, and the reality of complicated, life-threatening conditions and cures should enjoy this.

One of the best collections of medical experiences that I've ever read. Dr. Marsh is to be commended for his honesty and transparency in giving us a great read for pleasure and study.

Because much of my practice is in the medical field, I read a lot of this type book. These books give insight into the problems that doctors face and that helps me better understand their field and feelings.

Often, books of case stories are more about medical heroics than the foibles of the practitioner. This book is crying out to us to understand that doctors are human with emotions and faults to accompany their great talent and courage. This book is loaded with interesting stories of both success and failure and is well worth the time to read it.

We place a lot of responsibility on the shoulders of the surgeon. Some are good, some not. Some are in the process of getting 'good'. As patients, we need to understand this. We need to learn about choosing a surgeon before we need one.

Great book. Well written. Highly recommend.

I highly recommend this May 2015 book by a UK neurosurgeon. " Do No Harm"

This book will make you laugh and make you cry. If you are an MD, see yourself and your career. See the medical profession falling apart.

See the problems in the UK that the USA is now suffering from (management, government, stupid rules, overblown privacy concerns, far undertrained young doctors who keep diaries to document their insufficient 48 hr workweeks, etc)

Above all, the neurosurgery cases are gut wrenching. The surgery is "easy". The decision to operate is the hard part. The patient outcome is the issue. The author writes with empathy, genuine concern, and reflection. If I ever need a neurosurgeon, I hope I have one with his wisdom. It takes more than wielding a scalpel to be a good surgeon.

Brain surgery is not for the squeamish. As it happens, I am squeamish, but neurosurgeon Henry Marsh's storytelling was compelling enough for me to overcome those feelings and read Do No Harm straight through without stopping.

What makes this medical book different from many of its type is that Marsh is extremely candid about the many cases that did not go well. Part of that might be due to Marsh's being British. I think an American doctor would focus more on the triumphs. Marsh, while a confident surgeon, also admits that much of any surgeon's outcomes will be down to luck, whether good or bad.

In addition to tales of his surgeries, Marsh also talks about the British National Health Service (NHS) and how it is a bureaucratic mess. On the other hand, he criticizes private health care in Britain for doing too many unnecessary procedures to boost profits.

Marsh also talks about his own experiences as a patient and his trips to Ukraine after the fall of the Soviet Union to help prop up the shaky neurosurgery department at a hospital in Kiev.

Marsh never seems to forget that he is treating a person and not an illness or a brain. And to top it off, he's a pretty good writer.

I enjoyed the author's stories and had no problem with any hubris as some had mentioned. The author might come off as a little opinionated, but to me it came across in a very natural and human way, opening up to his feelings -- It's common enough to feel aggrieved at balky new computer software, be annoyed by restrictive new directives from management, or even to curse being in a long grocery lineup when we're busy. The author doesn't get preachy about his lessons learned; they come naturally as part of his stories.

While I enjoyed every tale, some people may indeed get tired of the stories. It's almost like a book by a soldier at war: Death and severe injury appear in so many of his tales. He really opens up, including about his own errors and slips that cost people their health or lives, inevitable even in a successful career. But if one can stomach the dark side of life, his tales of the surgery he has done, of medical conditions, of how things worked in his hospitals, and what patients have had to deal with, can be quite fascinating.

The surgical parts were interesting, if not scintillating, but the arrogance, supposedly forgivable in surgeons according to other readers, was a bit much. He misses the days when senior doctors could bully juniors. He loves to tell us how so many feelings are unique to the successful surgeon. There are numerous sections in which he rails, like someone's grandpa afraid of cell phones, against the the new-fangled ways of computerized record keeping... He lost me at last when he referred to morbidly obese patients at his hospital as "small whales being rolled around on gurneys". I mean, sure: think those things, and even admit to thinking them. But to admit to thinking them with no acknowledgement that you realize that they are mean, cruel or downright wrong, makes you too self-important an observer for me to enjoy reading.

Perhaps it was the reader's interpretation (I listened to the audible version, which is read by someone other than the author), but I couldn't find enough interest in the tales and rather sparse medical ephemera - which is something I usually love - to want to put up with the unfortunately unlikeable author.

I have doctor and surgeon friends who aren't sociopaths or narcissists, so I refuse to buy into the fact that it is a requirement of the trade. I think that distinction may only hold true for those in the medical professions who can't get enough lauds for their super-hero actions.

No thanks.

And, for those of you thinking that he is railing against the NHS, he is not. He is railing against how it is currently being run. This is not a book against national health care, but against the currentcorporate bureaucracy of it, which is similar to the way HMOs in the US are run. The NHS needs fixing, not abolishing.

This is as much a autobiography as I is a medical book. Some of the stories (and that's what it is, a collection of stories) are quite moving. The author is aware that he has to play God, in deciding how and when to operate. And, unsurprisingly for a surgeon, he's more than a bit of an egotist. He is in his later years, near the end of his career, and looks back with a surprising number of regrets. The book would be vastly improved if an editor had knifed out the complaints about England's national health service and its bureaucracy. We in the US could hardly give a darn. But I did finish the book. It held my interest.

An amazingly frank reflection on the many patients who do not do well despite having expert Neurosurgical care. As a retired orthopaedist who did part of his early training in neurosurgery and then was asked to switch to become a Neurosurgeon; I declined. At that time I realized I did not have the courage to tackle the tough cases and tough decisions that could suddenly appear during surgery when operating on the brain. I felt I would always doubt that a poor result would be my fault. Only later with experience did my surgical wisdom mature and I found solace in the realization that as long as my planning was correct and the team was properly trained and prepared, then my patient and I could not ask for anything more. I finally could accept a less than perfect result.
Every medical student, surgical resident and neurosurgical patient should read this to learn that real life is not like heroic TV medicine.
Hopefully every surgical patient facing a difficult decision has a empathetic Dr. Marsh doing their procedure

Dr. Marsh pulls no punches as he recounts the terrible surgical mistakes that end in the paralyses or deaths of patients in the hands of neurosurgeons. But there are successes, as well. Neurosurgeons often face embarrassment and/or despair as they talk to patients or their families. The doctors sincerely want to cure their patients but are often unable to do so. They perform incredibly difficult and treacherous surgeries on tumors they often know will return. But they feel they must offer their patients hope even though almost certain what they do is probably futile. Tough book to read but the conundrum is entirely understandable.

Easy to read even without understanding the medical technical terms used for the various types of tumours. It shows clearly the frustrations doctors experience within the British National Health Service and how patients suffer because of over-regulation of every minor detail within a hospital environment...non related to the medical illness. Doctors have less and less time for their patients because they are forced by the NH system to deal with beurocratic issues. What the author does very well is explain in detail the anxiety, stress and insecurity accompanying a neurosurgeon. Very readable for persons with a curious mind and not prone to hypochondria.

I absolutely loved this book and nearly cried when it ended because it was that good. The book is written with such incredible detail it is as if you are in the operating room next to Dr. Marsh and colleagues as they carefully drill into someone brain or worse explain to a patient that she will never see again (for example). I read many of books written by physicians and this one is one of the best because it not only provides clinical examples but also a glimpse into the emotional and exhausting aspects of patient care. Dr. Marsh is incredibly open and honest about his insecurities and his strengths. He nicely describes the incredibly dysfunction healthcare system of today and just how he manages through it all. I love this author and wish him all the best in his retirement.

Very interesting book that I finished in one day (I could not put it down at night-to my wife’s irritation). Well written whose characters thoughts and feelings felt so real and raw with a little mix of mild humor added perfectly at the best time. I don’t read a lot of books about surgery or neurosurgery and I found it utterly fascinating. The chapters Empyema and Hubris were the most interesting but that does not mean the other chapters in the book weren’t as good because they were. It was just those chapters were the ones that spoke to me personally.

Well written-you won’t regret investing your time in this fascinating book!

As a current medical trainee, I have found myself increasingly drawn towards absorbing medical non-fiction accounts, a certain way of villifying the emotions and experiences I too am processing. Do No Harm was one of such books. I found myself wondering, as some have, what the overall theme or even chonologic development might take place. An accurate deacription of this book's development or unfolding is indeed meandering, at best.

To my fellow medical trainees (and also to those in search of quality medical literature), I would strongly recommend digesting works such as House of God, the works of Shep Nuland, or the fictitious work Cutting for Stone.

I received a copy of Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh from Goodreads Firstreads program in exchange for an honest opinion.

Do No Harm is a brutally honest, extremely compelling memoir of a top neurosurgeon. Each chapter discusses a different type of brain tumor/abnormality with frank conversations of the surgery itself for the condition, some of the patient cases he has dealt with, good outcomes or bad, and his emotional response to the cases.

I was impressed with Marsh's ability to make us understand the medical situations, his honesty in admitting mistakes, and the sheer humanness of his responses - fear, anger, disappointment, sadness towards cases gone bad, and joy and satisfaction of a job well done when the outcomes were good. He does a wonderful job of giving us insight into a world that, hopefully, most of us will never have to encounter. For those of us who have had encounters with neurosurgeons, it gives us a view of the other side.

An informative and compelling read.

What starts out as chapters describing a particular surgery on one of his former patients ends up being an affront to the English medical situation. Henry Marsh is now a retired brain surgeon who spends time in the Ukraine doing volunteer work, in a hospital far inferior to any he had worked in while practicing.

The stories are not always happy endings. Some patients come in with terminal cases. Others experience hemorrhage post-surgery, and others die of other complications while recovering. Sometimes it's the patient, sometimes it's the patient's family and sometimes it's the bureaucratic red tape of the hospital that makes the story memorable (for good or bad). He is a humbled surgeon and an honest writer. What he has experienced in England as a neurosurgeon can be experienced in the US as well as both countries have bureaucratic nightmares to wrestle with. He is an expereinced doctor who hates hospitals and disdains management.

Marsh admits he's often lost his temper, screamed an expletive, thrown a chair in frustration because of hospital mismanagement or something else that went wrong. But he writes well, if not sometimes too medically, to keep the flow going. Some stories are truly heartwretching, but that comes with the profession. He is an Englishman and writes using the British English, and that means that from time to time there are different words used, but the stories are understood.

The second part of the book has a more frustrated tone than the first part, as he slowly unwinds about some of the nightmares of English health care.. Chapters are divided by medical condition of the patient and given medical terms. He sure has had a rewarding and colorful career, which he lays out for the reader with much humbled honesty.

I really liked Dr. Marsh's personal memoir covering his many years of experience as a neurosurgeon. While not overly technical, Dr. Marsh uses proper terminology throughout, making each chapter an exact, focused review of a particular condition, how it affected his patient, and what Dr. March had to do to deal with the problem. I thoroughly enjoyed learning more about the way surgery is done and how many different, and seemingly trivial, factors can make a huge impact in the process. He adds enough background on the different conditions (vascular problems, tumors, degenerative diseases) to be comprehensible to a general public readership but doesn't back away from the specifics.

Throughout he is willing to bear his soul and discuss his surgical failures in a straightforward and factual manner. He clearly conveys how surgeons and physicians attempt to instill confidence in their patients but to not make promises which cannot be upheld. A small slip or inadvertent twitch of the hand can end a life or leave a patient irreparably disabled thereafter.

He also makes no bones about how increased bureaucracy has made the practice of medicine far more difficult. As a British surgeon, he focuses mainly on the national health service in the UK but also uses his experiences in the Ukraine to illustrate how empty-headed office-holders make it difficult for surgeons and patients. He discretely touts the better conditions at private facilities where the market has more influence. However, as most American physicians and patients probably know, the market cannot fix the problems caused by a huge mass of meddling middle-managers. It is both reassuring and a bit saddening to know that the challenges faced by "do-ers" in these countries are similar.

I liked the way this book was structured. Each chapter was titled with a different disease Dr. Marsh operated on, but did not just focus on the surgical procedure. He was able to tie in his interactions with colleagues, conversations with patients and their families, his personal life, health care abroad, and thoughts on how being a neurosurgeon has changed over the decades.

One thing you can’t fault the author for was his honesty. He spoke of mistakes he had made: surgical errors and moments he couldn’t find the right words to help desperate patients. There were also times he seemed conceited and unlikeable, like standing in a grocery line and thinking that he shouldn’t have to wait behind the others because his work is more important.

I could feel the passion he had for neurosurgery, with his detailed descriptions of the brain. It made me wish the book came with pictures, so I could see the structures he reverently spoke about as I read. It was here that the book fell a bit short for me, I started to disconnect when the medical details become too complicated for me (not a neurosurgeon) to grasp.

I recommend reading this book. I felt like I got inside the head of a neurosurgeon and it was enlightening on several levels!

One of the liveliest non-fiction books I’ve read this year is Henry Marsh’s Do No Harm: Stories of Life, Death and Brain Surgery. Marsh is a neurosurgeon in England, and he uses this book to draw readers into the stories of patients, his work as a brain surgeon, and the life and death consequences of his work. I was impressed by the candid way in which he admits to mistakes. His fights with managers and bureaucracy are often humorous. Most of all this is a delightful exploration of our human life in all its wonder. I was delighted from beginning to end.

Rating: Four-star (I like it)

Good book. Shows the reality of being a neurosurgeon. My colleagues and I are always extra nice to neurosurgeons. We feel sorry for them. They work very long hours and have very difficult cases.

Henry Marsh's personality is typical for a neurosurgeon. They have to have big egos. It helps them to get past the tough times that all of them go thru. The surprising thing is how forthcoming he was about all the challenges and complications of neurosurgery.

I found this book captivating. At first I was a bit put off by the style. As another reviewer noted, this book is not "poetic." It's not beautifully written, but neither is it poorly written. It's plain spoken, and that turns out to be quite refreshing. So is Henry Marsh (called Mr. in Great Britain). He's done a lifetime of good work, but is humble. A surgeon who recommends that a patient's family sue him? Not in America. And I suspect not likely anywhere.

Traumatic brain injury and death have visited my family more than the usual amount of times. Because of this, instead of feeling adverse to reading about neurology and neurosurgery, it interests me greatly. Knowing more than usual served me well when faced with one of the difficult conversations with neurosurgeons Henry Marsh repeatedly writes about in this book.

It is refreshing in the extreme to read about a surgeon who can admit his mistakes and understand how much luck plays in both life and surgery. Marsh writes about the arc of his career as a neurosurgeon and the wisdom, humility, and even distancing that he's had to develop in order to work in this difficult specialty. In some ways, he doesn't give away too much personal information; we know his first marriage ended badly on account of his being a neurosurgeon, but what that really means is never explained. I suppose it's unimportant, a salacious detail.

This book is about surgery, the life of a doctor in the hospital, first and foremost. It is about neurosurgery, in language most laypeople can understand.

There's something a tad dry about this book at times, but it underscores the times when Marsh is not dry. At one point he indulges in cursing for an entire paragraph, and (unlike another reviewer), I found it rather thrilling. He could have indulged in a rant about bureaucracy and the National Health Service in a more coherent fashion, but he did not. He's a human being, not a superhero, and that is, in fact, what this book seems to really be about. Neurosurgeons are flawed human beings doing the job that gives them nearly God-like powers. Henry Marsh knows that he is not a God indeed, and for that I'm glad to have read his very human book.

As a neurosurgeon completing forty years of practice, I have experienced almost every situation in which Mr.Marsh found himself.He eloquently presents the triumph and tragedy a surgeon routinely confronts in this complex field. He artfully explains the extraordinary stress and risk of making decisions both intraoperative and in the clinical management of patients,the result of which,if wrong, can wreck a patient's life and that of their family as well. Marsh compassionately expresses the mechanics of coping with adverse results that all surgeons must endure....death, paralysis, and even vegetative existence and the difficult task speaking to families of patients sustaining complications that may be the fault of the surgeon.I applaud Marsh for his honesty and self criticism...an exception among contemporary members of our specialty. Reading this marvelous work made me wonder how I ever managed to spend a lifetime as a neurosurgeon. Anthony A. Chiurco MD

I had the audio book and it was wonderful to listen to while driving. His honesty is refreshing and has a hint of humor as well. I learned so much from this book and felt like I could envision it as if I were in the room when he went into detail. Five star book, very well written.

Good writing but so sad at times. Great insight into the world of a neurosurgeon. It's a tough profession but fortunately Henry Marsh is both an excellent surgeon and compassionate. There are many successful cases but the failed brain or spinal surgeries leave a person with even more deficiencies and pain and there's always that risk. I found the book fascinating but it's not for those who are squeamish about medical procedures.

This book in a wonderfully written, incredibly engaging account of a senior neurosurgeon who thrillingly conveys the incredibly delicate work of brain surgery - operating on an organ that is like jelly, where a small mistake can have the gravest consequences (which the book does not shy away from telling us aboout). What makes the book wonderful is the human aspect it tells - the fears and stresses neurosurgeons make as they move through a patients' brain (e.g., pulling a tumor away from the optic nerves of a women losing her eyesight). The book is incredibly engrossing as it describes surgeries and outcomes of patients, and giving inside picture of what goes on in an operating room (e.g., interactions of staff, including surgeons being trained by working on "simple" cases). It also gives the perspective of a surgeon wondering whether it is actually beneficial to provide an intervention when risks may be large and benefits very uncertain - a difficult and interesting discussion.

This is one of the best books I have read in a very long time. Fascinating in terms of science but also in terms of exposing feelings and fears of those who do some of most complex work around. Very highly recommended!!

Like many other reviewers, I initially found this book hard to finish due to the sheer arrogance of the narrator’s voice. Nevertheless, I forged on. I did so as both a former ICU and hospice nurse seeking understanding into the coping mechanisms of other healthcare providers who are continually witness to extreme suffering and tragedy, and also as a thrice survivor of a brain tumor. Unfortunately, I was not rewarded by this author’s belated guise of purported self-reflection. Rather, I found insight by contrasting his soul-deadening worldview, with that of Dr. Atul Gawande, the author of, Being Mortal.
Neurosurgeon, Henry Marsh, at the end of his undoubtedly lucrative career giving him both social and monetary capital, insults his readers by imagining this memoir is somehow redemptive of his decades-long dehumanization of patients and, ultimately, himself. Through a litany of human tragedy, he shows a lack of intimate cognition of the lived pain of the people under his care. Instead, he subjects the reader to his stark clinical musing of his own power over life and death. He alone will control the outcome of the life in his hands, or should I say, soulless conglomeration of chemical reactions, which he refers to as the human brain.
He derides the benighted who actually find divinity in the sentient nature of human life. He ridicules the healthcare system in his country that is gradually eroding his elevated ascribed status, and whose administrators bother him with the mundane tasks of the logistics of care delivery that, apparently, he is above. He thinks by simply finding them contemptuous, rather than throwing things and screaming in anger as he has in the past, he has now evolved to enlightenment. He has not. Henry Marsh is a deluded man who is suffering in self-inflicted spiritual isolation.
The scant collegial interactions he mentions are of silent looks by fellow surgeons in allusion of the shared burden of enormous responsibility, or terse statements he imagines to be supportive. Yet, in reality, Henry Marsh is completely alone. The vacuum of his existence is perfectly captured in the prideful recounting of his generous “gift” of a luxurious red-leather couch to the neurosurgeon’s lounge, in a hospital that seemingly employs only one senior neurosurgeon. Then, oblivious of the incongruity, he writes of his outrage when several general surgeons had the audacity to attempt to enter it. Like the red-leather couch, Henry Marsh resides in a lonely sanctuary of mind.
Dr. Atul Gawande and Dr. Henry Marsh both work in the field of medicine and are inundated with suffering. Yet, unlike Atul Gawande, who owns his pain and seeks to define it by searching for insights and the solace of other healthcare professionals, and who together create solutions, Henry Marsh turns inward. He reduces his patients, the tragedies they experience, and his own suffering into a sterile, scientific algorithm of his own delineation. His ontological and epistemological frameworks are simplistic and lacking in any semblance of reverence for life. Devastating surgical outcomes are viewed through a mechanistic lens, devoid of emotion. The only grappling he does is philosophically on the immense power of his surgical craft; he believes he has complete agency, fate is at the end of his scalpel. It is this that absorbs him, only this.
The witnessing of suffering and the human condition for Atul Gawande is personally diminutive; he realizes he is one small part of a much larger and awe-inspiring whole. For Henry Marsh, it is personally aggrandizing and diminutive of any real existence beyond oneself. I would recommend Henry Marsh read Atul Gawande’s book, Being Mortal, and contrast the paths each have taken, and of the two, ask who has found peace.

I struggle to comprehend some of the comments claiming that they "loved how humble he is." I have worked with a neurosurgeon, and maybe he was an anomaly, but he is one of the kindest and most humble people I have ever met. He told me that "the truly great doctors become more humble as they gain experience because they comprehend the extent of what is left to know." I picked this book because of the reviews and was happy to find myself recognizing the procedures of neurosurgeons. He recounts excellent stories of surgery, explaining the procedures and their reasonings without losing a non-medical audience, and he is brutally honest in a way that most could never allow themselves to be. However, he acts like a genuine 2 year old, not like a senior physician with years of experience having lives in his hands. I understand frustrations, but I DO NOT understand berating other doctors, throwing fits when other surgeons use the SURGEONS LOUNGE, or having a cow about a poster or the very idea that he, a neurosurgeon, should have to interact with normal people who do "far less important things". Maybe I'm being harsh considering that he did do a brave thing by telling his mistakes, but he was such an unlike able character and Doctor that it's hard to feel any real gratitude.

A fascinating book, especially if you have some background in the medical sciences. It might have been helpful, however, if the author had delved a little more deeply into the function of neurons and how the brain works. True, he did describe in general terms functions of different parts of the brain, but not the cells themselves. As an aside, it might have made for a more interesting book if the author had included a few photographs - of him in the Ukrainian (sp?) hospital as compared to his UK surgical suite, the author at 'work' with the surgical microscope he mentions, a photomicrograph of a neuron - even one of him with his bicycle!

Thoroughly enjoyed reading this book. Henry Marsh ability to look at both sides of his profession and speciality and willingness to be accountable in difficult situations, truly makes you look at areas where you can improve in your career and life. His perspective and account of the changes in the NHS and Medicine in general confirms something I have always heard second hand from my Father, a recently retired Consultant Aneasthetist and active examiner for the Royal College of Surgeons; how the impact of lower medical training standards and reduced on-the-job exposure rate that the new Doctors are experiencing due to a ridiculous cap on weekly hours, is becoming more apparent in their job performance and overall ability to treat patients effectively.

I wonderfully written book about a neurosurgeons trials and travails treating and operating on patients. Dr. Marsh is very honest with his feelings and attitudes about his patients and he talks openly about cases where he could not help, and occasionally, as every human must, make errors. He paints a very realistic picture of the hospital environment, struggling with bureaucrats and new impossible regulations. The empathy that Dr. Marsh exhibits towards his patients is palpable. He talks and addresses death, a topic that we all in this western society tend to evade and shove, but a topic that would benefit greatly from open discussion.

As an American, I can only be jealous of the British NIH system that will treat each patient as best as it can, with no regard to insurance. Dr. Marsh complains about delays in operation from the time of the initial diagnosis, 2 weeks in the worst cases. It is definitely no better in the States here, with our privatized care.

Life & death choices, & seconds to make them.
I & my ex-wife had to make that medically decision once.
As a former crisis & school therapist you have to make mental health decisions in the same manner.

I agree with the Neurosurgeon you have to have a sense of humor that is your out. Exercise, healthy lifestyle & of course sex will help.

Warning: This book is for adults only & contains extreme violent or graphic adult content or profanity &/or sexually explicit scenarios. It may be offensive to some readers.

I did not receive any type of compensation for reading & reviewing this book. While I receive free books from publishers & authors, I am under no obligation to write a positive review. Only an honest one.

A very awesome book cover, great font & writing style. A very well written informative book on Neurosurgery. It was very easy for me to read/follow from start/finish & never a dull moment. There were no grammar/typo errors, nor any repetitive or out of line sequence sentences. Lots of exciting scenarios, with several twists/turns & a great set of unique characters to keep track of. This could also make another great Neurosurgery movie, class PP presentation, or mini TV series. There is no doubt in my mind this is a very easy rating of 5 stars.

Thank you for the free Goodreads; Thomas Dunne Books (St. Martin’s Press); Autographed; paperback book
Tony Parsons MSW (Washburn)

It was a great reading experience. I am a medical doctor though not a surgeon and I could find myself in so many of his thoughts and experiences, it was like having someone expressing your thoughts in a more articulate way than you'd be able to. His insight on patients and family members emotions is impressive as well. Above all it was a very honest book, as with all surgeons some traces of vanity can be noticed through his understated ways, but hey it is justified.
I already loved his lectures when he came to Albania, delighted to confirm he's a fine writer as well.

.An interesting look into the life and work of a brain surgeon from his day to day experiences in the hospital to performing various surgeries upon patients he encounters. The surgeon in question is Henry Marsh, a fellow of the Royal College Of Surgeons and appointed neurosurgeon at Atkinson Morley's/ St. George Hospital. He's also a subject of the Emmy Award Winning Documentary, The English Surgeon. This book covers topics and different conditions he's encountered in his career such as Aneurysms, Trauma and various diagnoses and stories of brain abnormalities like Pineocytomas, Haemangioblastomas, Ependymomas, Glioblastoma, Neurotmesis, Akinetic Mutism and other various conditions. Covers many cases he's worked on throughout his career, his travels to Russia and Kiev to work with patients, also his own family and personal experiences with his wife, mother and son. Gives insight from both the patients and doctors perspective. their interactions and relationships and in some cases Henry's loss of professional detachment and his distress compared to some of his patients composure. This may be of interest to you if you have any of the conditions described or are interested in a look into the life of a brain surgeon.

A wonderful and touching collection of stories that illustrate the set of challenges facing a surgeon and his patients. The author presents these stories in a very truthful and unvarnished way which repeatedly has you realizing the humanity that lies behind every surgical mask. I found myself feeling immense gratitude for those that take on this very difficult work.

I'm very fond of books about neuroscience and neurosurgery. This one is a particular winner. Neither pedantic nor poetic, this down-to-earth, humble neurosurgeon writes warmly and engagingly about his life in medicine, the fascinating and terrible things that happen in a person's brain, and the very human side of a variety of ailments. I recently read a somewhat stilted book by a neurosurgeon who spent a bit too much time patting himself on the back. There's none of that condescension here. Have your hanky ready - there are parts that will make you cry. Mr. Marsh (in the UK, surgeons are addressed as Mister) acknowledges his fears, his mistakes, and his deep caring for his patients. All I can say is, if I ever need a neurosurgeon, I'd like him to be available. In the meantime, I'd like him to write another book!

Finally a selfless doctor, lots of adult perpective and not hogging the credit for his good deeds to his own profession, Thank you for acknowledging the nurses The comments on the British medical system were telling,,,,how much have we thought of a prvate and public sector here in the states?

As a nurse I love medicine based books. This one is interesting in its discussion of the anatomy, delicate ness and risks of many brain & related surgeries. I would have enjoyed hearing even more about the health care system politics & patient & surgeon's emotional investments & responses. Still a very worthwhile read & I recommend it to those with any interest in the subject.

An interesting and in depth memoir of the unique nature of being both a neurosurgeon as well as a medical patient. Marsh is charming, and unflinchingly owns his own failures as well as sharing successes and some very funny experiences as well. A fairly quick but satisfying read.

I usually love these kind of books but I started skimming the book because I was so tired of him endlessly griping about the medical community changes. We get it there are not enough beds and too much red tape but come on already. I don't want to start and end each chapter detailed every abuse.

This is an excellent (non-fiction) book about a Neurosurgeon and his patients. He stresses that Neurosurgery is a risky and inexact science. This book gives a lot of insight into the British Medical system which is socialized medicine at its best. It can be cumbersome and quirky.

I deeply appreciate the willingness of Henry Marsh to share his experiences as a neurosurgeon. While it is clear that neurosurgeons have to be extremely self-confident in order to do their work, it is the modesty of the author that makes this book so valuable. While he describes many complicated, and usually successful, surgeries, he is also willing to write about his failures, and his feelings about his failures. Woven throughout the book are descriptions of his frustrations with the British health care system in which he works. This provides a context that makes the accomplishments of doctors, and the endurance of patients, poignant as well as impressive. His writing style is modest, straightforward, and imbued with a gentle humor that makes the book very enjoyable to read, even when he is describing the details of removing a brain tumor.

This is a very thoughtful memoir. Having worked in medical education for almost 20 years, I enjoy narrative medicine. In other words, I enjoy reading about physician experiences; aside from finding them interesting, I also feel it makes me a better teacher and administrator. The author Henry Marsh is a gifted story teller, but the best part of this book is the honesty he portrays throughout the entire book. There is no sugar-coating of anything, nor is it some sort of polemic or political piece like so many physician narratives today. Instead, this is an honest account of a man who clearly feels that his work is his mission and calling in life, he doesn't love it but I also don't get the sense that he would be able to ever do anything else. An amazing book.

My expectations for this book exceeded the reality. It's a good book - possibly even deserving four stars - but not great, and certainly not as great as the glowing reviews led me to expect.

Dr. Marsh (or "Mr." Marsh, as apparently Brits don't refer to their doctors as "Dr.") seems to be a decent man; as humble as a brain surgeon can be and very much aware of his failings. However, even when the most noble and human/humane of his attributes come through, there's a certain aloofness and sang-froid to his writing. Maybe it's just British reserve. In addition, he tells story after story of the surgeries he's performed, some of his own personal tribulations, patients he's seen, and so on, to the point that the book seems to be (and possibly is) little more than a compilation of articles written for a magazine or newspaper.

The book also suffers by comparison to the wonderful memoir "On the Move" by Oliver Sacks, which is supremely human and much more of a narrative than this work.

All in all, not an ignoble work, but not the best by far.

ScienceThrillers.com review: Do No Harm: Stories of Life, Death, and Brain Surgery
made the top 5 of the NYTimes bestseller list in Science this summer. People are loving this book.

Me, not as much.

Granted, I read the whole book and enjoyed doing so–evidence that this is good stuff, well written, intellectually engaging, even page-turning with suspense at times. The reason I didn’t fall in love, I think, is my personal reaction to the voice of the author, who represents a certain type of older male surgeon that I find less than endearing.

Henry Marsh is a British neurosurgeon who has been in the business for a long time. (Apparently he’s a bit of a media star in England.) In this memoir-ish book, Marsh tells eye-opening stories about patients he’s had, and cases he’s performed, including some that did not end well. A blurb on the book’s back cover praises Marsh for “rare and unflinching honesty,” and I agree. This book’s strength is Marsh’s confessional approach to telling his stories, revealing his inner frustrations, worries, and insecurities.

That a man who cuts open other people’s heads and mucks around with the insides suffers from doubts and insecurity should be no surprise, but in the psychologically strange world of surgery, it is shocking, in a way. For most of us, a mistake at work requires a broom or perhaps a delete key. For a neurosurgeon, even the tiniest lapse of judgment or concentration can mean lifelong paralysis, loss of speech, or death for the patient. No wonder that doubt creeps in. Yet on the outside, the surgeon must appear absolutely confident for the good of the patient, who can only cope with their situation by ascribing godlike properties to their doctor.

This odd mental arrangement is laid bare in Marsh’s book. He admits that to operate when you know that you are fallible requires extraordinary courage, coupled with some unhealthy defense mechanisms: a tendency to forget your mistakes, and to blame others.

Thus the arrogance of surgeons is legendary, and here we get into why I was put off by this narrator. While I give Marsh credit for his barefaced sincerity, and his desire to put the patient first, an arrogance runs through his stories that is not always sympathetic. Marsh has a particular disrespect for administration. Granted, his misadventures with the British National Health Service justify much of his scorn, but at the same time he represents an older generation of doctors who do not understand that medicine has changed. Surgeons are no longer boss of the world, not even in the OR. They can’t do whatever they want.

This spills over into their relationships with coworkers, in particular, I think, women in medicine. The good old days of male trainees being chained to the hospital for days on end, and then lingering to share a drink with the boys, are gone. Marsh relates an episode of frustration with scheduling a case because an anesthesiologist had to leave the hospital to pick up her child. While Marsh puts most of the blame on the bureaucracy and its newfangled rules restricting physicians’ working hours, I sensed a total lack of appreciation for why younger doctors, especially women, might have lives outside the hospital. (Marsh, like most older surgeons, is no longer married to his first wife.)

Do No Harm is primarily a loosely connected series of anecdotes, not a sustained narrative. Each chapter is named after a neurosurgical condition (Pineocytoma; Aneurysm) and includes a story about a patient with that. Many chapters have detailed descriptions of surgery, so they’re not for readers who are squeamish.

Marsh also touches a little on end of life issues, on the wisdom of doing nothing in some cases, and the tension between hope and futility. This is a theme I find fascinating but is far better explored in another physician’s book, Being Mortal: Medicine and What Matters in the End BEING MORTAL by Atul Gawande which I highly recommend.

If you like Do No Harm, you’ll love: Being Mortal by Atul Gawande; The Afflictions by Vikram Paralkar The Afflictions; Working Stiff by Judy Melinek and TJ Mitchell Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner.

It is difficult to imagine an American surgeon speaking of his failures in such a straightforward way. Apparently British doctors don't have to worry about personal liability. Perhaps we would sometimes rather our doctors remain infallible heroes when we put our lives in their hands. This surgeon does not talk about the countless successes that undoubtedly made him a renowned surgeon, but instead looks at both successes and failures with unusual candor. A refreshing look at the complex and still mysterious world of brain surgery.

While this did at times seem a bit disjointed and scattered I enjoyed this book very much. For me it served as an especially good adjunct to the book Being Mortal. Both authors are physicians in the later years of their careers with important things to say about how the practice of medicine has evolved over the last 30 years or so.

Just so-so...I admire this surgeon but this book leaves much to be desired; some of the patient's stories are just left hanging, and there is way too much personal stuff unrelated to the medicine, IMHO. I bought and read "When the Air Hits Your Brian" by Dr. Vertosick, and not only do the stories practically address the same medical and surgical problems. this guy does them so much better.

I had the opportunity to read and review this publication free of charge.

This book is a true gem. Neurosurgery is a mysterious field that I really know very little about, but having read this book, I have a far greater appreciation for the profession, and yes, craft that these artists perform. Sure, some of the writing gets a bit technical, but overall I found it easy to understand and follow.

And even more interesting than the nuts and bolts of surgery that are covered is what the doctors that perform these feats are feeling and thinking. Reading the book gave me the same feeling of seeing a great documentary about a subject that you don't even realize that you know nothing about!

In summary, highly recommended, well done sir!

Dr. Marsh has a clear, concise writing style and makes it easy for the reader to understand the very complicated surgeries he does on his patients' brains. He describes many types of brain rumors with specific examples. Some are heartbreaking. Some are humorous. He tells us of his personal brushes with medicine, including with his young son and his own retinal tear and broken leg. And everyone can identify with his frustration over needless bureaucracy and inefficiency.
I would recommend this book to anyone who is interested in science, the brain and modern medicine.

I like learning about medical issues. This story is told from the surgeons viewpoint and explains various brain diseases and the emotional turmoil of patients and surgeons in deciding for or against surgical intervention. The book was a good read but not for the faint of heart.

I cannot stress the relevance of this book enough (some important reflections for us in the same business)

Henry Marsh communicates a lot of the stuff, that we, as doctors, either don't have time to tell, or shouldn't tell patients for their own best. Furthermore, a very relevant attack on the current business-like models that wreak havoc on our practise and dehumanizes the doctor-patient relationship

An insight into the life and work of a neurosurgeon that gives the public an understanding of the other side of things. How it happens that doctors become detached but the need for that. And interesting how brain surgery is performed.

A book about the difficulty that is medicine and surgery. How to deal with uncertainty? How to deal with death? How to deal with mistakes? How to deal with success? How to deal with a bureaucracy more concerned about politics than medicine? Mr. Marsh tells lovely stories and yells about the seven different types of turds the nurses must document while searching for an operative note he needs to help a patient.

Excellent book on neurosurgery. I loved the author's comments on the profession, life, mortality, ethics, and aging. Most have no idea how much effort goes into medical training. I disagree with many of the reviewers. I loved this book for the vulnerability the author exposes and the honest ways he describes his failures.
Highly recommended.

I almost couldn't put this book down. Fascinating, not only for the cases he operated on, but also for everything surrounding the actual physical operation, all the emotions involved for both surgeon and patient.

You might wonder why people would ever want to read about a long list of shattering
tragedies caused by horrible brain diseases and trauma?
Well, the books long list of horrors might be just the thing we need to
remind us that life is a precious gift.
And Henry March is certainly a good guide in these strange lands.
It might all be pretty gruesome, but there is still compassion.
There are people who cares, and who spend their lives
trying to heal others. There are even people who care so much
that they suffer when their patients suffer. Indeed, you can see
it in Hery Marsh's face that all of the years as a neurosurgeon
has not left him untouched.
So, it might be horrible world out there, a world filled
with tragedies, but there is still hope, and there is still
compassion. So, it isn't all bad.
Clearly a message that deserves 5 stars.
And it obviously doesn't hurt the book that it is well written,
filled with many good insights and comments about the
world we live in.

-Simon

The topic fascinates me, the author's stories and descriptions were fascinating and scary at the same time. No one wants to get sick or suffer a tumor of any kind anywhere on the body. Am most grateful for men and women who become competent surgeons and are able to heal.

An interesting read even for someone with no medical background. What comes through most clearly is the surgeon's feelings about his work and his patients. That is something I never thought of before: The incredible agony that comes from making the smallest mistake which can destroy a patient forever.

This book was recommended by a doctor friend. I wouldn't have reading otherwise. I found it to be exceptionally well written and surprisingly seat of the pants for a non fiction book on brain surgery.

Excellent, engaging. Good insights to the NHS and physicians' relationships with healthcare because of that structure. But mostly a terrific read about one physician's experience as a neurosurgeon, some of his remarkable cases and his life story.

It gives great ideas night into the life of a neurosurgeon working in a socialized medical system. Dr. Marsh has a great deal of empathy for his patients. He also describes his work and his view honestly, almost brutally. Not recommended to hypochondriacs or the weak of heart.

It was interesting to read about the trials and tribulations that a neurosurgeon goes through in their career. I was also impressed by how humble Dr. Henry Marsh relates his experiences. I enjoyed comparing what I know about hospital care in the U.S. compared with the U.K.! I have been recommending this book to the health care professionals I know.

I really enjoyed this. It's a very candid (and very British) view of what it's like to be a Neurosurgeon. Very down-to-earth, not pretentious or self-aggrandizing at all and in fact the complete opposite of that.

A very worthy memoir of a life spent in medicine. A quick, easy, and entertaining read.

Perhaps not the thing to read right before you go in for brain surgery however (or maybe it is, I'm not sure).

Anyhow, recommended.

G.

An interesting look into the world of brain surgery as practiced in London at this period. The author is honest about the problems of, and sometimes limited solutions available to, his patients. It was enlightening to see things from the doctor's perspective, and I would especially recommend this book to those considering a medical career, or patients and families facing brain or spine surgery.

Wonderful book .. Sir Henry Marsh has somewhat satisfied my inner desire of becoming a neurosurgeon by giving a first person account of what happens inside operation theaters while doing brain surgery , how a brain looks like ..etc etc .. Grt read

Courageous sampling of the life of a neurosurgeon.... There is a hint of the emotional investment and personal hurts encountered in caring for others. It also gives an oblique view of the course we are on with the AHA in this country.

Holding little back regarding his own failures and critical of the UKs National Health System much of which we are guilty of reproducing Mr Marsh recalls some of the catastrophes and successes he experienced during his career.

Intermingled he describes he mother's final days dying of metastatic breast cancer and his on fears developing a vision threatening retinal detachment followed by a broken leg.

I recommend that all young neurosurgeons and residents in training read this volume. When to operate and when to not becomes not only personal matter buy also a societal problem. There are no clear answers

First read a review of this book in the Seattle Times. Somehow thought it would be better from reading the review. Thought Dr Marsh was more frank and open about the glamour of brain surgery than I would have been, with his descriptions of failures and errors on his and other's involvement. Recently lost a relative to the type of rapid growing brain tumors the good doctor tries to remove and he gives a lucid,thorough description of the complexity of the surgical process. God bless you Dr Marsh and all like you that battle these killers.

Avant-Garde Politician: Leaders for a New Epoch

In imperial Portuguese statecraft rulers and their advisors often viewed themselves as medical healers of the body politic. Some contemporary thinkers impressively continue this tradition, such as "Dr. Politico" (Dr. Luis Enrique Alcala) in Venezuela. And, indeed, this fascinating book, as well as in the literature on medical training and practice as a whole, presents issues salient to political leaders, subject to careful application.
Thus: "Much of what happens in hospitals is a matter of luck (p. ix),"[but it also is] a question of balancing risks, sophisticated technology, experience and skill (p. 41), while political leaders face much more uncertainty without being equipped by study and experience to handle it well; "the self-importance [produced by being a neurosurgeon] (p. 14) is all the more a danger accompanying political leadership, while being much less subjected to peer control and other safeguards; "Doctors like to talk of the `art and science' of medicine. I...prefer to see [it] as a practical art...that takes years to learn" (p. 31), but nearly all political leaders sorely lack the extensive knowledge, systematic study and supervised learning from practice essential for fulfilling their missions well; "Doctors need to be held accountable, since power corrupts" (p. 180), but this is relatively easy when results become soon visible and statistical quality control can be applied, while political leaders easily cover up errors, or are held responsible by simplistic publics for what does not depend on them. And so on.
Politics and medicine are in many respects radically different. Thus, there is a model of a "healthy person", a catalogue of the more frequent diseases, and evidence-supported "best practices," however changing with time. Nevertheless, one overall critical lesson from the history of medicine fully applicable to politics is provided by the progression from "Feldscherers" (a term going back to barbers engaged in surgery, first used around 1877 and then applied to fields surgeons lacking serious qualifications), to highly professional medical specialists.
Extensive study of political leaders as well as observation of many of them in action leads me to the bitter conclusion that most of them are in in the stage of Feldscherers, lacking most of the qualifications needed for coping with the fateful issues increasingly facing humanity. Democratic elections are essential in most countries, but the truth must be confronted: they are far from assuring the quality of successful candidates, all the more so when big money and political marketing cover up the real traits of candidates. Therefore, as discussed in my most recent book, radically upgrading of the qualities of political leaders is essential.
In my reading this book raises implicitly the fateful question how to assure that political leaders have the required moral and cognitive qualities, thus adding to its merits as being fascinating to read.
Professor Yehezkel Dror
The Hebrew University of Jerusalem

This is a great book. As a physician I was totally able to relate. Altho "deathly" serious in parts, I also laughed out loud in other parts.
I recommend it highly for physicians and also non medical readers.

We hear a lot about medicine/doctors/ hospitals/life threateniing illness/ the NHS/ in the Media. How often do we get to know the day by day case by case experiences of a practising, successful and revered brain surgeon? One who can make the science as understandable-maybe more so- than the mechanic who serviced our quirky and old car-or even the new-ish car with the funny litttle noise that no one else could hear or diagnose? A testimony as to how the scientific and the human together make the best medicine..A riveting read.

This book is simply shallow. I expected a lot more. When it touches a deep issue, it's just for a moment and in a superficial way. The cases are not that interesting. It gave me the impression that the author is a bit rude and egocentric also. Do not recommend it.

I am very involved with the practice of medicine, worked with numerous neurosurgeons (and other physicians/surgeons), and have enjoyed many of the other first-account medical books whose authors wrote glowing reviews of “Do No Harm” on its front cover. The summation of these factors I thought would make me an ideal candidate to LOVE this book.

Put bluntly, I did not.

Dr. Henry Marsh’s accounts are very dry as he explains extremely detailed aspects of his surgeries while simultaneously leaving out key information for a layman to understand them. Interestingly enough, the best analogy I would use to describe the paradoxical relationship would actually be going to a doctor’s office where they tell you a lot of information yet leave you without any understanding. I was only able to follow Dr. Marsh because of previously obtained knowledge in the field and seeing the same surgeries first-hand. In my opinion, the book would be better if it expanded on his personal triumphs and failures as neurosurgeon rather than incompletely outlining why his procedures were so difficult.

Speaking of the need to convince the reader that his surgeries were not easy, the book is lathered in constant themes of “I’m a neurosurgeon. This means I’m more important than you, god-like, and my marriage falls apart because I’m so amazing” and “I’m the true victim to curse of being a wonderful surgeon.”

I would also like to point that the book is written as an account of the trials and tributes of being a neurosurgeon, yet every story I’ve read in this book so far the outcome has been positive. Not every operation can be successful – his descriptions of the surgeries make that abundantly clear. The story arch of detailing a difficult surgery, explaining that he is the best surgeon for the patient at the time, surgery goes well, and he praises himself on his excellent ability is repetitive and boring. This had led me to the conclusion that Dr. Marsh did not provide a true personal account as advertised or his job title has led to delusions of grandiosity.

In summation, the book does not feel to be a true account but rather a collection of stories where an older man recounts his self-entitled importance and past glories. A striking difference to the successful first-account medical books whose authors raved “Do No Harm” leading to the question: “Did I read the same book?”

I purchased this book looking for some professional insight from a neurologist that would help me understand what a family member went they when diagnosed with a brain tumor, who survived, but is now more handicapped than preservers, confined to a wheel chair, eyesight and speech significantly impaired and who will need personalized care for the rest of her lift. Frankly I think that Dr. marsh is an arrogant physician or should I say primadonna who is more concerned about himself than his patients. Very disappointed in the book that really gave me no comfort or much understanding regarding her condition.

This book was not exactly riveting. I never completed reading it although if it hadn't been for the bad language that popped up here and there I probably would have finished it. Disappointing how even eminent surgeons these days can't express themselves without expletives !
The doctor was candid and humble about his feelings and his mistakes but all in all this book struck me as flat.