I think this is a first for Cornflower Books: a book reviewed here twice. Eighteen months ago Mr. C. gave his thoughts on neurosurgeon Henry Marsh's memoir Do No Harm: Stories of Life, Death, and Brain Surgery; I read it over the weekend and must now add mine.
I haven't been as gripped by a book of any kind for a long time. It's not that the cases Mr. Marsh describes have a grim or ghoulish compulsion to them (though it's true that many make harrowing reading), it's the honesty with which he writes, admitting to his own and others' mistakes - some of them avoidable errors - with a candour which makes human these 'god-like' men*, and when you contrast the surgeon's fallibility with the trust and faith put in them by patients and their families, and the fact that they so often operate on a knife-edge between success and failure, life and death, "wrecked" life or good life, you cannot help but read on. Add to that the writer's natural eloquence and the facility with which he tells his stories, his "wary sympathy" for those in his care, his clear self-knowledge, and what you have is an enthralling account of a very difficult job.
The brain is an organ of mystery, the surgeon's instruments "moving through thought itself, through emotion and reason [...]", and with a poetry of its own - the Sylvian fissure, the basal veins of Rosenthal, the Great Vein of Galen. Certain neurosurgical procedures are likened to bomb disposal work, and the surgeon learns to accept intense anxiety as a normal part of his day, and yet he would gladly spend all his working hours operating, practising his "craft", as medicine is described here.
Henry Marsh was a hospital porter before he became a doctor, and his unconventional career path - via a degree in PPE and without any science 'O' or 'A' levels - is traced in the book, as is his own engagement with various branches of medicine including neurosurgery as a patient himself or close relative of one. He is deeply frustrated by the apparently ludicrous rules and self-serving bureaucracy of our health service, and yet he has gone regularly to work in the desperately ill-equipped, primitive but byzantine world of Ukrainian neurosurgery in the hope of helping people who have no access otherwise to the standard of care that this country offers. He is skilled in the "Olympian detachment" necessary to assess cases and make the inevitable difficult decisions, but he brings to his patients a genuine empathy, and a willingness to go far out of his way for them. He writes of real people and events with a novelist's eye for telling detail and a playwright's sense of timing, and he describes the "heaven and hell" of the neurosurgeon's lot without sentiment or sensationalism.
The book is first rate and I can't recommend it too highly; it more than deserves its second outing here.
*They are mostly men.