‘Unflinching’: neurosurgeon Henry Marsh. Photograph: BBC/Eyeline Films
Why has no a single ever written a guide like this just before? It just tells the stories, with excellent tenderness, insight and self-doubt, of a phenomenal neurosurgeon who has been at the height of his specialism for decades and now has picked, with retirement looming, to publish an honest guide. Why haven’t far more surgeons written books, specifically of this prosaic beauty? Of blood and doubts, mistakes, decisions: had been they all so unable to descend into the mire of Grub Street, unless of course it was with black or, worse, “wry” humour?
Properly, thank God for Henry Marsh. His speciality is drilling into people’s heads and sucking out or cauterising various difficulty globules, generally daily life-threatening. Those are the bald basics, but they disguise a multitude of traumas, not least people of a very human surgeon. He writes with near-existential subtlety about the really fact of working within a brain, supposed repository of the soul and with myriad capacities for emotion, memory, belief, speech and, perhaps, soul: but also, primarily, jelly and blood. He has been 4mm away, usually, even with microtelescopes, from catastrophe.
“As I turn into more and far more knowledgeable, it appears that luck turns into ever far more critical.” Not the most copper-bottomed reassurance you could want from the man who’s going to plough your brain, but sincere. And he has removed so numerous issues, with filigreed certain-handed finesse: there was a 15-hour operation as soon as, but it had to be attempted. “The skull is a sealed box and there is only a limited amount of area in the head.”
He’s been to Kiev, provided selfless time there to fledgling neurosurgeons who may as nicely have been working with flints and candlelight, and saved many lives there too.
But he doesn’t flinch from admitting disasters. His picked word is “catastrophic”. It applies to bleeding inside that sealed nut of the skull, as in “When I had sawn open the woman’s skull and opened the meninges, I located to my horror that her brain was obscured by a movie of dark red blood that shouldn’t have been there.” He has “wrecked” sufferers, he woefully admits individuals left half-frozen, half-crippled, dead. But there was no option. Or was there? 1 of the finest admissions to emerge in this phenomenal guide is that of each surgeon’s dilemma, which is the inability to play God: but instead to have to make a decision, soon after nights of soul-looking, regardless of whether it really is worth it. All moral oversimplifications steal away like morning mist.
Throughout, there runs a caustic commentary on the recent target-setting woes of the NHS. Sufferers getting shunted, at 3am, not between wards but among hospitals, at times 150 miles apart. Not the Ukraine, quite, but the idiocies could give it a run for its money.
“I have misplaced count of the number of diverse passwords I now require to get my work done every single day.”
He tells, briefly in the last chapter, the story of having to race up different flights of stairs, repeatedly, to ascertain a password for a ruinously high-priced NHS-broad pc technique, just the newest in a succession. “Attempt Mr Johnston’s,” he’s advised. “That usually operates. He hates computer systems.” Forty-5 months have passed considering that the introduction of the newest doomed method. The password is “Fuck Off 45″.
Marsh tries it back in his office, in numerous upper/reduce situation and space-optional guises. He is sitting prior to a policeman who has had sudden critical epilepsy attacks, and his ageing mother and father, and waiting to get into the program to find the pertinent x-ray, which will most likely save the man’s lifestyle. He has to run once again, two flights up, to double-verify the password. Two months have elapsed. Turns out it is now “Fuck Off 47.”
Apparently Mr Marsh’s decision to retire has been hastened by the risk of disciplinary action, at the hands of an NHS manager, for wearing a wristwatch on his rounds. There is no evidence of the threat of infection currently being infinitesimally increased by the wearing of this kind of. What a bloody loss. And what a bloody, splendid book: commas optional.