Friday, January 1, 2021

"Do No Harm," by Henry Marsh--Nonfiction Review

BRAINS! We’re talking about brains in this review, and how delicious they are, and how neurosurgeons fix them—yep—nothing else. Nailed it Kevin, perfect way to start a new year of reviews. Today’s book “Do No Harm” is by Dr. Henry Marsh, a neurosurgeon.   


Henry Marsh


What I love about this book:

So if you go back through this blog for the last year, you’ll notice I show a great interest in medicine—to drill down even further, I’m especially fascinated by neurosurgery and psychology. Dr. Henry Marsh is a neurosurgeon, and to put it the most succinctly, I love this book “Do No Harm” because he gives you a first-hand account of what it is like to be a top neurosurgeon.

Marsh’s style of writing is direct and to the point. He does use medical jargon throughout the text—in fact, he starts almost every chapter with an arcane medical term, but he almost always explains it in language and metaphors easy to grasp. It’s a remarkably accessible book for anyone, no matter how much prior knowledge you might have about the medical profession. 

There is an awesomeness to neurosurgery that Marsh captures in his straightforward explanations, and I mean that in the old sense, to inspire awe. When he discusses what it’s like as he ventures into someone’s skull with his microscopes and probes, he makes the experience sound like entering a cathedral—and in a way, it is. The human brain is still the most complex and intricate object that we can study, and the fact that it is the living organ that makes a person, well a person, makes it all the more profound. 

Also, in this book, Marsh describes his experiences with Soviet medicine when he consulted in Ukraine right after the collapse of the Soviet Union. This is an intriguing—albeit morbid—look at medicine under the Soviets, which, to put it mildly from Marsh’s experiences, was bleak. Despite the propaganda, cutting-edge medical research wasn’t really something the Soviets bothered themselves with while they focused on weapons to compete with the west. I’m sure an uncountable number of people suffered as a result.  


What I don’t love about this book:

I will warn you about this book; it goes into the minute and exquisite details of what goes on in neurosurgery. Normally, I’m not a squeamish person. In my personal life, I write cosmic horror that roots around in the theme of body horror, after all. That being said, Marsh is so precise in his explanations that a few times, he even got to me. So if you’re like me—an audiobook person—best not to listen to this book over lunch, especially if you’re eating anything that can be described as “gooey.”

A big problem with large hospitals that this book discusses is the disconnect between doctors and the rest of the staff that works there. It’s certainly not reassuring that people in the life-saving business are also engaged in constant petty bureaucratic squabbles with management. Not a fun thing to learn, but I guess necessary to know.  

Having read multiple books about medicine and doctors’ memoirs about their careers, including multiple neurosurgeons, I can tell you they all have one thing in common; they all have sad bits. No one likes to feel sad—well, almost no one—but I find that sadness has a way of making a story all the more profound. So while I like most people don’t like feeling sad, I think it’s an essential quality in these books. 



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Parting thoughts:

I think that I’m so fascinated with neurosurgeons and their lives because the human mind, for even the most ardent materialist, is something akin to a soul. It is where we all live in the end.

As someone who spends a lot of time in his own head, when I consider all the things that can go wrong with this three-pound mass of quivering meat, and that could irrevocably change who and what that person is—I’m equally repulsed and intrigued. Of all the medical conditions, I fear the most, stroke, memory loss, and mental illness in general rank as my highest fears. It’s one of the reasons I’m always monitoring myself and insist on keeping my mind engaged every single day. 

From all my adventures of reading about the subject, there is just so much we still don’t know about how the brain works. Again—it is the most complicated structure that is also self-aware, that we know of, and teasing out its mysteries is the work of generations. We know several things about the brain’s fundamentals in the area of neurotransmitters and how synapses and so forth work. But how consciousness arises from this complex network of cells and brain structures is still opaque. The best it’s been described to me is consciousness just seems to be an emergent property of complexity. What I take that to mean is: if you make a network sufficiently complex, eventually, conscious thought will emerge. That’s where the ever-popular simile of the brain as a kind of computer comes from, but there are problems with that concept. 

Computers—for now—don’t really evolve physically as in change physical components. There is such a thing as software that evolves, but that’s a different subject. The hardware is still designed, and with each generation, that hardware is improved by its designers. Brains, however, have gone through that evolutionary process, just like every other body structure. Evolution doesn’t necessarily always make improvements. It’s just a process that determines traits based on what survives. It’s incredible that they’re so complex and work the way they do, but trying to understand them is like trying to reverse engineer a river and then build that exact river, a billion years removed. Then, to realize that each of them is a custom job makes the concept that much more daunting. On top of all of that, it’s probably more like a billion rivers tied together in an intricate pattern that beggars the imagination to come up with words to describe them.

So yeah—we don’t really know how brains work from a macro point of view. We just know a lot of little things about how they work.


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