If you’re really squeamish about blood and body parts and squishy bits, this isn’t the book for you. Marsh talks a lot about the practicality of operating on the brain, as well as about interacting with patients, decision making, dealing with outcomes, training new surgeons, etc. He’s very frank about all of it. If, like me, you’re planning to become a doctor, you might want to read it just to get a frank, unvarnished view of what it’s like to work in the NHS, what it’s like to have people’s lives in your hands, and how to (and sometimes how not to) interact with patients and coworkers. He has the humility to admit that he’s not perfect, without false modesty. He’s a brain surgeon, and he’s bloody good at it: if he weren’t, a lot more people would be dead. But he does make mistakes, and he owns up to them — both the avoidable and the unavoidable ones.
Some parts of this book feel painfully real, too. I’ve been the family member being told by a doctor that someone isn’t going to make it; seeing it from the doctor’s perspective is no easier. I really appreciated Marsh’s humanity about these things: he wasn’t afraid to admit that he didn’t want to meet bereaved family members, but he did meet them all the same, and confess to his mistakes where he’d made them.
On another level, of course, the book is fascinating just because it’s about the brain. Neurology or genetics are tentatively my interests right now, and while I’m not going within a football field’s length of neurosurgery, this still had a lot of fascinating insights.
As a volunteer for a charity for the blind, I heard about a patient my age who had brain surgery. She was fine before, aside from the tumour on her pituitary gland which was just starting to cause problems. She came out of it totally blind; in removing the tumour on her pituitary gland, the surgeon also irreparably damaged her optic chiasm (where the optic nerves cross). Mostly, I’ve thought about this from her perspective — now I find myself wondering about that surgeon. Did he think it went perfectly, until after? The damage might not have been apparent until she woke up from anaesthesia. He did well, otherwise; got the whole tumour, as near as damn it. And yet the course of that young woman’s life is completely changed all the same. A lot of the things she wanted to do aren’t possible anymore. I bet it felt just a little bit like failure, even if he saved her life.
It makes me doubt being a doctor, a little. But it also makes me think about the importance of good doctors — not just technically good, but doctors who try to do good; who may make mistakes, but admit to them, and try to redress the damage. I want to be one of them, for sure.