Monday, January 25, 2016

"Do no Harm" by Henry Marsh

Over last few years I read a dozen books about doctors and hospitals; mostly neurology and psychiatry, with some other specialties thrown in. And for some time these books fit rather neatly into two distinct categories: "inspirational" books (like "Hot Lights Cold Steel" by M. Collins), or challenging books full of woes of disillusionment (like "The House of God" by S. Shem). Books that paint medicine in light colors and make you want to become a doctor immediately, and those that describe its underside, and encourage you to run.

I would tell putative premed students that they need to read "The House of God" before they start studying for MCAT, before they commit to the track, as if they still want to be a doctor after reading this book, they can probably be a doctor (a phrase stolen from some review on Goodreads; I obviously have no idea whether it is true, but it sounds good). And then, while studying, they can read "Hot Lights Cold Steel" every time they feel low and need some encouragement, because reading this book makes you want to take MCAT.

For many medical semi-non-fiction books these two large categories work surprisingly well. All Oliver Sacks for example counts as inspirational. Books by Atul Gawande (especially his "Better") mostly feel like "deterring books" that could warn a naive student about some issues ahead. And so on.

But anyways, all this long preamble is only to state that the relatively recent book "Do no Harm" by Henry Marsh really does not fit these two categories. It starts totally like an inspirational book would, with wonderful matter-of-fact descriptions of neurosurgery, where an experienced doctor invites you to the operating theater and makes you an awed spectator of their craft. But then it quickly plummets in a quagmire of dark meditations on two topics that clearly cause the author lots of pain: bureaucracy and paperwork that steal his vocation from him, and imperfection of his skill and knowledge as he faces inoperable tumors, untreatable conditions and medical mistakes. As he faces pain, death, and human suffering.

As I read the book, I kept mentally reassigning it from the "inspirational" shelf onto the "deterring" one, and then back to "inspirational". Moving it back and forth. Now as I finished it, it seems that overall the book has more questions than answers, and unanswerable questions at that, so I guess it belongs to the "read it before taking MCAT" shelf after all. But at the same time it is not dark, it is not disillusioned. The inspirational thread is also strong in this one. It really should be on the "must-read" list of any neuro-inspired premed student.

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