A Brain surgeon in the 21st century nhs

Where does Do No Harm rank among all the audiobooks you’ve listened to so far?

I have enjoyed this book the most of any I have listened to in the past year.

What did you like best about this story?

The insights into the stresses and strains of being a surgeon.
The authors honesty.
The brilliant description of our present nhs.

Have you listened to any of Jim Barclay’s other performances? How does this one compare?

This is the first one I have heard and it was excellent.

Was this a book you wanted to listen to all in one sitting?

No

Any additional comments?

I listened to this audio book with huge pleasure. It details the stories of a series of patients with neurosurgical problems who have been treated by Mr Marsh. With great humility and compassion he details the stories of those patients who have done well and those who have not done so well. He interweaves this with the story of his own life as a neurosurgeon. I am an abdominal surgeon myself and have never read an account which so accurately catches the highs and lows of surgical life; the dread of complications and the continuing sense of guilt and failure when patients do badly. The author also brilliantly captures the way medicine is practiced in NHS hospitals with poor computer systems, insensitive hospital management and lack of continuity of care from inexperienced juniors. This book might be rather disturbing reading for patients just about to undergo surgery in the NHS, but if you want to know what it is like to be a neurosurgeon, you couldn't do better and some of the NHS incidents had me roaring with laughter

41 people found this helpful

neurosurgeons, problems and protocol

This is an excellent read (listen). Clearly narrated and wonderfully expressed.
Marsh's description of surgery is amazing and puts you right there in the operating theatre. His description of the protocols he has to deal with are enlightening. This book shows the difficulties faced when having to make life or death decisions and also having to communicate with families. A great book which I will listen to again and again.
Roger Brown

12 people found this helpful

Amazing! Narrator gave me a headache... very apt..

Would you be willing to try another one of Jim Barclay’s performances?

No way. Never. If I did I would need an extra box of parasol for the headache he gives me. When he talks he sounds as though he is having an argument with somebody: certainly not a relaxing listen.

Do you think Do No Harm needs a follow-up book? Why or why not?

Maybe a book which speaks more about the positive side of neurosurgery and the NHS. I found some of Marsh's views and comments rather cynical - but what can be expected of someone who has been working since before the 'death by powerpoint' one must attend lectures every five minutes on health and safety and infection control in the NHS.

However, these are there for a reason. I think he undermines the NHS a little bit in that sense, he is a rogue surgeon who doesn't like to play by rules.

Any additional comments?

The main reason I scored this audiobook a lot lower than I wanted to was because of the narration.

This is purely down to personal preference, but he gave me a headache. He sounded quite arrogant and I think this came across in the dialogue inasmuch as this may not have been intended.

As far as the book is concerned, I think Marsh has been very honest and brave in his depiction of life as a neurosurgeon in the NHS. He details many tragedies (moreso than the positive cases I think) but the narrator made him come across snotty and arrogant. I am sure he isn't as I have followed much of his work and watched documentaries of him online.

His work in Ukraine is highly commendable and noble and you can't help but be in awe of his talent and his willingness to go where others daren't to help those in need. Give this book a read, it's really interesting and gives you a very honest and open account of life as a surgeon in the NHS.

7 people found this helpful

Astonishing insight

Where does Do No Harm rank among all the audiobooks you’ve listened to so far?

An outstanding, warts and all, account. Henry Marsh's narrative of his life as a neuro surgeon is compelling in every way. Told with honesty and integrity, it's one of the most amazing biographies I've ever read or listened to.

What other book might you compare Do No Harm to, and why?

It's in a league of its own

What about Jim Barclay’s performance did you like?

His reading sounds the way I imagine Henry Marsh would recount events. Sometimes short tempered or irritated, particularly over irrelevant bureaucracy, often compassionate, always informed nd above all, human.

Was this a book you wanted to listen to all in one sitting?

No, some chapters are quite harrowing, dealing with difficult medical conditions and sometimes loss. But always compelling listening.

Any additional comments?

The chapter dealing with his mothers final days was particularly moving. Although presented from an almost clinical perspective, it was filled with observation and love.

7 people found this helpful

Excellent

Just the right mix of upbeat, sad and maddening NHS stories. Thoroughly enjoyed it. Very good narrator. Would recommend it

5 people found this helpful

Rare insight into the real nhs and its surgeons

What made the experience of listening to Do No Harm the most enjoyable?

As a retired nurse who trained in the 1970s I could relate to the experiences Henry Marsh writes about. He is brutally honest and I recognised many of the situations he describes. The victories and the disasters, they are all here.

What did you like best about this story?

The honesty and the nostalgia generated by Henry Marsh's account of his career within the NHS. The touching, moving accounts of the many different patients stories.

Did the narration match the pace of the story?

The voice suited the " surgeon " status, as you might imagine Henry a Marsh to speak but listening, on headphones in particular, was annoying due to the frequent noisy intakes of breath between sentences.

If you made a film of this book, what would be the tag line be?

The truth behind the nhs and the people who look after us.

Any additional comments?

Overall, I thoroughly enjoyed this audiobook. Perhaps my nursing background helped as there is a lot of medical jargon but on the whole Henry Marsh does try to keep it simple without losing his professional expertise coming across loud and clear. Yet, he isn't afraid to admit his mistakes and I think that is the main thing I will remember about this book.

9 people found this helpful

Fascinating and Absorbing

If you could sum up Do No Harm in three words, what would they be?

Intriguing, moving and life affirming. It adds a humanity to an area of medical science that is life changing and terrifying for those who encounter it. The narration is strong if slightly monotone and almost works. It does lack the passion you get from an author reading on a subject like this

What about Jim Barclay’s performance did you like?

It is business like and has the ring of a consultant. It does lack passion though and can sound distant and observational which is at odds with the tone of the narrative.

If you made a film of this book, what would be the tag line be?

Your mind in his hands...

Any additional comments?

Enjoyable and very sobering.

3 people found this helpful

Excellent book

An enjoyable insight into Henry Marsh's life and career. It's refreshing to hear that brain surgeons are humans too beneath their cool exterior. I also share many of Mr Marsh's frustrations with hospital managers but I'm at the other end of the career spectrum; two years into postgraduate training and it has reinforced my decision to work abroad.

3 people found this helpful

An examined life, profoundly honest, freely shared

Brain surgery is amazing. You are operating at a microscopic scale in a minefield primed with arteries carrying high pressure blood, on a soft fatty substance that contains the thoughts and memories of a fellow human being. Henry Marsh takes you down the operating microscope and shares his excitement and fear with the reader. Experienced as an audiobook, the narrative crackles in the middle of your own brain; I mostly took it all in at one listen (rare for me).

I suspect that writing this book was a cathartic experience for Marsh, and I sincerely hope it succeeded for him. As a brain surgeon, for thirty years, he has had to deal with the emotional burden of his day to day work having an impact on his patients that ranges from lifesaving, to death and worse. Marsh unflinchingly examines this question, without hubris, without delusions, with a searching honesty that is probably the quality I value most in a human being. He didn’t have to write this book (his job is being a surgeon), he is not a great writer (over keen on circumlocutions such as, ‘the contrast could not be greater with…’ and adding atmosphere via the weather), and I feel grateful that he has shared his very personal experiences.

The book gives fascinating insights into the relationship between surgeon and patient, these asymmetric strangers, from the doctor’s point of view.

Marsh sails by the political issues of the NHS; he simply is not interested. He hardly mentions rising costs or waiting lists, presumably because economics and management are simply not his bailiwick. He snipes at the farcical outcomes of targets and rules, he mildly regrets the loss of status and authority of consultant surgeons, he occasionally notes the outrageous costs involved - £4000 worth of one-time use kit littering the operating theatre floor. With winning insouciance he mentions how glad he is to enjoy private health care whenever he is ill, and feels no need to provide further explanation or apology, beyond his simple desire for dignity and his own, en-suite, hospital room.

By the way, once you have finished this book, you can see brain surgery videos on Youtube. Having read the book, they don’t seem as gory as they would without the book to guide you through.

Narration
I don’t think it is right for non-fiction narrators use accents to add colour to quotations (as I’ve said before). In this book, the patients speak with humble, cap-doffing, uneducated voices, while Henry himself speaks with an authoritative, received pronunciation, 'confident consultant' voice. I find it deeply patronising.
Stopping points are nicely coordinated with the book chapters.

14 people found this helpful

Not ‘When Breath Becomes Air’

Bought this accidentally when looking for ‘When Breath Becomes Air’. The subject matter is fascinating, but sadly Marsh is not. The story feels like it was written in the seventies (women, for example, are frequently described subjectively, ‘pretty’ or ‘plump’ etc.) and the performer often seems to apply regional or working-class accents to the patients, and many are presented as forelock-tugging simpletons. Marsh is no doubt a hugely talented surgeon, and his discussions regarding the brain are profound and absorbing. His storytelling (and the performance of the narrator), sadly, presents a puffed-up dinosaur, forever charging around, unaware of his privilege and surrounded by self importance. I hate to leave a story unfinished, but had to keep skipping forward because Marsh and the narrator were such unpleasant company.

2 people found this helpful