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Difficult decision-making and dealing with mistakes are themes that repeatedly arise. Other topics are also covered including modern medical training, the reality of consent, being ill as a doctor, the modern health service and the meaning of success.
Each chapter presents either clinical cases or other events from Marsh’s life. These are then interspersed with his thoughts on the events. He does mention some success through the book and describes achieving most “when our patients recover completely and forget us completely”. Difficult decision-making and dealing with mistakes is most explicitly demonstrated when recalling a visit to a Catholic nursing home where he finds patients he had previously forgotten and at least one who “I had wrecked”.
Difficult decision-making and dealing with mistakes are themes that repeatedly arise
The book is written in a way to inform the lay reader of the deepest thoughts of a neurosurgeon. Medical terminology is used throughout, with meanings clearly explained. This is not to say that it does not appeal to a medical audience as simultaneously. The writing style is matter-of-fact without being dry. His stories are moving and in places brutally honest. Do No Harm certainly gives an insight into the reality of life as a neurosurgeon in a modern hospital. For patients, it provides an insight into the fallibilities and difficulties of being a doctor. For students, it is a must-read if you are considering a career in neurosurgery. For doctors, it is a fantastic example of reflection.
Detailing his life from humble beginnings in Lancashire, the former President of the Royal College of Physicians and of MPS takes the reader through his childhood and formative years with humility, which is a consistent theme throughout the book. He charts his many achievements from qualification then into academia, medical politics, the presidency of the RCP and culminating in his nomination as a peer of the realm.
Notably describing his role in the advent of the university department at Salford Hospital “from scratch” along with its initial shortcomings, as well as comments regarding research (and how not to do it) and the changes in postgraduate medical training of the 1990s, the reader is given a front seat with this account of aspects of the profession that can often seem peculiar if not mysterious. Discussion is made of contemporary issues affecting NHS politics especially pertinent to the New Labour years, and the author is not afraid of casting an opinion or giving fair reflection with the benefit of hindsight.
the reader is given a front seat with this account of aspects of the profession that can often seem peculiar if not mysterious
I found the descriptions around medical training (the eventual establishment of the Academy of Medical Royal Colleges and Postgraduate Medical Education and Training Board) and issues surrounding reform of the NHS of particular interest and found food for thought in aspects concerning financing and NHS interaction with politics and politicians. I couldn’t help feeling that a number of these issues described, including attempts at reform, would have been equally valid when the author commenced his career in the NHS. On matters of NHS reform, financing and political pressures the author clearly had a privileged insight, especially during the term of the Labour government. I would commend the author’s views to anyone interested in such matters.
Reflecting his privileged title, the author visits a number of topics of interest that he has spoken about at the House of Lords, and unashamedly bestows opinions ranging from assisted suicide to anonymity in sperm donation. The importance of the author’s Jewish faith is identifiable and his subsequent interest in Middle Eastern politics results in an attempt at summarising and digesting this complex and otherwise problematic issue with numerous good opinions.
The book concludes with a moving tribute to Daniel, the author’s late son, the impact of his passing being vividly and eloquently described, leaving the reader sharing a sense of melancholy if not shedding tears in sympathy with the author’s tragedy.