Do No Harm

Henry Marsh’s memoir Do No Harm: Stories of Life, Death, and Brain Surgery is a candid account of his career as a British neurosurgeon, drawn largely from his decades at St George’s Hospital in London and later work in Ukraine. The book is structured as a series of short, often bluntly titled chapters named after procedures, conditions, and complications, such as “Pineal Glioma,” “Craniotomy,” “Aneurysm,” and “Glioblastoma,” rather than a chronological life story. Marsh describes the technical and emotional realities of operating on the brain: the immense responsibility of deciding whether to cut, the limits of what surgery can achieve, and the frequent gap between surgical success and a good outcome for the patient. He writes openly about his own errors and near-misses, including a case in which he operates on the wrong side of a patient’s skull, and about the guilt and fear that accompany such mistakes. A recurring theme is the uncertainty of neurosurgery, where even routine operations can leave patients blind, paralysed, or changed in personality, and where surgeons must often weigh prolonging life against preserving its quality. The memoir also examines hospital bureaucracy, NHS resource constraints, and the doctor-patient relationship, especially the difficulty of telling patients and families when further treatment is futile. Marsh’s later chapters cover his retirement from full-time NHS work and his repeated trips to Ukraine, where he performed surgery and helped train local neurosurgeons. Throughout, he portrays neurosurgery as a demanding, sometimes arrogant profession, while insisting that honesty about failure and limitation is central to ethical practice.