After last week’s blog post discussing ableism in the media, which highlighted the fact that disabled people are not paid to be critics and therefore shouldn’t have to invest in content only for their remarks to be dismissed as irrelevant, I’ve decided to… review a book. The difference here is that I read this book of my own volition, and having commented on it several times on social media while reading it, I know that people are genuinely interested to know my thoughts on the topic.
The book in question is Do No Harm by Henry Marsh, who was one of the UK’s leading neurosurgeons prior to his retirement, and is also someone who could give Narcissus a few lessons in self-adoration. The book itself is actually very well written, and surprisingly accessible considering the technical nature of the anecdotes regarding neurosurgery. However, the author is extremely unlikeable, and the content is frighteningly ableist.
Marsh’s arrogance is perhaps best displayed when searching for a patient across multiple wards, and after asking a member of staff for information, is “irritated at not being recognised in [his] own hospital”. Hospitals employ thousands of people, and bring in hundreds on temporary contracts from agencies, not to mention the millions of patients that pass through them on an annual basis. To expect every single member of staff to recognise you, and presumably to immediately bow and kiss your feet, is ridiculous, even for the most accomplished of surgeons.
Several times throughout the book, Marsh displays disdain at modern bureaucracy, which admittedly causes many of us frustration. However, the elements of this bureaucracy he decries are deeply concerning. He complains that junior doctors not being made to work hundreds of hours every week means that they lack experience, despite the fact that this way of working has led to countless preventable deaths when tired doctors made mistakes. He complains about infection control asking him not to wear a tie or watch during clinics, as clearly being cautious around patients with life-ending neurological diseases is too much to ask. Towards the end of the book, he also expresses his displeasure at having to perform the extremely tedious task of placing a blank sheet of paper over the list of patient names on his desk during appointments as data security protocol, and the need for having sensitive electronic data hidden behind passwords. Essentially, anything that requires him to deviate from previous practice, as if medicine isn’t a constantly evolving field, was a target for his bad temper.
Unfortunately, Marsh’s bad attitude are not the biggest concerns in Do No Harm. On several occasions during reading, I had to stop and calm myself down, because his disdain for disabled people was sickening.
Neurosurgery is obviously a risky business, with the potential for death or disability being quite high compared to other surgeries. Naturally, Marsh has had surgeries he was conducting go wrong. In some of the cases that he described, this led to death, either on the table or during recovery. He views this as a mercy, because apparently having someone die on him is easier than having to walk past a “vegetable” he created. While expressing regret over causing disability is commendable, he genuinely seemed to view even those with partial paralysis of the face or body as being worse-off than if they had died. In fact, when some of these people did eventually die, he expressed relief. He even mentions that in several cases he refused to operate at all, or only operated very reluctantly, because he deemed the risks of living with a neurological disease to be better than helping to reduce the impact of said disease, at the cost that a disability might be caused.
This brings me to a case towards the end of the book that, frankly, felt personal. Marsh opens the segment with “I will be telling [the patient], struggling to appear sympathetic and uncritical, that their backache is perhaps not as terrible a problem as they feel it to be”. He continues by describing how he is running a clinic and calls in a woman, who is “dramatically limping” due to severe back pain. Before she has even entered the room, he has decided that he cannot help her. He simply stares out of the window and waits for her to stop talking, not actually listening to what she says, because of this decision. He even condemns her for having surgery done privately, and condemns the surgeons who performed the surgery because she paid for it. Quite what she was supposed to do when NHS doctors refused to do anything to help her or even listen, leaving her with crippling chronic pain, escapes me. Similarly, if money really is the only reason for a surgeon to operate, then surely the only reason he wouldn’t operate is the same. Once again, patients needing healthcare are blamed for poor NHS funding, not arrogant neurosurgeons earning ridiculous wages. He then sends her away, dismissing the pain as being “psychological”, and tells her to go to the chronic pain clinic instead.
After reading this I threw the book down in pure rage, which as someone who loves books as objects as well as for their content, is something I never do.
My gynaecologist loves to tell me how pain isn’t measurable and is subjective, and that my case is “complex”, which he then uses as reasons not to properly treat my endometriosis. He tells me that my pain isn’t caused by endometriosis, and is “something else” that he won’t specify. He has condemned the idea of receiving surgery privately as it is “unnecessary”. He fobbed me off on the pain clinic, who couldn’t help me. He’s lectured me on how much my needing healthcare costs, how I’m taking resources from other patients. Reading the story of this poor woman receiving the same, diabolical attitude made me want to sob.
This book highlights some of the most troubling issues in modern medicine; the dismissive attitudes of doctors towards patients, their superiority complexes, and their complete inability to empathise with disabled people. It’s abhorrent, but I would actually like to thank Henry Marsh for exposing these issues in such an open and honest way.
In conclusion, while this book is an interesting read, I’d only recommend it to those with thick skin. I would also recommend picking it up second-hand so as not to spend too much money on it, and so as not to send more money to the fat cat behind it.