Do No Harm: Stories of Life, Death and Brain Surgery (25 page)

BOOK: Do No Harm: Stories of Life, Death and Brain Surgery

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Touched by Philip’s remembering this, I told him that she was fine and that her epilepsy was currently under control. He told me that he was continuing to have minor fits several times a week, and that his business had gone bankrupt because he had lost his driving licence.

‘Lost a lot of weight with the chemo though,’ he said with a laugh. ‘I look a lot better, don’t I? Made me pretty sick. I’m alive. I’m happy to be alive. That’s all that matters, but I need to get my driving licence back. I get only sixty-five pounds a week in benefits. It’s not exactly easy to live on that.’

I agreed to ask his GP to refer him to an epilepsy specialist. Not for the first time, I thought of the trivial nature of any problems that I might have compared to my patients’ and felt ashamed and disappointed that I still worry about them nevertheless. You might expect that seeing so much pain and suffering might help you keep your own difficulties in perspective but, alas, it does not.

The last patient was a woman in her thirties with severe trigeminal neuralgia. I had operated on her the previous year and vaguely remembered that she had then come back a few months later with recurrent pain – the operation occasionally fails – but I could not remember what had happened afterwards. I fumbled through the notes unable to find anything of help. I prepared a speech of apology expecting her to look miserable with pain and disappointment. Now, however, she was quite different. I expressed surprise at how well she looked.

‘I’ve been absolutely fine since the op,’ she declared.

‘But I thought the pain had come back!’ I said.

‘But you operated again!’

‘Did I really? Oh I am sorry – I see so many patients that I tend to forget . . .’ I replied.

I pulled her notes off the pile and spent several minutes failing to find something about her having had a second operation. Out of the inches of paper a brown tab stuck out – one of the few documents that the Trust has designed that is easily located.

‘Ah!’ I said, ‘Look. I may not be able to find the operating note but I can tell you that you passed a type-4 turd on 23 April . . .’ I showed her the elaborate hospital Stool Chart, coloured a sombre and appropriate brown, each sheet with a graphically illustrated guide to the seven different types of turd in accordance with the classification of faeces developed, according to the chart, by a certain Dr Heaton of Bristol.

She looked at the document with disbelief and burst out laughing.

I pointed out to her that she had passed a type-5 next day – ‘small and lumpy, like nuts’ according to Dr Heaton – and showed her the accompanying picture. I told her that, as a brain surgeon, I couldn’t give a shit about her bowel movements although the Trust management clearly considered it a matter of deep importance.

We laughed together for a long time. When we had first met, her eyes were dull with pain-killing drugs and if she tried to talk her face would contort with agonizing pain. I thought how radiantly beautiful she now looked. She stood up to leave and went to the door but then came back and kissed me.

‘I hope I never see you again,’ she said.

‘I quite understand,’ I replied.

ACKNOWLEDGEMENTS

I hope that my patients and colleagues will forgive me for writing this book. Although the stories I have told are all true I have changed many of the details to preserve confidentiality when necessary. When we are ill our suffering is our own and our family’s, but for the doctors caring for us it is only one among many similar stories.

I have been greatly helped by my wise agent Julian Alexander and my excellent editor Bea Hemming. How much worse the book would have been without their guidance! Several friends kindly read drafts of the book and made invaluable suggestions, in particular, Erica Wagner, Paula Milne, Roman Zoltowski and my brother Laurence Marsh. Throughout the twenty-seven years of my time as a consultant neurosurgeon I have had the good fortune to have Gail Thompson as my secretary, whose support, efficiency and care for patients has been second to none.

The book would never have been written without the love, advice and encouragement of my wife Kate, who also came up with the title, and to whom it is dedicated.

A NOTE ON THE COVER

Brainscape
18
is an etching from a drawing by Susan Aldworth. It was made on location in the neuroradiology suite at the Royal London Hospital on 3 January 2006, where Aldworth was Artist in Residence from 2005 to 2008.
Brainscape
18
shows a patient undergoing a cerebral angiogram to locate an aneurysm in their brain.

www.susanaldworth.com

A W&N ebook

First published in Great Britain in 2014 by Weidenfeld & Nicolson

This ebook first published in 2014 by Weidenfeld & Nicolson

The right of Henry Marsh to be identified as the author

of this work has been asserted in accordance with the

retrieval system, or transmitted in any form or by any means, without the prior

permission in writing of the publisher, nor to be otherwise circulated in any form of

binding or cover than that in which it is published without a similar condition,

including this condition, being imposed on the subsequent publisher.

A CIP catalogue record for this book

is available from the British Library.