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“Do no harm” is what doctors are taught first while trying to evaluate what can be done to improve someone’s health. It is also the title of a book by Henry Marsh, one of the world’s leading neurosurgeons who practices primarily in London. In addition, he has travelled to the Ukraine for fifteen years, consulting for people of all ages including young children who have growths in their brains.

I started reading his memoir yesterday afternoon. It’s organized by types of brain maladies and operations he has performed throughout his thirty-year career. Now sixty-five, Henry Marsh is a vibrant, good-looking, albeit sometimes tired looking fellow. It turns out that after a twenty-five year old marriage that ended in divorce, he met his second wife a year later. Kate Fox is a beautiful (that’s the only word to describe her) blonde, social anthropologist who co-directs a study center in England and writes books about whether the British are really grumpy by nature or not. (Not is the answer of her study – they are just too polite.) Anyhow, their marriage and his dedication to her in the book happily punctuates this neurosurgeon’s life. He’s been lucky to have been able to succeed at a profession that is both draining and what he himself describes as a “blood sport.”

Last night, I found a documentary called “The English Surgeon” based on Marsh’s fifteen year collaborations with a determined Ukrainian doctor who sought to improve medical care in general and brain surgery in particular. It was eye-opening to observe the stark hospital environs in which Marsh and his friend inhabit and to witness the equipment that they had to use: a Bosch drill, parts of plugs that are used and thrown away by the handfuls in the UK but preserved and used for ten years in the Ukraine. Rudimentary doesn’t begin to describe the level of medical care there. It is brutally stark and a sense of hopelessness pervades the human landscape. Faces are pale and full of apprehension and worry. Many of those who come to Marsh with their X-rays are beyond help. Through his friend’s translations, over and over again, Marsh has to tell people that there is nothing an operation can do and that he cannot help them.

One woman in her thirties thought she had a virus from an insect bite. After looking at her X-Rays, they could not bring themselves to give her the bad news that she would go blind and die within two or three years because she was by herself unaccompanied by a friend or family member. They asked her to bring her mother from Moscow for a future visit before breaking the news of her fatal diagnosis to her. People milled around in the waiting room, vying to see the brain doctor from the West. One fellow, Igor, was operated on successfully while awake, anchored to the operating chair while his head was opened up with the aforementioned Bosch drill. (We had a hard time watching that part of the documentary which won an Emmy.)

Today, I’m starting to read the third chapter of Henry Marsh’s book that I began yesterday. It’s clear from the stories he relates that most of the time, the hardest decision is whether to operate or not. Recently, someone I knew from high school had radiation for brain tumors arising from Stage IV Melanoma. His brain tumors receded but as a consequence of the treatment, he was left in a permanently altered mental and psychological state. His behavior now is anti-social, impatient and deeply depressed. No longer able to drive, he is dependent upon home-aides for just about everything. His depression resulting from the radiation was labelled as “organic” – meaning that it wasn’t going to go away with anti-depressants or talk therapy. “Cures” and their after-effects versus quality of life is an endless personal debate many of us will face, whether we like it or not.

The brain is our operating dock for the movie of our lives. Reading about Henry Marsh’s experience, his failures as well as his successes is both illuminating and sobering. There’s no explanation for why tumors occur in young children or adults. If you are not afraid of learning about human suffering and what courageous people do to ameliorate it, I can recommend his book, “Do No Harm.” Two documentaries about Marsh have been made called, “Your Life in Their Hands,” and “The English Surgeon.”

As we go through our day, listening to the news, making lunch and cleaning the house, it’s helpful to acknowledge how lucky we are (so far) and to appreciate the technology and medical care we take for granted wherever we happen to live.