Hazel McHaffie

Henry Marsh

Acknowledgements

By the time you’ve written ‘THE END’, gone through dozens of edits, and proof read the final draft of your precious novel till you’re cross eyed, the very idea of writing another word can seem like a labour too far. But hey, what about all those folk who helped to bring this baby to birth?

Some writers content themselves with a dutiful list of agents, publishers, editors (all exemplary of course ) who’ve seen the value of the story and steered it through choppy waters to publication. Most thank friends and family (all stalwarts of course). The page can be simply ‘Thank you …’ followed by a list of names, or it can extend to several pages and include Great Aunt Gertrude who provided scotch broth on cold school days and became an unwitting template for Aunt Sally in the current magnum opus. Hey, been there, done that, myself; I’m not knocking it. I’m fascinated too by those that tell us people actually paid substantial sums of money (to charity of course) in exchange for immortality in the said book.

But best of all are the ones that manage to inject a sense of fun into this potentially dry catalogue. And I love the self-deprecating ones and those that manage to twist a fact to put an unusual slant on it. So I thought I’d share a few of my favourites with you this week.

This is indeed a work of fiction, and more so than usual. Almost nothing in the previous 340-odd pages is based on reality. Research, hardly a priority, was rarely called upon. Accuracy was not deemed crucial. There was no federal camp at Frostburg, no uranium lawsuit (yet), no dead judge to inspire me, and no acquaintance in prison scheming to get out, at least not to my knowledge.
Inevitably, though, even the laziest of writers need some foundation for their creations, and I was occasionally at a loss. As always, I relied on others. Thanks to …

John Grisham (The Racketeer)

This book took an embarrassingly long time to write, also my short-term memory isn’t what it was – apparently this is what happens when you’re perimenopausal (not menopausal, I should stress; that’s still decades away, and by the time it happens I’ll be grand again and back winning Mastermind) – so there’s a very good chance that someone may have given me invaluable help at an early stage in the book and that I’ve now completely forgotten. If you are that person, I am truly sorry.

Marian Keyes (This Charming Man)

Last year I lost two friends, each of great spirit and heart. Whenever Alex Cooper (lead in story) goes to the ballet – as she does herewith Natalie Moody – she will be watching the dancers at American Ballet Theatre and honoring Howard Gilan, an extraordinary man whose spirit lives on in all those – man and beast – whom he embraced.
And my young protegee, Maxine Pfeffer, who lost her valiant struggle with cancer, will always be Coop’s paralegal, Max. Thinking of her will forever bring a smile to my face.
Some of my Vassar classmates asked me to create a character in memory of one of our dear friends, the actress Marilyn Swartz Seven, who also died too young. She is here as a woman of mystery – a role I hope she would have enjoyed performing.

Linda Fairstein (Cold Hit)

In these dog days when lawyers rule the universe, I have to persist with these disclaimers, which happen to be perfectly true. With one exception nobody in this story, and no outfit or corporation, thank God, is based upon an actual person or outfit in the real world … so with luck I shall not be spending the rest of my life in the law courts or worse, though nowadays you can never be sure. But I can tell you this. As my journey through the pharmaceutical jungle progressed, I came to realise that, by comparison with the reality, my story was as tame as a holiday postcard.


John Le Carré (The Constant Gardener)

I hope that my patients and colleagues will forgive me for writing this book.

Henry Marsh (Do No Harm)

 

Oh and, strictly speaking a preface but to leave you smiling:

[This} is the only book of mine which I tried to produce without sitting down at the typewriter and getting a crick in the back.
Not that I ever thought of dictating it to a stenographer. How anyone can compose a story by word of mouth, face to face with a bored looking secretary with a notebook is more than I can imagine. Yet many authors think nothing of saying “Ready, Miss Spelvin? Take dictation. Quote No comma Lord Jasper Murgatroyd comma close quote said no better make it hissed Evangeline comma quote I would not marry you if you were the last man on earth close quote period Quote Well comma, I’m not the last man on earth comma so the point does not arise comma close quote replied Lord Jasper comma twirling his moustache cynically period And so the long day wore on”
If I started to do that sort of ting I should be feeling all the time the girl was saying to herself as she took it down, “Well comma this beats me period How comma with homes for the feeble-minded touting for customers on every side comma has a fathead like this Wodehouse succeeded in remaining at large all these years mark of interrogation”
But I did get one of those machines where you talk into a mouthpiece and have your observations recorded on wax, and I started Thank You, Jeeves, on it. And after the first few paragraphs I thought I would turn back and play the stuff over to hear how it sounded.
It sounded too awful for human consumption.

You can’t think out plots like mine without getting a suspicion from time to time that something has gone seriously wrong with the brain’s two hemispheres and the broad band of transversely running fibres known as the corpus collosum.

P G Wodehouse (Thank you, Jeeves)

Thanks, guys. I am resolved to take a leaf out of your books and make my own next acknowledgements more appealing in future.

 

 

, , , , , ,

Comments

Fallibility in medicine

Any day now I expect to get a letter giving me a date on which a person unknown to me will thread a catheter into my heart and fire radio waves at it. There is a 2 in 1,000 chance he will kill me in the process. Not the time you’d think to be contemplating the matter of medical fallibility; but I can honestly say I am perfectly sanguine about this prospect.

Almost all surgical procedures carry risks. As pioneer Rene Leriche wrote rather more poetically in 1951: ‘Every surgeon carries within himself a small cemetery, where from time to time he goes to pray – a place of bitterness and regret, where he must look for an explanation for his failures.’ Note: Every surgeon. I’m also very aware that some specialties are more hazardous than others: hearts and brains are especially vulnerable areas to tinker with. Ahhh, brains! … now there’s a different kettle of fish altogether.

Henry Marsh is a brain surgeon, so eminent a one moreover that he’s been the subject of two major documentaries and was awarded a CBE in 2010 – click on this picture to see him in operationHenry Marsh in operation. But he hasn’t always been so single-minded and determined. His was a fairly circuitous route into medicine and even once he entered the profession he felt pretty jaded about it – bored even … until that is he encountered neurosurgery. Then he fell in love. In the thirty years since, practising his chosen discipline, he’s had countless successes, as well as his fair share of ‘terrible failures‘, all punctuated with periods of ‘deep despair‘. Not surprisingly. His is one of the most high powered, high risk, stressful and dangerous jobs.

If you think you carry a heavy burden of responsibility, if you ever feel guilty about things that have gone wrong on your watch, then I recommend you read his book, Do No Harm, published last year. In his own words:

‘As a neurosurgeon you have to come to terms with ruining people’s lives and with making mistakes. But one still feels terrible about it and how much it will cost … But nobody, nobody other than a neurosurgeon understands what it is like to have to drag yourself up to the ward and see, every day – somebody one has destroyed and face the anxious and angry family at the bedside who have lost all confidence in you … You can’t stay pleased with yourself for long in neurosurgery. There’s always another disaster waiting round the corner.’

Nor does he attempt to hide behind his colleagues or seek safety in numbers; he paints himself as fearfully human and flawed. That takes courage. He shares his bad temper, bad language, bad judgement calls, bad manners, his occasional lack of professional detachment.

Do No HarmBut through all the chagrin and curses shines his awe of the magnificence and significance of the human brain – something ‘infinitely mysterious’. As he slices into the soft white jelly he finds it almost incomprehensible even yet to believe that he is ‘moving through thought itself, through emotion and reason,’ rummaging amongst memories and dreams and reflections, all that is important in human life. But he is always, always aware that one false move, one moment of inattention, can take away for ever sight, or memory, the ability to recognise family, or the power to move … even life itself. And that sense of wonder and fear has never left him. Because of it, even today, moving towards retirement, he still gets stage fright, still feels intense anxiety, still builds in little superstitious rituals. He is brutally conscious of his own fallibility.

However, because he is now so experienced, he can afford to share stories from the past where he got things wrong. Would that all doctors could admit their failures and misjudgements and learn from their mistakes to the greater good of all. So often all patients/relatives are looking for is an apology. Mr Marsh is not afraid to offer one. I liked him the more for his humility.

Reading his account of life at the sharp end, though, I also experienced a lowness of spirit. As a patient, as a relative, as a health care professional, I’ve been frustrated and upset by inefficiency and disorganisation and absurd bureaucracy and bad practice within the NHS, and as an insignificant player in this vast organisation, felt horribly powerless. But I retained a vague sense that those higher up the food chain could bypass the nonsense and get results. Henry Marsh is at the top of the clinical hierarchy, but he too has been rendered impotent in the face of managerial and political directives. I so much identified with his feelings of resentment and anger when even he couldn’t get tests done, or results made available, or colleagues to cooperate; when he couldn’t prevent serious operations being cancelled at the eleventh hour.

I also felt his very human pain when conditions were inoperable, when patients developed catastrophic complications, when they died. And I silently applauded. Wouldn’t we all want to be looked after by a surgeon with compassion, a man who really cares? He learned this valuable lesson during his student years: ‘It was their (surgeons’) kindness to patients, as much as their technical skill, which I found inspiring.’ Indeed. Me too. I’ll be looking for that when I am finally admitted for that procedure on my heart.

A legitimate question to ask of one’s surgeon is: What would you do if it were your mother/your child? And this question resonates with Marsh particularly because many years ago he was the parent of a baby son with a brain tumour; he felt the frailty and powerlessness of any parent anywhere in such circumstances. The feeling was resurrected to a degree when he became a patient himself needing operations on both eyes, when he broke his leg, when his mother was dying of cancer, when his father developed dementia. It’s salutary being on the other side and, he believes, an important part of any doctor’s education. I could identify with this too; my recent experiences on the receiving end have highlighted the essential imbalance between the clothed and unclothed; the upright and the supine; the caregiver and the customer.

Do No Harm is alive with vibrant stories, details of many patients with many different conditions and diagnoses, treated with various degrees of success. I could personally never cope with the burden of mutilation, death and disaster that litters Marsh’s path; I have neither the psychological strength nor the ability to forgive myself. I’d have sunk without trace very early on. But I’m sincerely awed by the courage of clinicians like him who bear that burden for us all.

, , , , , ,

Comments