"Neurosurgery—strange, brutal, and miraculous—had seduced him, and he started the training as soon as he could. Marsh is fascinated by the brain. He loves looking at it through his counterbalanced surgical microscope, which “leans out over the patient’s head like an inquisitive, thoughtful crane.” To Marsh, the view is beautiful. At the center of the brain, he writes, the internal cerebral veins are like “the great arches of a cathedral roof”; the Great Vein of Galen can be seen “dark blue and glittering in the light of the microscope.” It is “a very private view,” “clearer, sharper and more brilliant than the world outside,” and “made all the more intense and mysterious by my anxiety.”

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As an epigraph to "Do No Harm," he quotes the French doctor René Leriche: Marsh knows there's something unprofessional about this inwardness—a surgeon's emotions are supposed to be beside the point compared with his patient's suffering—but he is drawn to "reckless honesty." (When he delivered "All My Worst Mistakes" to an audience of neurosurgical colleagues, he writes, "it was met by a stunned silence and no questions were asked.") "Do No Harm" is an act of atonement, an anatomy of error, and an attempt to answer, from the inside, a startling question: How can people spend decades cutting into people's brains and emerge whole?"

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The darkness of Marsh’s book isn’t a kind of false modesty; his self-abnegation isn’t disguised self-regard. Instead, his desire for atonement seems to darken his recollections—faced with the irrevocability of his patients’ suffering, he is unable to escape from its shadow. And the memoir’s final chapter suggests a further possibility. Marsh writes about a woman who comes to see him in his clinic. Twenty years earlier, she had a benign brain tumor removed; even as the operation saved her life, it severed one of her facial nerves. Surgeons call this kind of trade a “sacrifice.” In most people, the result of this sacrifice would be a numbness of the face, with which they come to terms. Only a few, Marsh writes, are, like the woman, “driven mad by the numbness.” The Latin name for this, he says, is “anaesthesia dolorosa—painful loss of feeling”; the final chapter is named for that condition. Marsh, I think, is afraid of anaesthesia dolorosa. He can’t bear the thought of going numb. He is determined to feel as much as he can.

(I love everything that Josh Rothman brings to my attention. Henry Marsh in The New Yorker.)