Wednesday, March 4

Considering "The English Surgeon"

Searching for the essence of a doctor, I believe Socrates would arrive at something along the lines of "one who heals." Continuing with this classical philosophical thread, we could create a syllogism. All neurosurgeons are doctors. Henry Marsh is a neurosurgeon. Thus, Henry Marsh is a doctor, one who heals. His devotion to healing is exceptional, going well beyond what we may reasonably expect from doctors, and this is the subject of the documentary The English Surgeon. Since visiting Kiev in 1992 and discovering their appalling medical practices regarding the brain, he has made regular pilgrimages to the capital of the Ukraine to do what he can for the people. He makes diagnoses. He performs surgery. He brings bits actually designed for the skull instead of the over-the-counter carpentry pieces his Kiev-counterpart Igor Kurilets is otherwise forced to work with. He brings hope.

For his efforts, Marsh is celebrated. Kurilets refers to him as "King Henry" once early on. Marian Dolishny, a poor villager from western Ukraine, invests all of his hope and money in Marsh in the hopes of a cure to the epileptic fits which keep him from holding a job and foretell an early death. Marsh's visits to the Ukraine mean a lot to people whose medical system is so screwed up that patients must pay double if they don't want to wait two weeks to arrange an appointment for a critical head scan.

Still, Marsh questions the good he does. He delivers this beautiful line before departing London. "When push comes to shove we can afford to lose an arm or a leg, but I am operating on people's thoughts and feelings...and if something goes wrong I can destroy that person's character ……forever." It may not be rocket science, but it is brain surgery. It is kind of difficult, and the consequences for mistakes are extreme. Marsh himself is wracked with guilt for a surgery he fails on one of his first visits to Kiev, leaving the young girl Tanya significantly worse than before and hastening her death. At the end of the documentary, Marsh visits Tanya's family and her grave. He has no appetite, but the entire family is gathered together for as fine a meal as they can muster. The mother is nothing but grateful for Marsh's work. She holds neither grudge nor resentment.

I understand that mistakes happen. I understand, too, that surgery is a difficult practice, never offering a guarantee of success. Like Tanya's mother, I admire Marsh for his attempts and can forgive him for his failures, though he can't forgive himself. Even if he can't always fulfill the hope his arrival incites, Marsh does good. Still, I have difficulties with Marsh. It may be presumptuous to question this respected surgeon who has worked his profession decades longer than I have even been alive, but I have problems with the length to which he draws out his reliance on hope. Sandwiched between Dolishny's awake surgery and the visit to Tanya's family, Marsh meets a young woman who comes for a second opinion after complaining of minor symptoms. He takes a brief look at the scans and tells Kurilets, in English, that she has six months. No surgery or treatment is possible, but Marsh convinces him to tell her nothing in Ukranian. It's better to live with hope he says. It was the emotional peak of the movie for me despite following and preceding such intense scenes. Watching her sit passively, cheerfully, while the doctors discuss whether to tell her the truth in a language she doesn't understand is heartbreaking. Let her know of the inevitable and allow her to prepare for it? Hide the truth and protect her from the terror of inexorable death? I feel Marsh comes up with the wrong answer.

Even if I'm right about this though, it is a small failure in such a life and career. The successes still stand on their own. The failures leave no mark upon them.

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