The English Surgeon - “Just Get On With It”
This he has done, quietly and without fuss, for the past 15 years, travelling several times a year to the Ukraine. There, he runs a free clinic in surroundings that are Victorian at best - Middle Ages horrorshow at worst. Geoffrey Smith’s documentary, ‘The English Surgeon’, shows Marsh doing those things we’re all used to seeing doctors do onscreen: scrubbing up, looking at CT scans and so on. But minus the histrionics and the self-referential heroism. Just poor and desperately ill people with undiagnosed or ill-diagnosed brain tumours, crowding the corridors with their frightened families. They all want, as they say in the movies, a piece of him. And who can blame them? And the director could have left it there, couldn’t he? We’d all get to wander out of the cinema with that lukewarm, feelgood woolliness that wears off after about ten minutes - and that would be that.
But that isn’t that. Not at all. Smith steps closer and pulls back the wizard’s curtain, to show us the actual man behind it. Here is, not a glamourous TV doctor, but merely Henry Marsh. Here he is, happily tinkering about with bits of wood in his English back garden, making his own packing cases for the medical equipment he’s shipping. And there, appalled by the waste inherent in the British Health system, but excited to see the frozen lakes on the drive from the airport, and thrilled for his Ukrainian colleague, Igor Krilets, to see the perfectly good drill bits he’s brought from Britain, where they’re used only once before being thrown away. Igor stares at them in wonder, turning them carefully over and over in his hands.
And then there’s the doubt. Because there are times when some of us need certainty, aren’t there? Especially from doctors. And what if that certainty is death? We may then want hope where there is none to be had. Then what on earth do you say? Do you tell it like it is? Or are you economical with the truth? Either way, Marsh must speak to his patients through Igor, who interprets. Is it necessary, they discuss in English, to tell this cheerful 23 year old woman - who is all smiles - that she will soon be utterly blind and, in shockingly short order, dead? And if so, how, and when? Then there is a small child whose mother asks, what she should do for her? (I suppose we want to feel useful at these times, to establish some activity in the vain belief it might help fend off the inevitable.) Marsh explains, to Igor, that the only thing to be done is "nothing" and that she must simply wait for her daughter to die. Igor tells her exactly this. As he does so, Marsh directs his gaze at Igor, his desk, the floor, clearly wretched. The woman stands, thanking Marsh, and worse, apologizing profusely for bothering him. And so it goes here all day.
This might be the raw stuff of drama (usually with a sugar-coated ending), but nothing we ever get a glimpse of in reality. A real doctor visibly struggling with what to say, and how; with what to do, and whether he has the means to do it; and with what he has done and whether he should have done it. He is haunted by past decisions, and perhaps most of all, the knowledge that his clamouring patients, many of them children, could be saved if diagnosed earlier, or still could be…if they were elsewhere, or if, right here, he had the resources.
At home in London, Marsh reflects upon the fact that as a neurosurgeon he has the ability, in an instant, to make someone’s thoughts, feelings, memories disappear…in essence, to destroy the chemicals that make us who we are, and even to know that we are. It’s a daunting prospect and he is always, always conscious of it. But as a surgeon, a bit grumpy, a bit stressed as he scrubs up, he must put these emotions aside, make a decision, and act. And when all is said and done, it is often necessary, as he puts it, "to stick the knife in".
After the film, Marsh gets up on stage for a brief Q & A. I want to ask him why, of all people, we see him in the film riding his bike without a helmet - but I decide this is a bit cheeky. Later, I chat with him in the bar, and, discovering that he trained the surgeon who treated my Mother, forget to enquire. I head home on the subway and remember something: he had admitted, unprompted, that surgeons are by necessity risk-takers, and, he laughed, "narcissists". Maybe that’s the clue to the helmet thing. More importantly, though, his honest acknowledgement indicates a duality possessed by very few: the professional All Powerful God-in-a-white-coat half we know all too well. But in Henry Marsh we witness also that which is rare: a thing comprised of humility, empathy, responsibility. He clearly feels it is his duty as both a doctor and a human being to look an absolutely horrifying situation right in the face and not turn away. And after that, to just "get on with it", to do whatever you can, however small, and however imperfectly, to make it better.