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The Bureaucratic Absurdities of Socialized Medicine



(p. 13) Reading "Do No Harm," Henry Marsh's frank and absorbing narrative of his life in neurosurgery, it was easy to imagine him at the table. The men, and increasingly women, who slice back the scalp, open the skull and enter the brain to extract tumors, clip aneurysms and liberate nerves, share a certain ego required for such work. They typically are bold and blunt, viewing themselves as emperors of the clinical world. Marsh adds irony to this characterization, made clear in the opening line of the book, "I often have to cut into the brain and it is something I hate doing."


. . .


Britain's National Health Service is a socialized system, and Marsh chafes at new rigid rules imposed by its administrators. He is particularly incensed by a mandatory dress code: Neurosurgeons are subject to disciplinary action for wearing a wristwatch. There is scant evidence that this item contributes to hospital infections, but he is shadowed on ward rounds by a bureaucrat who takes notes on his dress and behavior. The reign of the emperor is ending, but Marsh refuses to comply and serve as a myrmidon.

Clinical practice is becoming a theater of the absurd for patients as well. Hospital charts are filled with N.H.S. forms detailing irrelevant aspects of care. Searching for a patient's operative note, Marsh finds documentation she passed a "Type 4 turd." He shows her an elaborate stool chart "colored a somber and appropriate brown, each sheet with a graphically illustrated guide to the seven different types of turd. . . . She looked at the document with disbelief and burst out laughing."



For the full review, see:

JEROME GROOPMAN. "Consider the Comma." The New York Times Book Review (Sun., MAY 24, 2015): 13.

(Note: ellipsis between paragraphs, added; ellipsis within paragraph, in original.)

(Note: the online version of the review has the date MAY 21, 2015, and has the title "'Do No Harm,' by Henry Marsh.")





(p. C6) Amid the life-or-death dramas of neurosurgery in this book are some blackly comic scenes recounting the absurdities of hospital bureaucracy in the National Health Service: not just chronic bed shortages (which mean long waits and frantic juggling of surgery schedules), but also what Dr. Marsh calls a "loss of regimental spirit" and ridiculous meetings, like a slide presentation from "a young man with a background in catering telling me I should develop empathy, keep focused and stay calm."


For the full review, see:

MICHIKO KAKUTANI. "From a Surgeon, Exhilarations and Regrets." The New York Times (Tues., MAY 19, 2015): C1 & C6.

(Note: the online version of the review has the date MAY 18, 2015, and has the title "Books of The Times; Review: In 'Do No Harm,' a Brain Surgeon Tells All.")




The book under review, in both reviews, is:

Marsh, Henry. Do No Harm: Stories of Life, Death, and Brain Surgery. New York: Thomas Dunne Books/St. Martin's Press, 2015.







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