I often have to cut into the brain (2012) | Hacker News Reader

I often have to cut into the brain (2012)

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98 pointshowsilly16 comments

The author of that extract recently wrote a piece [1] for the Guardian on his experience of the reversal of the doctor-patient roles, when he was diagnosed with prostate cancer. I found his writing reflective and empathetic. Worth a read.

[1] https://www.theguardian.com/society/2022/aug/13/brain-surgeo...

> You are looking directly into the centre of the brain, a secret and mysterious place where all the most vital functions that keep us alive and conscious are to be found. Above you, like the great vault of a cathedral roof, are the deep veins of the brain – the Internal Cerebral Veins, and beyond them the basal veins of Rosenthal and then in the midline the Great Vein of Galen, dark blue and glittering in the light of the microscope

This felt like I was reading Tolkien mixed with a bit of William Gibson. Fantastic.

I found the author's honesty fascinating ("I had caused a major stroke").

I wonder if he was practicing in the US whether he could be as forthcoming, with lawyers hovering.

The unfortunate situation is that the more transparent the medical system, the easier it is to lose faith in it - yet ultimately you get better outcomes with such transparency.

This, I think, was the most poignant passage of the article:

"She would be added to the list of my disasters – another headstone in that cemetery which the French surgeon Leriche once said all surgeons carry within themselves."

I've read most of the recent autobiographies by top British doctors (including Henry's) and they all have sour stories to tell around facing panels of bureaucrats (full on courtroom sagas, no - they're not a common feature of British medical justice).

It never seemed to be lawsuits that soured them on the profession, though, but targets and bureaucracy. Even amongst doctors I know, most woes are pinned down to the NHS's modern addiction to statistics to judge everything.

I believe it was Henry himself who lamented that he was always happy to take on complex, last ditch "you might as well operate, they're dying anyway" cases and he frequently pulled off miracles. In a statistics driven system, though, it looks very bad and you can lose funding (or even your job) if a certain percentage of your patients die, so why perform such risky operations when you can let them die naturally? This is hugely demoralizing to the sort of people who become high end surgeons and early retirement is common.

>Even amongst doctors I know, most woes are pinned down to the NHS's modern addiction to statistics to judge everything.

Yes, statistics are never a substitute for knowledge, no matter how much SVs insists that it is.

Reading this I felt I’m in the operation theater watching a brain surgery live.

His book Do No Harm is fantastic. Highly recommend.

Seconded. His followup book as well where he reflects a lot more at a philosophical level.

Do No Harm is a real rollercoaster. You can be confronted with death at one moment, then laughing the next as he angrily rails against the inanities of NHS IT policy. (I listened to it as an audiobook - the narrator was absolutely top notch and extremely entertaining.)

Admissions: Life as a Brain Surgeon by Henry Marsh

Prime candidate for nano bots

When I fully realized that we are basically made up of biological nanobots, I became a lot less optimistic about nanotechnology. I believe every aspiring nanotechnologist should be required to study microbiology to some extend to become aware what can go wrong with self-replicating and self-arranging systems.

i dont think nanobot's should be self-replicating, instead we could have a system where we feed the bio-markers of tumor the system that generates couple of billions nanobots programmed to seek out and destroy those cells then overtime biodegrade into nothing. We don't even need to go all robotics, we could piggyback some virus/bacteria that is able to evade immune system, doesn't reproduce, can't mutate (which is important, if mutation is high than what you program it do is irrelevant as it can deviate from it), and simply just find the cells pre-programmed to be found and not even deliver poison, just mark them as targets for immune system.

We can't even get cheap gas or a stable electric grid. I wouldn't hold my breath for nanobots any time soon...

Thanks for sharing.

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