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The English Surgeon

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by Christiaan Harden
Neuro-surgery will always be a very risky business. But, when you’re operating in the Ukraine with make-shift tools from a local market and a cordless Bosch drill, the risks are ‘100 times as great’.

Most would find these conditions intolerable, but leading neuro-surgeon Henry Marsh is not most people. Appalled by the archaic, bankrupt medical system he found when first visiting the country in 1992, and frustrated with increasing NHS bureaucracy, the charming Marsh has for 15 years made regular trips, offering his help and expertise for free. But can we as individuals really make a difference? Henry Marsh proves that we can.

Shot at the height of winter, The English Surgeon captures his indomitable spirit with perfection and skilfully examines the struggle of conscience that every surgeon has to face. Gruesome, touching and darkly humourous, this wonderful film even explores the very meaning of life itself. ‘What are we if we don’t help others? We are nothing, nothing at all’, ponders Marsh.

A chaotic two weeks in his life reveal the huge pressures that surgeons have to deal with every time they choose to operate – and how they cope when telling patients and their families that it’s too late. Marsh sees more dramatic cases in just one weekend than he usually would in London in a year, and because most Ukrainians can’t afford the treatment or the diagnosis has been delayed – there is often nothing he can do. Scene after scene we witness the surgeon deliver heart-wrenching death sentences to patients entirely unaware of their fate, and watch as he struggles to cope.
There is one patient, however, who Marsh believes he can help. Marian Dolishny is a sweet, warm young man from a poor farming family in the poverty-stricken west. An enormous brain tumour is causing him severe epilepsy: he can no longer work, and if not removed, it will kill him. Marsh knows that one false move during the operation could wipe out Marian’s infectious personality, paralyse or even kill him.  He decides that a general anaesthetic would increase the risk of paralysis so Marian agrees to go through the harrowing operation … wide awake. An unforgettable 15-minute scene then unfolds - a surreal and often humourous scene, captured from multiple angles, with the all the drama and high-tension of a high-octane thriller and the gore of the worst horror film imaginable. The surgery is performed using a second-hand drill with a flat battery, while Marian lies fully conscious, chatting with Marsh and his quirky Ukrainian colleague, Igor. This is a remarkable scene, in a remarkable documentary.

What makes Marsh all the more fascinating is that he’s willing to reveal his vulnerable side, prepared to admit doubt and discuss the very real possibility of failure. Haunted by an operation on a young girl called Tanya that went horribly wrong, the surgeon knows that sooner or later something else terrible will happen, yet continues undeterred to help those he can.

The English Surgeon isn’t just about neuro-surgery, the risks of operating or the surgeon’s dilemma – it is above all else, a film about hope. Henry Marsh provides hope where once there was none. Without his help, his expertise and the second-hand equipment he salvages from the NHS, countless Ukrainians would have died unnecessarily.

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