By Tim Anderson. You likely consider Netflix as a considerable resource for inexpensive entertainment, but I wonder if you have considered it a useful place to explore the meaning of life?
I’m thinking of the documentary The English Surgeon which presents the body/spirit dilemma more persuasively than any philosophical argument I’ve ever heard.
Please note that the film I am recommending is NOT The English PATIENT, which is a maudlin,self-involved crater of carbonated nihilism that works well only if you have already given up on life and love, and wish to expire while casting a pleasing silhouette.
The English Surgeon is something quite different. We’re introduced to Henry Marsh as he builds a packing crate from scrap plywood in his back garden. He is preparing a shipment of disused medical equipment. He’s handy with all these cutting and drilling tools, and we see that the symmetrical crate he has designed on the fly perfectly accepts the odd shapes and weights of the various gadgets. Henry, or Dr. Marsh as he is usually known, has plenty of experience in drilling and cutting, though usually it is through people’s skulls. He is one of Britain’s leading neurosurgeons.
In early scenes, we see him performing the daily duties of his work in London. Consulting on cases, reading brain scans, sputtering with frustration over a new on-line administration system that purports to more “efficiently” track his time. There is something both sweet and absurd about watching an extraordinarily intelligent man try to navigate his way through the petty bureaucracy of a modern hospital. Henry is able to grope around in people’s heads and sort them out – a true “brainiac” – and yet can’t work out the answers to an online questionnaire in a way that satisfies the program. Beep, says the computer, repeatedly, refusing his efforts to placate it. We feel a kind of triumph when he finally loses his patience and stalks away from the screen in disgust, abandoning his obligations to conform.
He has commitments elsewhere.
For a number of years Henry Marsh has been traveling to Ukraine, where he volunteers his time at a brain clinic. As I write this, Ukraine is convulsed in political chaos, and I’m conscious of how the scenes in this Kyiv hospital from 2008 foreshadow the current state of affairs. Henry has a protégé in the hospital, Dr. Igor Kurilets. (One wants to make a joke at this point – “Igor, get me the brains!” But in the interest of good taste, I will not do so.)
Dr. Igor regularly has his privileges suspended by the hospital administration, sometimes for years at a time. The reasons are murky, but most likely have to do with his acceptance of help from a Western doctor, which is somehow viewed as critical of the “perfectly planned” medical system of the Ukraine. Igor, who has grown up in the Soviet era, has an appropriate level of respect for such planning. “Action,” he says, is the only thing that matters.
In the meantime, Henry gathers all sorts of drill bits and specialized doo-dads, and brings along a box on every trip. He shares his latest prizes with Igor at the kitchen table in Igor’s apartment. He displays a drill-bit that is used once in a British hospital and then discarded. In Ukraine, it will find its way into the heads of forty or fifty patients before it is used up.
When he arrives at the clinic, Henry is low-key, almost shy. He speaks with a sort of lower-case precision as he looks through the scans of the dozens of Ukrainians who line up in the waiting room. Many of the cases are far advanced, as there is little early detection, and the patients’ lack of money means that treatment is often put off. As a result, the patients that arrive at the clinic are sicker, more desperate, and their treatment plans much more complex than the patients Henry sees in London. The ill Ukrainians and their advocates crowd the doorway to the office. Igor acts as translator,counselor, traffic cop and mediator.
Perhaps you are wondering about the philosophy concerning the meaning of life that I promised. All right, here it is.
Dr. Henry makes two statements during the course of the film that I found very persuasive. Both of the statements center around the words “you are”. In these two heartfelt statements he describes what it is to be human. In both cases, I believe him, and yet the statements lie uneasily together.
The first time he makes a “you are” statement, the English doctor is standing in a operating room. He has sawn open the head of a young man named Marian. Henry is in the process of removing a brain tumor with a suction tool. He is vacuuming diseased tissue from deep within the brain while the patient, fully conscious, reports on how he feels. Not “what” he feels – the brain is incapable of pain, apparently. Henry determines the location of the tumor by moderately reliable scans, and then proceeds with the perhaps more reliable tactile sense of the composition of the tissue. If he destroys healthy tissue, there is no going back. This is a tense moment for both patient and surgeon. Henry is conscious of the fact that he is not dealing only with simple tissue, but the young man’s means of consciousness. He says, “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.”
After all, he says, “you are your brain.”
And there it is, from someone who should know.
But is that all? There is something else, another definition of what a person is that perhaps goes further in explaining what goes on in Henry’s head, or should we say in a very medically imprecise way – in his heart. After all, if the brain is the sole explanation for his own behaviour, we would have to be able to locate the epicenter of the “help strangers from another culture” region of Dr. Henry’s brain. We might also want to know why that region is under-developed in so many of us.
Henry has operated on many people in Ukraine, but one case in particular haunts him. Tanya was a bright-eyed child. Scratchy video from a dozen years before shows her walking unevenly across a room, her motor functions already under attack from her disease. Her mother holds her steady for the camera, and their two winning smiles show almost identical expressions, except that we cannot help but see in the woman’s eyes something else – the grief of a mother who is losing her child by degrees.
When he looks back on Tanya’s case, Henry isn’t sure what he was thinking. Perhaps his compassion got the better of his judgment. Hers was a difficult and advanced case, the kind that he often simply turns aside for lack of hope. But in this case he did not turn aside. He operated.
The results were not improvement, but an extension of life that was perhaps more catastrophic than an early death. Tanya lost many of her capacities, her appearance growing increasingly distorted over the following years before she finally died. Henry has had many hundreds of patients. For some reason, it is her face that keeps coming back to him. Even years later, her case still presents itself to his thoughts, he still turns it over, wrestles with it. But it is the one case he can do nothing about. Or perhaps he can –
He allows us to follow him on a trip to the outlying town where Tanya’s family lives. On the long drive, he talks over the case with Igor. He is afraid, he says, to see the girl’s mother again. What will he say? His regret is palpable. Henry looks out the window at the frozen landscape.
He is greeted like a hero. Here is the great man from England who tried to save their Tanya. Tears are shed. Toasts are made with vodka. The table is spread with (one senses) more than the family can afford. Eat, they encourage him, even as they wipe their tears. I can’t eat, he whispers to Igor. Eventually, Henry offers his own speech. It is short, indirect, kind, dignified. An English sort of speech.
Finally, we walk with Henry to the graveyard where Tanya is buried. There we recognize the face of the young girl in a very life-like carving. He stands before her. Her undistorted smile has the sweetness that first captured his imagination, and her profile rendered in granite is much steadier now. Henry stands alone in the graveyard, his head down, and he makes his second statement.
“What are we if we don’t try to help others?” he asks, and in the next moment, he gives his own answer. “We’re nothing. Nothing at all.” If you see someone in need, who you can help, and you don’t respond, says Henry, you are nothing. And this is also entirely believable. In fact, the substance of Henry’s life has been helping people – it is the “something” that constitutes him as “Henry”. To be human is to be self-giving – one might say, to love.
So Dr. Henry offers us two statements which his own experience have proven to be true, but are not the same. Somewhere within them is a question behind every question.
If Henry is only the tissue that makes up his brain, what need is there for remembering? What good is there in the hugs, the kindnesses, the toasts? There is no need for his drive in the snow to see these near-strangers. He will tell you himself – the brain is incapable of pain. If he destroyed Tanya in trying to help her, why is she still with him? Why does he feel it so? And why is her bereft family so full of gratitude to him?
The film doesn’t answer these questions, but one senses that the answers are there if you want them.
With thanks to readers Mike Mason, Karen Cooper, Luci Shaw and Janet Anderson