The English Surgeon | |
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Directed by | Geoffrey Smith |
Produced by | Geoffrey Smith |
Starring | Henry Marsh, Igor Petrovich Kurilets |
Edited by | Kathy O'Shea |
Music by | Nick Cave Warren Ellis |
Release date |
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Running time | 93 minutes |
Country | United Kingdom |
Language | English |
The English Surgeon is a documentary film that premiered at the BFI London Film Festival in 2007. [1] It focuses on the work of Henry Marsh, a neurosurgeon from the UK, and his efforts to help desperately ill patients in Ukrainian hospitals.
Henry Marsh first went to Kyiv, Ukraine in 1992 to give lectures, and was appalled when he saw the medical system there. He states he was treating patients with medical complications that had not been seen in the United Kingdom for more than 60 or 70 years. When he offered his help, he was told that it would be nothing more than “a drop of water in the ocean” unless he changed the whole health care system. Deciding to do what he could, he started to train local doctors in surgical procedures, bringing equipment from the UK and performing surgery without charge. Alongside Ukrainian colleague Dr Igor Kurilets, he treated many patients who had been told they had no hope of survival, despite the political issues that arose. [2]
The film was shot in a Ukrainian hospital full of desperate patients and makeshift equipment, but it is not a medical film—it is about Henry Marsh, his partnership with Ukrainian colleague Igor Petrovich Kurilets, and their struggle with moral, ethical and professional issues. [2]
Marsh is an English specialist neurosurgeon who operates on the brain using only local anaesthetic so that patients remain conscious and can provide feedback during the procedure. Marsh emphasises how hospital environment and design affect patient outcomes, and how having only single rooms in hospitals reduces infection and allows patients to have peace, rest, and quiet in order to make a full recovery. [3]
With a soundtrack composed and performed by Nick Cave and Warren Ellis, the film is set in a bleak Ukrainian landscape as the doctors struggle against logistical odds and the old Soviet health system. [4]
Kurilets faced death threats from opponents as he attempted to improve the local health care system. He would sleep in a different room every night and was fired numerous times. In spite of the obstacles, the doctors manage to save numerous lives. [5]
Many of the patients whose brain scans they review have been diagnosed far too late due to medical costs and lack of equipment in Ukraine. This leads to the dilemma that is highlighted multiple times: would performing surgery do more harm than good? Marsh compares the position to a game of Russian roulette played with two revolvers. The documentary shows the interactions between the doctors as they are forced to tell patients that they are terminally ill and do not have much longer to live.
The documentary focuses on the treatment of one specific patient, Marian. He was tending his garden when he suddenly felt himself become numb from head to toe, and unable to talk or even scream. After multiple hospital visits, it is revealed that Marian has a tumour which is causing epilepsy. However, surgery is a significant risk because it could lead to complete paralysis of one side of his body. Marsh proposes that he should remove the tumour while Marian is awake, using a technique known as brain mapping. This allows him to observe Marian's reactions throughout the procedure and ensure that he does not lose his speech or motor function. Marian makes a full recovery.
A significant theme of the documentary is that Ukraine lacks the proper equipment to diagnose and treat their patients, one issue being the lack of perforators (surgical drills commonly used in craniotomies). Marsh states that in the UK these drills are used once and thrown away, but that with proper sanitation they are actually reusable. He brought in used perforators, and Kurilets worked to find a way to sanitize and replace the rubber coverings so that they could be reused.
Marsh discusses the story of Tanya. She was a child who had a tumour causing half her face to be paralysed. In Marsh's opinion the tumour was potentially curable, and he brought her back to London for surgery. However, complications arose. In a first operation, Tanya lost her circulating blood volume twice over, and after a second operation she became paralysed. She died two years later. Henry's emotional journey takes him to visit the mother and family of Tanya at the end of the film, as he had never stopped thinking about her or her family.
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.
A lobotomy or leucotomy is a discredited form of neurosurgical treatment for psychiatric disorder or neurological disorder that involves severing connections in the brain's prefrontal cortex. The surgery causes most of the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain, to be severed.
Harvey Williams Cushing was an American neurosurgeon, pathologist, writer, and draftsman. A pioneer of brain surgery, he was the first exclusive neurosurgeon and the first person to describe Cushing's disease. He wrote a biography of physician William Osler in three volumes.
Walter Jackson Freeman II was an American physician who specialized in lobotomy. Wanting to simplify lobotomies so that it could be carried out by psychiatrists in psychiatric hospitals, where there were often no operating rooms, surgeons, or anesthesia and limited budgets, Freeman invented a transorbital lobotomy procedure. The ice-pick transorbital approach, a transorbital lobotomy, involved placing an orbitoclast under the eyelid and against the top of the eye socket; a mallet was then used to drive the orbitoclast through the thin layer of bone and into the brain. Freeman's transorbital lobotomy method did not require a neurosurgeon and could be performed outside of an operating room, often by untrained psychiatrists without the use of anesthesia by using electroconvulsive therapy to induce seizure and unconsciousness. In 1947, Freeman's partner James W. Watts ended their partnership because Watts was disgusted by Freeman's modification of the lobotomy from a surgical operation into a simple "office" procedure.
Walter Edward Dandy was an American neurosurgeon and scientist. He is considered one of the founding fathers of neurosurgery, along with Victor Horsley (1857–1916) and Harvey Cushing (1869–1939). Dandy is credited with numerous neurosurgical discoveries and innovations, including the description of the circulation of cerebrospinal fluid in the brain, surgical treatment of hydrocephalus, the invention of air ventriculography and pneumoencephalography, the description of brain endoscopy, the establishment of the first intensive care unit, and the first clipping of an intracranial aneurysm, which marked the birth of cerebrovascular neurosurgery.
Charles Teo AM is an Australian neurosurgeon.
Henry Thomas Marsh CBE FRCS is a British neurosurgeon and author, a pioneer of awake craniotomy techniques and of neurosurgical work in Ukraine.
Eben Alexander III is an American neurosurgeon and author. In 2008, he went under a medically-induced coma while being treated for meningitis. His book Proof of Heaven: A Neurosurgeon's Journey into the Afterlife (2012) describes his near-death experience while in the coma. He asserts that the coma resulted in brain death, that consciousness is not only a product of the brain and that it can go on to an afterlife.
Roger Härtl is an American neurological surgeon at Weill-Cornell Medical College and NewYork-Presbyterian Hospital. He is the Director of Spinal Surgery at the Weill Cornell Brain & Spine Center. Härtl has been named by Becker's Spine Review as one of the Top 50 Spine Surgeons in the United States as well as one of the Top 10 Spine and Neurosurgeon Leaders at Non-Profit Hospitals. He was named one of New York's Top Doctors by New York Magazine after he saved the life of New York firefighter Eugene Stolowski.
Psychosurgery, also called neurosurgery for mental disorder or functional neurosurgery, is surgery in which brain tissue is destroyed with the aim of alleviating the symptoms of mental disorder. It was first used in modern times by Gottlieb Burckhardt in 1891, but only in a few isolated instances, not becoming more widely used until the 1930s following the work of Portuguese neurologist António Egas Moniz. The 1940s was the decade when psychosurgery was most popular, largely due to the efforts of American neurologist Walter Freeman; its use has been declining since then. Freeman's particular form of psychosurgery, the lobotomy, was last used in the 1970s, but other forms of psychosurgery, such as the cingulotomy and capsulotomy have survived.
James Rutka is a Canadian neurosurgeon from Toronto, Canada. Rutka served as RS McLaughlin Professor and Chair of the Department of Surgery in the Faculty of Medicine at the University of Toronto from 2011 – 2022. He subspecializes in pediatric neurosurgery at The Hospital for Sick Children (SickKids), and is a Senior Scientist in the Research Institute at SickKids. His main clinical interests include the neurosurgical treatment of children with brain tumours and epilepsy. His research interests lie in the molecular biology of human brain tumours – specifically in the determination of the mechanisms by which brain tumours grow and invade. He is the Director of the Arthur and Sonia Labatt Brain Tumour Research Centre at SickKids, and Editor-in-Chief of the Journal of Neurosurgery.
N. K. Venkataramana is an Indian neurosurgeon and the founder of ANSA Research Foundation, a non-profit non governmental organization promoting research on neuroscience, neurological disorders, cancer biology, stem cells and tumor tissue repository. He is a recipient of Dr. B. C. Roy Award, the highest Indian award in the medical category and the Rajyotsava Prashasti, the second highest civilian award of the Government of Karnataka.
Christopher Daniel Duntsch is a former American neurosurgeon who has been nicknamed Dr. D. and Dr. Death for 33 incidents of gross neurosurgical malpractice while working at hospitals in the Dallas–Fort Worth metroplex, which maimed 31 patients and caused 2 deaths. He was accused of injuring 33 out of 38 patients in less than two years – a track record so unlikely that hospital administrators and district attorneys simply felt that it was too unbelievable to be true, allowing Duntsch to continue to practice before his license was revoked by the Texas Medical Board, and to avoid prosecution for years. In 2017, Duntsch was convicted of maiming one of his patients and sentenced to life imprisonment.
Do No Harm: Stories of Life, Death, and Brain Surgery is a 2014 memoir written by Henry Marsh and published by Weidenfeld & Nicolson. The book details the author's career as a neurosurgeon.
Diana Jean Kinloch Beck was the first British female neurosurgeon. She established the neurosurgery service at the Middlesex Hospital in London. In 1952 she gained a public profile for performing life-saving surgery on A. A. Milne.
Dr. Basant Kumar Misra is a neurosurgeon specialising in treating brain, spine, cerebrovascular and peripheral nervous system disorders, injuries, pathologies and malformations. He is the Vice-President of the World Federation of Neurosurgical Societies, and the former President of the Asian Australasian Society of Neurological Surgeons, and the Neurological Society of India. He is a recipient of Dr. B. C. Roy Award, the highest medical honour in India.
Bleed Out is a 2018 HBO feature documentary film that explores how an American family deals with the effects of medical malpractice. The film revolves around a ten-year journey, captured through archival footage, spy-cams, and interviews. Writer-director Steve Burrows reveals the ways his mother, Judie Burrows, was afflicted for the rest of her life due to a mistake during a partial hip surgery procedure.
Rolando Fausto Del Maestro is an Italian-born Canadian neurosurgeon, the William Feindel Professor Emeritus in neuro-oncology and director of the Neurosurgical Simulation Research Center at the Montreal Neurological Institute and Hospital, where he has been involved in simulating real brain surgery by creating virtual setting scenarios, founded upon the principles of flight simulation.
Jeffrey Victor Rosenfeld is an Australian neurosurgeon and professor of medicine. He is a senior neurosurgeon in the Department of Neurosurgery at The Alfred Hospital, and the Emeritus Professor of Surgery at Monash University, as well as being a major general in the Australian Defence Force, where he has served as a general surgeon since 1984. His research has focussed on traumatic brain injury, bionic vision, and medical engineering. He is best known for devising an operation to remove hypothalamic haematomas from children's brains. Since 2021 he has been the Patron of the Australian Friends of Sheba Medical Centre organization.
On 10 September 1985, 22-year-old Chong Yun Jing, who underwent surgery a few months before due to a brain tumour, died as a result of meningitis, which seemingly was one of the complications of the surgery she received. During investigations however, it was suspected that Chong's medical results of a brain tumour was a misdiagnosis made by Dr Lim Djoe Phing, an Indonesian-born neurosurgeon who conducted the surgery on Chong, given that several medical experts consulted in this case stated that Chong did not actually suffer from a brain tumour all along, and she should not have received surgery in the first place. A coroner's inquiry was conducted in November 1987 to inspect the death of Chong, and after 27 days of deliberation, on 10 June 1988, the coroner's court found Dr Lim criminally responsible of causing Chong's death by negligence, and as a result, in April 1989, Dr Lim was suspended from medical practice for one year, and he was ordered to compensate Chong's surviving kin in a civil lawsuit filed against him in September 1992. The coroner's inquiry of Chong's death was known to be the longest running coroner's inquiry in Singapore's history.