Do No Harm

The first time I read Henry Marsh’s Do No Harm was in early February 2016, waiting outside an Intensive Care Unit of a no-smoking hospital filled with many “chimney people”, the staircases littered with cigarette ends, bathrooms without soap, hand sanitizer dispensers always empty except for the brief period when officials were touring the hospital. It is a misfortune to be critically injured. It is a curse to be there. This book accompanied me during those dreadful days. The following note is after reading this book for the second time during the last a few nights.

2:13am Saturday

It is impossible to not be in awe of medical research if you have been to Gustavianum Museum in Uppsala. The dizzyingly anatomical theatre and the wide collections of specimens nearby were most memorable to me. There I recall seeing brains and fetuses preserved in glass jars. In the course of my academic research, I have seen thousands of brain scans, ranging from healthy to those with mild illnesses to severe cognitive impairment, from fetus to adult to the aged population. The uniqueness of each never stops fascinating me. Together with many other museums I visited there, Uppsala earned herself a special place in my heart and mind.

Fascination, curiosity, empathy and scientific inquiry dominated my feelings while viewing the brain scans and the specimen. An inexpressibly helpless emotion was not felt until the moment I saw my own father’s brain scan, smashed, with blood dispersed everywhere, and a total lack of clarity of the brain tissue structures that you might see in my brain scan if you were to scan me right now. I had not seen any scans of a brain as distorted as his. I felt nausea at first sight. I felt the world was swirling around me and trying to suck me into its darkest and most fearful hell. It was easier for me to deny the severity of his traumatic brain injury until that moment, because from the outside it looked like he had external wound bleeding on his head and many bruises elsewhere in his body, but the skull was in ok shape. I still hoped that he would wake up after a week or a month.

I felt like the gravity was pulling me very hard to the ground. I was lost in this most acute fear. It was so pure that I could not imagine there is other emotion existing right there and then. I reminded myself that I must stand strong and calm, absolutely do not collapse, for the sake of people around me who were no less eager of knowing the details but without the pre-trained skills of reading the computed tomography scans.

Why did I think the way I did? How is it that the fear leads to physical sickness in the stomach? Why did I feel the inclination of collapse as if his trauma had migrated solely to me which I would superbly happily wish to take over? I was irrational. But I was rational too. I held myself together. Had I not written this down now, no one would have suspected how intensely fearful and sick I felt at that moment. Why did the kinds of emotions that I felt strongly afterwards not emerge at the very beginning? There seems to be some ordering of the emotions, depending on the circumstances, or, on my voluntary and self-controlled reactions. Sometimes they are mixed up. Other times, one or two stand out very clearly such that you can see it face to face, shouting “You, demon, I know you are occupying me right now, just you wait, I will get you out of me!”

What neuron activities lead me to write this now? Why do I have these thoughts? Why do I now choose to commit them to words? Why have I stopped shedding tears while recalling my father’s ordeal? What propelled me to walk up and down the aisle in front of the Intensive Care Unit thousands of times over many days while my brain was flooded with all the memories we shared? Why many times did I walk straight up to the smokers who were so very selfishly smoking right outside ICU to go and smoke out of the building? They might not listen to me, but I simply must do it. Why did I seem to have more courage than I thought I might have to face the challenges while the adversity is severe? What is happening in our brain that drives us to do what we do?

Dark outside, the dark skeleton of the soaring redwood tree against the steel-colored sky, the arms of the aspen trees dancing gently with the breeze, every so often some animals happily singing unknown tunes out there. I, wide awake, with many thoughts racing in my head. Why do I wake up naturally when most people of this part of the world are fast asleep? Why does my brain make that decision without ever consulting me, not that I object to the idea of waking in early hours and having deep thoughts in the most beautiful part of the day? How do we get to make the decision we make from a neuroscience perspective? There are so many articles and books about decision making. How do we know they are not merely retrospectively fitting curves to what have been observed rather than explaining the fundamental causes? I was fortunate to be at the talk given by Robert Sapolsky about his latest book Behave: The Biology of Humans at Our Best and Worst. I like the scientific endeavours Sapolsky is making towards behavioral biology. Much of the content sounded very plausible to me.

How old is the redwood tree outside my window? Has she seen another soul with similar thinking pattern and decision making process as mine? Is there really soul? No, in my view. Can thinking be classified into patterns? Likely so. How are those patterns developed? You might say habits. Then how is the very first instance of a habit formed?

Why do I always have the strong desire to enter an unknown scientific world? It is a beautiful sensation to feel. Why some people frequently throw the words: “we do not need to know about that”, or worse, “you do not need to know about that”? The latter is absolutely intolerable. Let me judge for myself whether I need or not to learn more about a topic. Why do I get that a lot from people with certain cultural backgrounds rather than others? How much of our thinking and behaviors are molded by the environments and how much is to our own independent will? If my thinking is more independent than yours, what contributed to that? Can we compare the neurons in my head and the connectivities they share, with yours, to explain the difference?  

To explore with the intense fear that I might make a mess is a natural inclination of mine, similar to the one that leads me to wake up at 2:13am on a Saturday to think and to write. It might seem to be self-inflicted suffering to many. It is a sheer pleasure for me.

I love this redwood tree and the aspen trees. They are my dear friends. I love reading and writing in my office through these early hours and hold a new day tightly from its very beginning. Time never abandons us if we appreciate the value of every moment.

A Room of One’s Own

Virginia Woolf gave a series of lectures in two women’s colleges of Cambridge University in 1928, and subsequently extended the content to its book form: A Room of One’s Own. It focuses on examining women’s roles as writers of and characters in fiction in a male-dominated literary world.

I first read this small volume together with other Virginia Woolf works during a phase of obsession with her writings in my late teens. It left a very strong impression on me, such that I have been aiming towards my 500 pounds a year and a room of my own to write. Laughably, I could not make my mind up about whether this room should be within walking distance of the British Library or Hyde Park. It remains to be decided when the time comes.

Having had the opportunity to re-read this volume recently, its feminism came through to me more profoundly than previously. I cannot help wondering how financial independence liberated her from other people’s opinions. Would a woman living on the financial support of her husband be able to come to the same realisation Woolf did and write in this way? What did women of her era think of Woolf’s views? Not so long ago, it was Mother’s Day in the USA. I respect and value the women who choose motherhood, but have no interest in that path myself. Even now, occasionally there is an uneasiness and awkwardness that people express towards women who choose to be childless, as if it is a woman’s unshakable responsibility to bear children. Is it? Why is to write or to paint or to innovate not a woman’s fundamental calling?

In my late teens, I was awfully puzzled by Virginia Woolf’s suicide. Why? Why? Why would a woman with such talent, courage to write and speak, financial security and good social standing do that? Perhaps there were a lot of hidden causes that I do not know about. In a recent discussion at work about depression, people concluded that I would never be depressed, because I have too many means and too strong a will to regain my vitality. To recognise and understand other people’s sufferings is an important step towards effective assistance though.

Financial independence is paramount not only to female writers, but also to females who choose other professions. I want to add to that, a woman should never fear speaking her mind or writing in her own voice, even when she does not have that 500 pounds a year and a room of her own. Do it anyway, whatever the circumstance is. We might be ignored and not listened to by the world. But if we do not speak nor write, there is nothing to be heard.

Here are some passages I like from the book:

Literature is open to everybody. I refuse to allow you, Beadle though you are, to turn me off the grass. Lock up your libraries if you like; but there is no gate, no lock, no bolt, that you can set upon the freedom of my mind.

Women have served all these centuries as looking glasses possessing the magic and delicious power of reflecting the figure of man at twice its natural size.

A woman must have money and a room of her own if she is to write fiction.

Literature is strewn with the wreckage of those who have minded beyond reason the opinion of others.

For masterpieces are not single and solitary births; they are the outcome of many years of thinking in common, of thinking by the body of the people, so that the experience of the mass is behind the single voice.

All women together ought to let flowers fall upon the tomb of Aphra Behn, for it was she who earned them the right to speak their minds.

So long as you write what you wish to write, that is all that matters; and whether it matters for ages or only for hours, nobody can say. But to sacrifice a hair of the head of your vision, a shade of its colour, in deference to some Headmaster with a silver pot in his hand or to some professor with a measuring-rod up his sleeve, is the most abject treachery, and the sacrifice of wealth and chastity which used to be said to be the greatest of human disasters, a mere flea-bite in comparison.

Suppose, for instance, that men were only represented in literature as the lovers of women, and were never the friends of men, soldiers, thinkers, dreamers; how few parts in the plays of Shakespeare could be allotted to them; how literature would suffer! We might perhaps have most of Othello; and a good deal of Antony; but no Caesar, no Brutus, no Hamlet, no Lear, no Jaques–literature would be incredibly impoverished, as indeed literature is impoverished beyond our counting by the doors that have been shut upon women.

And since a novel has this correspondence to real life, its values are to some extent those of real life. But it is obvious that the values of women differ very often from the values which have been made by the other sex; naturally this is so. Yet is it the masculine values that prevail. Speaking crudely, football and sport are “important”; the worship of fashion, the buying of clothes “trivial.” And these values are inevitably transferred from life to fiction. This is an important book, the critic assumes, because it deals with war. This is an insignificant book because it deals with the feelings of women in a drawing-room.

Here was a woman about the year 1800 writing without hate, without bitterness, without fear, without protest, without preaching. That was how Shakespeare wrote, I thought, looking at Antony and Cleopatra; and when people compare Shakespeare and Jane Austen, they may mean that the minds of both had consumed all impediments; and for that reason we do not know Jane Austen and we do not know Shakespeare, and for that reason Jane Austen pervades every word that she wrote, and so does Shakespeare.

A book is not made of sentences laid end to end, but of sentences built, if an image helps, into arcades or domes.

The indifference of the world which Keats and Flaubert and other men of genius have found so hard to bear was in her case not indifference but hostility. The world did not say to her as it said to them, Write if you choose; it makes no difference to me. The world said with a guffaw, Write? What’s the good of your writing?

They lack suggestive power. And when a book lacks suggestive power, however hard it hits the surface of the mind it cannot penetrate within.

Life for both sexes — and I looked at them, shouldering their way along the pavement — is arduous, difficult, a perpetual struggle. It calls for gigantic courage and strength. More than anything, perhaps, creatures of illusion as we are, it calls for confidence in oneself. Without self-confidence we are as babes in the cradle.

Be truthful, one would say, and the result is bound to be amazingly interesting.

Therefore I would ask you to write all kinds of books, hesitating at no subject however trivial or however vast. By hook or by crook, I hope that you will possess yourselves of money enough to travel and to idle, to contemplate the future or the past of the world, to dream over books and loiter at street corners and let the line of thought dip deep into the stream. For I am by no means confining you to fiction. If you would please me – and there are thousands like me – you would write books of travel and adventure, and research and scholarship, and history and biography, and criticism and philosophy and science. By so doing you will certainly profit the art of fiction. For books have a way of influencing each other. Fiction will be much the better for standing cheek by jowl with poetry and philosophy.

Great bodies of people are never responsible for what they do. They are driven by instincts which are not within their control.

The only advice, indeed, that one person can give another about reading is to take no advice, to follow your own instincts, to use your own reason, to come to your own conclusions.

When I rummage in my own mind I find no noble sentiments about being companions and equals and influencing the world to higher ends. I find myself saying briefly and prosaically that it is much more important to be oneself than anything else. Do not dream of influencing other people, I would say, if I knew how to make it sound exalted. Think of things in themselves.

Women are supposed to be very calm generally: but women feel just as men feel; they need exercise for their faculties and a field for their efforts as much as their brothers do; they suffer from too rigid a restraint, too absolute a stagnation, precisely as men would suffer; and it is narrow-minded in their more privileged fellow-creatures to say that they ought to confine themselves to making puddings and knitting stockings, to playing on the piano and embroidering bags. It is thoughtless to condemn them, or laugh at them, if they seek to do more or learn more than custom has pronounced necessary for their sex.

No force in the world can take from me my five hundred pounds. Food, house and clothing are mine forever. Therefore not merely do effort and labour cease, but also hatred and bitterness. I need not hate any man; he cannot hurt me. I need not flatter any man; he has nothing to give me. So imperceptibly I found myself adopting a new attitude towards the other half of the human race. It was absurd to blame any class or any sex, as a whole. Great bodies of people are never responsible for what they do. They are driven by instincts which are not within their control.

The human frame being what it is, heart, body, and brain all mixed together, and not contained in separate compartments as they will be no doubt in another million years, a good dinner is of great importance to good talk. One cannot think well, love well, sleep well, if one has not dined well.

Freedom and fullness of expression are of the essence of the art.

One can only show how one came to hold whatever opinion one does hold.

A mind that is purely masculine cannot create, any more than a mind that is purely feminine

The history of men’s opposition to women’s emancipation is more interesting perhaps than the story of that emancipation itself.

Intellectual freedom depends upon material things….Women have had less intellectual freedom than the sons of Athenian slaves. Women, then, have not had a dog’s chance of writing poetry. That is why I have laid so much stress on money and a room of one’s own.

One cannot hope to tell the truth. One can only show how one came to hold whatever opinion one does hold. One can only give one’s audience the chance of drawing their own conclusions as they observe the limitations, the prejudices, the idiosyncrasies of the speaker.

When I ask you to earn money and have a room of your own, I am asking you to live in the presence of reality, an invigorating life, it would appear, whether one can impart it or not.

Literature is impoverished beyond our counting by the doors that have been shut upon women.

At any rate, where books are concerned, it is notoriously difficult to fix labels of merit in such a way that they do not come off.

Suppose, for instance, that men were only represented in literature as the lovers of women, and were never the friends of men, soldiers, thinkers, dreamers; how few parts in the plays of Shakespeare could be allotted to them; how literature would suffer!

“This great book,” “this worthless book,” the same book is called by both names. Praise and blame alike mean nothing. No, delightful as the pastime of measuring may be, it is the most futile of all occupations, and to submit to the decrees of the measurers the most servile of attitudes. So long as you write what you wish to write, that is all that matters; and whether it matters for ages or only for hours, nobody can say. But to sacrifice a hair of the head of your vision, a shade of its colour, in deference to some Headmaster with a silver pot in his hand or to some professor with a measuring-rod up his sleeve, is the most abject treachery, and the sacrifice of wealth and chastity which used to be said to be the greatest of human disasters, a mere flea-bite in comparison.