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.

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