Describe The English Surgeon as the story of a plucky doctor attempting to defeat a brain tumour and you’d incur the wrath of its protagonist Henry Marsh, who, in a recent interview included here as an extra, moans that he hates seeing surgeons portrayed as heroes, as, in his words, “patients are more heroic.”
Marsh, a pleasingly self-deprecating neurosurgeon, can’t help saying something profound every time he opens his mouth, and you can see why documentary-maker Geoffrey Smith was drawn to him. An awful lot has changed since the film was made in 2007 and shown in BBC Four’s Storyville series. Marsh’s books and media appearances have brought him wider recognition, as has his recent diagnosis with advanced prostate cancer.
The English Surgeon is about Marsh’s work in Ukraine, a country he first visited in the early 1990s and continues to travel to despite the Russian invasion - it’s impossible not to wonder about the impact of the conflict on the medical staff and patients we meet.
Marsh’s collaborator is the tenacious Igor Kurilets, who runs a Kyiv neurological clinic on a shoestring. Kurilets compares neurosurgeons to Cossacks, both in the business of winning battles.
Marsh brings with him a suitcase packed with equipment surplus to UK requirements, explaining how NHS rules mean that surgical drill bits costing £80 a pop are discarded after a single use. He and Igor are later seen shopping for cordless drills at a DIY stall in a market, wondering whether they’ll be powerful enough to cut through bone.
We see scores of patients queuing in the hope of a consultation with Marsh, brain surgery described by him as “Russian Roulette with two revolvers,” because of the risk to a patient if the intervention goes wrong. And while most of the film focuses on Marsh and Igor’s efforts to remove a brain tumour from the stoic Marian, Smith frames it with Marsh revisiting an unsuccessful attempt to help a young girl with a benign tumour.
Smith’s unobtrusive camerawork lets us see everything. Marian’s operation is performed under local anaesthetic, a fascinating but messy business involving clamps, drills, tubes, and plenty of unappetizing noises. The outcome is positive, though the film ends with Marsh and Igor visiting the mother of the girl he failed to save. He recalls bringing Tanya to London to remove a large tumour which had been deemed inoperable, the surgery ultimately unsuccessful – “because of my operation, a terrible last two years of life.” Seeing Tanya’s family raising a toast to Marsh is an touching moment, his guilt at her death still very present.
There’s talk of the need to offer patients hope, Marsh reflecting that, whatever the risks, you must at least try. In his words, “what are we if we don’t try to help others? Nothing. Nothing at all.” Few films I’ve seen in recent years have moved me so much, and that a small-scale 90-minute documentary packs such emotional power is miraculous. Nick Cave and Warren Ellis’s euphonious score is deployed with restraint. Watch Marsh and Igor go about their business and you might just believe that there’s hope for humanity.
