“The Wolf Charmer”
Henry Marsh (1826–1912) after John La Farge (1835–1910)
wood engraving on tissue paper c. 1867
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“The Wolf Charmer”
Henry Marsh (1826–1912) after John La Farge (1835–1910)
wood engraving on tissue paper c. 1867
But we have never met our brains before, and perhaps we lack the metaphor with which to understand them. When I lie in bed in the morning, struggling to get up - a problem that has come with retirement and became much worse with hormone therapy and radiotherapy for cancer - I find it hard to escape a marine metaphor. My conscious self is like a small boat sailing on a deep ocean, or perhaps more like a submarine that comes to the surface when I awake. I then delude myself that I am steering the boat, when in fact its course is determined by the wind and the deep currents. But this is a false metaphor, of course, as my conscious and unconscious selves are part of the same phenomenon, in a way that we find impossible to describe. The submarine is part of the ocean, not separate from it. Most writers trying to describe the relationship between the conscious and unconscious sink into a muddled flood of analogies and metaphors - or perhaps I should more modestly say that I become muddled by what I read. My conscious and unconscious selves (for want of a better word) are made of the same material - the electrochemical activity of my 86 billion nerve cells. T am both my conscious and unconscious - they are not separate entities. Some psychologists and philosophers delight in telling us that our sense of self is an illusion. I briefly studied philosophy at Oxford University, but eventually fled to the more practical world of medicine. But at least I learned from studying philosophy for one year the importance of the phrase It all depends on what you mean by. The word 'self' is not easy to define, and the word illusion simply means that something is different from how it appears. I have no intention of going down the rabbit hole of what the word 'self' means, but I realise that I find it very hard to know what it is that I might be losing as my brain shrinks. How can I compare myself now with my past self?
Henry Marsh, And Finally
Henry Marsh
My conscious self is like a small boat sailing on a deep ocean, or perhaps more like a submarine that comes to the surface when I awake. I then delude myself that I am steering the boat, when in fact its course is determined by the wind and the deep currents.
— Henry Marsh, And Finally: Matters of Life and Death (St. Martin's Press, January 17, 2023) (via Alive on All Channels)
Henry Marsh - Bishop Hatto and the Rats, ca. 1866–67.
Neuroscience tells us that it is highly improbable, that we have souls, as everything we think and feel is no more or no less than the electrochemical chatter of our nerve cells.  Our sense of self, our feelings and our thoughts, our love for others, our hopes and ambitions, our hates and fears all die, when our brains die.  Many people deeply resent this view of things, which not only deprives us of life after death but also seems to downgrade thought to mere electrochemistry and reduces us to mere automata, to machines.  Such people are profoundly mistaken, since what it really does is upgrade matter into something infinitely mysterious that we do not understand.  There are one hundred billion nerve cells in our brains. Does each one have a fragment of consciousness within it? How many nerve cells do we require to be conscious or to feel pain? Or does consciousness and thought reside in the electrochemical impulses that join these billions of cells together? Is a snail aware? Does it feel pain when you crush it underfoot? Nobody knows.  from Do No Harm by Henry Marsh
Few people outside medicine realize that what tortures doctors most is uncertainty, rather than the fact they often deal with people who are suffering or who are about to die. It is easy enough to let somebody die if one knows beyond doubt that they cannot be saved - if one is a decent doctor one will be sympathetic, but the situation is clear. This is life, and we all have to die sooner or later. It is when I do not know for certain whether I can help or not, or should help or not, that things become so difficult.
Henry Marsh M.D., Do No Harm: Stories of Life, Death and Brain Surgery
But death is not always a bad outcome, you know, and a quick death can be better than a slow one.
Henry Marsh, Do No Harm: Stories of Life, Death and Brain Surgery