What is it like to have power over life and death, and yet to struggle with your own humanity?
Dr. Henry Marsh is one of England's foremost brain surgeons, a pioneer in his field and respected throughout the world. Surprisingly modest despite all his achievements, he still rides an old bicycle to work and worries constantly about his patients and the potential damage of such delicate surgery. "When push comes to shove we can afford to lose an arm or a leg, but . . . if something goes wrong [in brain surgery] I can destroy that person's character -- forever," he says.
When Marsh brings his surgical skills to less-developed countries such as Russia, Azerbaijan, Sudan or, as documented in The English Surgeon, Ukraine, the conflict between promise and failure becomes wrenchingly sharp. It is in Ukraine, with its decaying medical infrastructure and myriad obstacles, where he and a crusading colleague -- a Marsh protégé -- have done tremendous good, though Marsh is still ruminating over his failure to save one child.
Geoffrey Smith's The English Surgeon has its national broadcast premiere on Tuesday, Sept. 8, 2009, at 10 p.m. during the 22nd season of POV (Point of View) on PBS. (Check local listings.) American television's longest-running independent documentary series, POV is the winner of a Special Emmy Award for Excellence in Television Documentary Filmmaking. The series continues on Tuesdays through Sept. 22 and returns with special presentations on Nov. 11 and Dec. 30.
Driven to help those who are least likely to receive the neurosurgery they need to survive, Marsh has been going to Ukraine's capital, Kyiv, for more than 17 years. He has built his own crates to send donated and scavenged medical supplies to Ukraine, where he is on a personal mission to help improve the primitive medical care available to those who need neurosurgery. Afflicted patients see him as a savior from the West; desperate parents travel great distances to bring him their children; and Marsh's Ukrainian colleague, Dr. Igor Kurilets, sees him as a benefactor and a mentor.
Devoted to his patients, Kurilets has to work within his country's logistical and political constraints. Instead of an expensive medical drill for boring into patients' skulls, he bought a cordless Bosch handyman drill from the local market; when he needed rooms to rent for his independent clinic, he found temporary refuge in the KGB hospital -- the very place that for years housed people who tried to persecute him and Marsh for working outside of the state system.
Kurilets is a man of irrepressible cheer in the face of the numerous official investigations that have taken place since he teamed up with Marsh. The strong bond the men share is partly borne of their struggle simply to keep practicing medicine in a society undergoing great upheavals.
Shot over three chaotic weeks in the winter of 2007, The English Surgeon follows Marsh and Kurilets as they work endless hours in clinics full of desperately ill people. Selected by Kurilets because he believes they might benefit most from Marsh's expertise, these patients represent only a fraction of the people in Ukraine who need neurosurgery. But in harrowing scene after harrowing scene, Marsh agonizes over more doubtful cases and over those patients he knows are beyond help -- and over how to deliver the news. For all the satisfaction Marsh gets from going to Kyiv, once there he must confront a lack of trained staff, equipment and basic supplies, as well as patients grossly misdiagnosed or too late in finding him. Most haunting for Marsh are the children he can't save.
"It's like selling your soul to the devil, but what can you do?" he says at one point. "My son had a brain tumor as a baby and I was desperate for someone to help me. I simply can't walk away from that need in others."
On a narrative level, The English Surgeon is the story of the fateful encounter of three men -- Marsh, Kurilets and Marian Dolishny, a young and poor Ukrainian from the rural western part of the country. Dolishny has a brain tumor that causes extreme epilepsy and is slowly killing him, and his last hope is Marsh. The young man has been told that his tumor is inoperable, but Marsh believes he can save him. Doing so, however, requires that Dolishny be awake throughout the entire operation -- a dramatic and unforgettable scene captured by three cameras inside the operating theater.
The emotional climax of the film is Marsh's journey to visit Katya, the mother of Tanya, the young girl he tried years ago to save and whose death haunts him most. Marsh shares an emotional meal with Katya and then visits the beautiful country cemetery where Tanya is buried. In this wrenching moment, with nothing but the wind and the crows around him, this highly accomplished and deeply reflective man confronts the pain that comes with failing as a doctor. Ultimately, Marsh treats this pain with the only antidote he knows -- a renewed dedication to helping others with his special skills.
"Henry's dilemma is one of his own making; that is what's so interesting about his story," says director Smith. "It's what lets his troubled and compassionate humanity through, and moves him to continue an often painful struggle to do good things in this selfish and flawed world. This is ultimately not a medical film, nor is it a portrait of a saint. Rather, it is about a man who openly wrestles with moral and ethical issues that touch every one of us."
The English Surgeon is an Eyeline Films and Bungalow Town production for BBC and ITVS International.