Times Online

Ben Hoyle, Times Arts Reporter

Henry Marsh, a leading British neurosurgeon who spends his holidays working 18 hour days for free in a Kiev operating theatre, must remove an enormous tumour from the brain of a Ukrainian man who will otherwise die.

Anaesthetic is too risky so the patient is kept awake while a hole is bored through his skull using a second-hand household drill with a flat battery.

Mr Marsh then performs the surgery, mindful that the slightest slip will kill, paralyse or alter Marian’s personality forever.

It is the pivotal moment in a documentary which has its world premiere at the festival on Tuesday and is by turns funny, frightening and deeply moving.

The English Surgeon grew out of Your Life in Their Hands, a BBC series which won a Royal Television Society award three years ago.

.Mr Marsh has been a regular visitor for 15 years having been appalled on his first trip by tumours that have not been seen in the West for “50 or 60 years.”

He forged a friendship with Igor Kurilets, an idiosyncratic Ukrainian neurosurgeon who has survived death threats and attempts to discredit him by the government and the KGB.

Their relationship and Mr Marsh’s unflinching honesty about his profession are what elevate the film far above a routine medical documentary.

Neurosurgery is as much about moral choices as it is about science he believes. A patient is essentially “playing Russian roulette with two revolvers”- the danger of operating and the danger of not operating- and he is deeply burdened by an episode in the past where he feels he took the wrong option.

His workload in Kiev and the procession of patients for whom his expertise has arrived too late leaves him frustrated and unhappy. He consoles himself with the thought: “What are we if we don’t try to help others? We are nothing, nothing at all.”

However he also admits that he finds the high stakes of life or death surgery thrilling.

“Surgery is not just about rational altruism,” he says just before the crucial operation. “It’s a blood sport in a way. Surgeons become surgeons for the excitement of it and the fierce joy of operating.”

The film will screen on BBC2 next year but Mr Smith is hoping to tie up a theatrical distribution deal at the film festival. Advance “buzz” around the film is encouraging with one critic already suggesting that it is “crying out for a proper cinema release.”

THE ENGLISH SURGEON.

Produced and directed by Geoffrey Smith.

Eyeline Films / Bungalow Town / BBC Storyville.

Best International Feature, Hotdocs 2008.

Best World Feature Documentary, Silverdocs 2008.

Time Out London

Trevor Johnston

Neurosurgeon Henry Marsh faces life-or-death decisions on a daily basis. Removing a brain tumour from a stricken patient could save their life, but the risks of the procedure could also kill or handicap them.

Testing enough to face this in a top London hospital but the ever-charming Marsh also helps out for free in the Ukraine, where the paucity of resources make the choices even starker.

Made for the BBC’s ‘Storyville’ strand, this is one extraordinary documentary, approaching hugely emotive subject matter with nimble delicacy and, it has to be said, steely reserve when it comes to filming a brain operation performed under only local anaesthetic. A life-affirming, unforgettable portrait of a true humanitarian, it’s crying out for a proper cinema release.