Holt's debut collection of short stories, In the Valley of the Kings , was praised by the New York Times Book Review as one of "those works of genius" that "will endure for as long as our hurt kind remains to require their truth." Now he returns with Internal Medicine --a work based on his own experiences as a physician-- offering an insider's access to the long night of the hospital, where the intricacies of medical technology confront the mysteries of the human spirit.Read more...
Holt's debut collection of short stories, In the Valley of the Kings, was praised by the New York Times Book Review as one of "those works of genius" that "will endure for as long as our hurt kind remains to require their truth." Now he returns with Internal Medicine--a work based on his own experiences as a physician-- offering an insider's access to the long night of the hospital, where the intricacies of medical technology confront the mysteries of the human spirit.
"A Sign of Weakness" takes us through a grueling nightlong vigil at the bedside of a dying woman. In her "small whimpering noises, rhythmic, paced almost to the beating of my heart," a doctor confronts his own helplessness, clinging "like a child to the thought of morning." In the unforgettable "Giving Bad News," we struggle with a man who maddeningly, terrifyingly refuses to remember his terminal diagnosis, forcing us to tell him, again and again, what we never should have wanted to tell him at all.
At the bedside of a hospice patient dying in a house full of cursing parrots, in "The Surgical Mask," we reach the limits of what we are able to face in human suffering, in our own horror at what happens to our bodies as they die.
In the psychiatric hospital of "Iron Maiden," a routine chest X-ray opens a window onto a nightmare vision of medieval torture and a recognition of how our mortality drives all of us to madness.
In these four stories, and five others, Internal Medicine captures the doctor's struggle not only with sickness, suffering, and death but the fears and frailties each of us--patient and doctor alike--brings to the bedside. In a powerful alchemy of insight and compassion, Holt reveals how those vulnerabilities are the foundations of caring. Intensely realized, gently ironic, heartfelt and heartbreaking, Internal Medicine is an account of what it means to be a doctor, to be mortal, and to be human.
- ISBN-13: 9780871408754
- ISBN-10: 0871408759
- Publisher: Liveright Publishing Corporation
- Publish Date: September 2014
- Page Count: 273
- Dimensions: 8.3 x 5.7 x 1 inches
- Shipping Weight: 1 pounds
Publishers Weekly® Reviews
- Reviewed in: Publishers Weekly, page .
- Review Date: 2014-05-26
- Reviewer: Staff
Writing to make sense of his medical residency, Holt, a fiction writer (In the Valley of the Kings) and geriatric specialist at the University of North Carolina, elegantly tells a more far-reaching tale of illness and healing in nine stories. Holt narrates through the voice of a young doctor—a composite figure, as are his “patients”—beginning with the frustrating case of a woman too claustrophobic to wear an oxygen mask and too ill to be without it, whose agonizing death teaches the doctor that no singular heroics are necessary. As a mentor advised, “There was nothing to do. But at least we could have done it together.” There’s also the heartrending story of a cancer-stricken artist in hospice, whose home full of exotic birds and oil portraits offers a rare gift, and the strange yet touching story of a patient who kept forgetting his fatal diagnosis, but would light up at the “few faces in the world he can still remember.” Each exquisitely crafted and evocative tale reveals not only the power of Holt’s storytelling, but the stark realization that for doctors and patients alike, it’s our bodies that “remain the essential mystery we keep trying to solve.” (Sept.)
Confronting a doctor's dilemmas
BookPage Nonfiction Top Pick, October 2014
Let me confess: I’m a medical book junkie. That said, Terrence Holt’s Internal Medicine: A Doctor’s Stories is my new favorite, both in terms of literary merit and intriguing medical details and drama.
Holt is uniquely qualified, having earned an M.F.A. in creative writing and a Ph.D. in English before turning to the study of medicine. Early on, he decided he wanted to write about the process of becoming a doctor. He eventually concluded that the best way to capture the essence of his journey without violating patient confidentiality was to write a series of “parables” that drew on his own experiences.
Whether or not you classify this collection of nine stories as nonfiction, they ring true in both details and spirit, starting with a doctor’s evolution from the first night on call as an intern and ending with ethical questions that a physician ponders 40 months later, his residency complete.
Holt describes telling a young woman that her death was imminent: “I’d like to say that I held her, or said soothing words. But I don’t hold female patients, even when they cry, and I had no soothing words. I knelt there and I watched her, and struggled to comprehend what I saw.”
Each account is equally compelling and thought-provoking. The narrator faces a dying woman who needs oxygen but finds the mask claustrophobic; an artist whose mouth and jaw have been eaten away by cancer; a mental patient whose mysterious but horrifying self-inflicted pain needs to be identified; and a young woman who arrives in the ER but has already, as it turns out, begun the act of suicide.
How can a doctor help patients such as these? What should or shouldn’t a physician do? How do doctors feel when confronted with such daily dilemmas and myriad personalities?
Dr. Holt never settles for easy answers, and the questions he poses—reflecting the frequent uncertainties of doctors and patients alike—will leave readers thinking long after the final page is turned.