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Internal Medicine: A Doctor's Stories, by Terrence Holt
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"[Terrence Holt] is Melville + Poe + Borges but with a heart far more capacious." (Junot Díaz)
Out of the crucible of medical training, award-winning writer Terrence Holt shapes this stunning account of residency, the years-long ordeal in which doctors are made. "Amid all the mess and squalor of the hospital, with its blind random unraveling of lives", Internal Medicine finds the compassion from which doctors discover the strength to care.
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.
- Sales Rank: #49497 in Audible
- Published on: 2015-04-24
- Format: Unabridged
- Original language: English
- Running time: 443 minutes
Most helpful customer reviews
12 of 13 people found the following review helpful.
INSIGHTFUL LOOK INTO A RESIDENTS LIFE
By Patricia Kershman
As a retired medical transcriptionist, I found this book enjoyable and well written. What was really "scary" to me was the fact that these Residents work so many long back to back shifts caring for humans and making life threatening decisions regarding someones body. The AMA really needs to change and stop this practice of working residents and interns on back to back 24 hour shifts. Who does it help? A "good read" for anyone who has worked with doctors and nurses in hospitals.
11 of 12 people found the following review helpful.
A healing touch for a weary reader
By Susan Bodiker
A combination of Chekhov and Hawthorne...haunting, beautifully written stories about doctors, patients and life. I treasured every word.
9 of 10 people found the following review helpful.
"I have tried, more than anything else, to be faithful to the inner life of medicine."
By E. Bukowsky
Terrence Holt wrote "Internal Medicine" over a period of ten years after he completed his residency. Many doctors who produce books about how they honed their skills insist that everything they tell us is basically true, except that they changed names and identifying characteristics to protect their patients' privacy. Holt, on the other hand, claims that he can do justice to his subject only " by transforming it into a parable." The author creates scenarios that encapsulate what he learned during his training. The patients he describes are "assemblages drawn from a variety of sources, compiled from multiple cases."
This introduction almost persuaded me to put "Internal Medicine" down without going further. After all, I crave verisimilitude--not flights of fancy--in works of non-fiction. I persisted out of curiosity, and found Holt to be a gifted and sensitive writer who captures the terror, uncertainty, exhaustion, and exhilaration that medical trainees must feel while they stumble along, trying to acquire experience, knowledge, and self-confidence.
Holt evokes the vulnerability of a patient who is wheeled into the emergency room and left on a gurney for hours, has terrible symptoms and waits in trepidation for his prognosis, and senses that that a cure is unlikely--there may nothing more that anyone can do. In addition, Dr. Holt takes us on rounds; consults with other doctors and nurses; wracks his brain to come up with correct diagnoses and a sensible treatment plans; responds to codes; tackles the unenviable task of informing families that their loved ones have passed on; and uneasily navigates the twilight zone between life and death.
There are also bizarre passages about uncooperative individuals who are both mentally and physically ill, a tormented oncologist who blithely ignores the Hippocratic Oath, and a woman whose face is disfigured, but derives comfort from the sight and sound of birds. Certain sections are contrived and melodramatic, and may displease readers who prefer realism to fabrication. Still, "Internal Medicine" packs a wallop. It is a powerful, engrossing, and often dispiriting exploration of how physicians deal with (or fail to deal with) the demands of their challenging profession.
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