Review by New York Times Review
Given the epidemic of doctor-writers out there, one could be forgiven for assuming that a book titled "Internal Medicine: A Doctor's Stories," written by a practicing physician, would be a work of nonfiction (and indeed, it is being marketed as such). But in the introduction, Holt writes that he is "recreating experience as parable," in part to protect his patients' privacy. Now, if fiction is indeed the lie that tells the truth, does it really matter whether these stores are strictly nonfiction or partially fiction? I can certainly vouch for the clinical and absurdist accuracy of Holt's description of medical residency. But still, one might want to know whether the hospice patient whose face had been eroded by cancer really did have to square off with Bible-thumping church ladies while a Greek chorus of cranky castaway parrots protested loudly. Or is this just a brilliant, hyperbolic way of highlighting "the squalor" of medicine and the "blind random unraveling of lives"? Whatever the case may be, this book illuminates human fragility in tales both lyrical and soul-wrenching. "One of the essential skills in residency," our narrator informs us, "is a capacity to forget." Indeed, blocking out some of the more traumatic experiences of training is a key survival skill. Luckily, Holt has not forgotten, and he recreates, for example, the harrowing desperation of an intern's first night on call. The doctor - called Harper - is paged to see a patient with shortness of breath, whom he knows only from a few scrawled words on a colleague's sign-out sheet Harper dutifully troops to the bedside and finds himself mired in the existential panic that breeds in the dead of night when you are skin-to-skin with the inscrutability of human pathology and it seems as if morning will never arrive. In the end, it doesn't seem to matter much if the book is fiction or nonfiction. Holt dissects the medical experience in exquisite and restrained prose.
Copyright (c) The New York Times Company [September 7, 2014]
Review by Booklist Review
Nine linked stories reveal the emotional, cognitive, and professional transformation of Holt's doctor-narrator, beginning as an intern taking calls on his first night and concluding as a physician practicing medicine in a small community. What happens in between his three-year internal medicine residency is remarkable and haunting. Holt, a physician and accomplished writer, capably depicts the culture of medical training, the hospital universe, and the inner workings of medicine. He describes breaking bad news to patients, being perceived as weak when asking for help, and having trouble threshing out the truth. Some of the characters are heartbreaking: a middle-aged woman painter whose face is gobbled up by squamous cell cancer, and an elderly man with a broken neck who is successfully resuscitated following a cardiac arrest but never regains consciousness. Holt reflects on the bedlam, misery, emotional numbness, and need for selective amnesia during residency training. For doctors, caring too much is risky, but not caring enough is unforgivable. An unforgettable story collection.--Miksanek, Tony Copyright 2014 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
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.) (c) Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Kirkus Book Review
Think you've heard it all about the grueling, fatigue-driven years suffered by interns and residents once they get their degrees? Think again. Holt (In the Valley of the Kings: Stories, 2009) came 20 years later to medicine than most of his peers, choosing a writing career first. Whatever the reasons for that latter-day commitment, the result is a beautiful, riveting book that puts readers on the spot in the ward, in the ICU, making the rounds, talking to families, making hospice calls and participating in the "bedlam" of a "Code Blue" resuscitation. What Holt set out to do was to convey the "un-narratibility" of hospital life ("too manifold, too layered, too many damn things happening one on top of the other") in parables that would condense and transform the experience, as he himself was transformed. To that end, he uses composites of many different cases. In the process, he has created unforgettable portraits of the gravely ill or dying: the obese woman hospitalized for a "tune-up" to rid her body of excess fluids; the young woman who should have died from too many Tylenols but was saved by a liver transplant; the hospice patient whose face was covered by a surgical mask to conceal the loss of most of her lower face to cancer. "Nothing happens in these pages that doesn't happen every day in a variety of ways in hospitals everywhere," writes the author. "I have had to simplify what defied narrative form, and alter or suppress whatever might have compromised the respect patients deserve. But in making sense of residency within the constraints of narrative form and human decency, I have hewed as closely as possible to the lived reality of the hospital." Holt says that he wrote the book over a period of 10 years. Let's hope for a shorter duration before we next hear from this gifted writer/physician. Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
