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.