INTERNAL MEDICINE

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.