Internal Medicine: A Doctor's Stories

A BookPage Best Book of 2014

“[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.