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Internal Medicine: A Doctor's Stories [NOOK Book]


“[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.


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Internal Medicine: A Doctor's Stories

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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.

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Editorial Reviews

The New York Times Book Review - Danielle Ofri
…this book illuminates human fragility in tales both lyrical and soul-wrenching…Holt dissects the medical experience in exquisite and restrained prose.
Publishers Weekly
★ 05/26/2014
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.)
Dr. Vincent Lam
“Where do the brutal limitations of our mortal selves meet the grace of kindness? Where do simple observations of the progress of lives become a spare human poetry? Perhaps nowhere more so than in the practice of medicine, and in the finest of writing. These are the remarkable occurrences that fill and enrich Terrence Holt's elegant and heart-rending memoir.”
Chris Adrian
“In Internal Medicine Terrence Holt has written a guided tour of a very particular hell, the 'Inferno' of medical training. This is a trenchant and devastating book but, miraculously, not a dispiriting one. Holt's beleaguered resident makes us gaze with him into abysses of every sort of physical, emotional, and spiritual pain, and yet what we feel with him, at the end of every story, is a resilient, exalting love of the world and the people doomed to suffer in it.”
William Giraldi
“In its undaunted vision of our plight and promise as a fallen race, its intricate rhythms of tenderness and pain, the torque of its knowing, Internal Medicine is an uncommon, lovely work of art. I feel myself expanded and enlarged by it. Holt's integrity and intelligence are gifts that alter how we view the wreckage and wonder of our lives.”
Danielle Ofri - New York Times Book Review
“[T]his book illuminates human fragility in tales both lyrical and soul-wrenching…. Holt dissects the medical experience in exquisite and restrained prose.”
Alice Cary - BookPage
“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… 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.”
Dennis Rosen - Boston Globe
“Holt, who also holds a master’s in fiction writing and a PhD in literature, is an excellent story teller… [T]he portrait Holt offers is artful, unfailingly human, and understandable.”
Kirkus Reviews
★ 2014-07-27
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.
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Product Details

  • ISBN-13: 9780871408808
  • Publisher: Liveright Publishing Corporation
  • Publication date: 9/8/2014
  • Sold by: Barnes & Noble
  • Format: eBook
  • Pages: 240
  • Sales rank: 32,678
  • File size: 512 KB

Meet the Author

Terrence Holt is a writer and an internist specializing
in geriatric medicine, teaching and practicing at the
University of North Carolina in Chapel Hill.
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Customer Reviews

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  • Anonymous

    Posted October 5, 2014


    Fallingkit looked around at the amazing sight. There eas every herb she could think of ! She paused infrot of some yarrow. "Yarrow." She said to her self.

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  • Anonymous

    Posted October 7, 2014


    This outstanding and quickly growing Clan was one of a select few to be invited to the gathering at 'wings of fire'! The moon is bloodsoaked. <p> ~|Directed to MedClan|~

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