Internal Medicine: A Doctor’s Stories

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Title: Internal Medicine: A Doctor’s Stories

Author: Terrence Holt, MD

Publisher: Liveright Publishing Corporation

Publication Date: September 2014

Price: $24.95; hardcover, 288 pages


“This book is the story of a residency in internal medicine. I wrote it over a period of 10 years, beginning just after my own residency ended…. I wrote this book primarily in an attempt to make sense of the process of becoming a doctor.” So begins the introduction of Internal Medicine: A Doctor’s Stories, the compelling new book by Terrence Holt, MD, a professor and internist at the University of North Carolina, Chapel Hill.

Dr. Holt is an accomplished writer. His previous book, In the Valley of Kings: Stories, was a finalist for the PEN/Robert W. Bingham Award for distinguished literary achievement, His abundant talent is on full display in each of the nine chapters in this concisely drawn book, which entices the reader to travel along with the young intern as he journeys through the corridors of medicine, capturing the drama of sickness, suffering, and death.

The book opens on Dr. Holt’s first call night as an intern, when he runs into Dr. M, one of the senior attendings he’d known for years. Dr. Holt writes, “How’s it going?” he asked me. I told him I was on call. “First call?” He smiled. “I remember my first call. About 10 o’clock that night, my resident said to me, ‘I’m going to be just behind that door. Call me if you need me. But remember—it’s a sign of weakness.’”

Medical School Is Over

Dr. M’s message, although delivered tongue-in-cheek, is loud and clear: Medical school is over. And from the onset, the reader feels the pulse and heartbeat of the hospital wards and the “frantic milling about that makes up an intern’s day.” This is real-life medicine and doctoring right down to the futile reality of watching patients die and not being able to do a damn thing about it. A 26-year-old woman with scleroderma is in respiratory distress, but she refuses to wear an oxygen mask because it makes her “feel claustrophobic.” As the night progresses, she begins to fade, and the interplay between the young doctor and a seasoned nurse is at once tender and perfunctory in its depiction of the hospital ward reality.

At one point, Dr. Holt puts the young patient’s oxygen mask on his own face, inhaling deeply to rejuvenate himself from fatigue. “I can’t breath,” says the young woman, as Dr. Holt places the mask back on her face and deftly brings her to life on the pages. “The light in the room was golden, the late sun of the July evening slanting through the high window. The face that turned to me had a stretched and polished look, her features immobile, the entire effect disturbingly like a doll’s face … only her eyes were mobile, following me as I moved.” She died during the night.

Whether at the bedside of a hospice patient in a chapter called, “The Surgical Mask,” or in the nightmarish world of the psychiatric hospital depicted in the chapter, “Iron Maiden,” the doctor-patient relationship is fully realized, revealing how human complexities and vulnerabilities are the foundation of caring for the sick. Internal Medicine: A Doctor’s Story is the unvarnished story of what it means to be a doctor—and to be human. Every doctor can relate to the gritty and tender stories in Dr. Holt’s impressive book. The beleaguered intern’s narrative is a gripping read from cover to cover. ■