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Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for new media
One of my dictionaries defines stories as usually true but not necessarily so. Dr Huyler's "stories" are presented as nonfiction autobiographical sketches. Most are less than three pages long, and in my opinion the shorter ones are stronger than the longer ones, which blend two or three story lines. Although the title describes these as stories dealing with emergency medicine, some date from the author's days as a medical student and resident on various other hospital services, such as intensive care and pathology. In the latter, his study of suicide awakens memories of a tragedy in his own family.
Superior literary quality is maintained through all 28 vignettes. In "A Good Scar," the intern is chosen to suture a huge face wound because the patient is not expected to live. In "The Virgin," she is not. "Needle" concerns a tension pneumothorax relieved. I especially empathized with "A Difference of Opinion" in which the author describes the "bizarre dynamic" of housestaff caught between the dictates of two alternating attendings, one who believes the patient is not salvageable and one who insists on "the full-court press."
Most physician readers will find the material familiar, strong, and evocative but not very surprising and will feel that they largely have been there. But, oh, the ability Huyler has to present the essence of common medical experience in transcendent, poetic prose, the stuff of the permanent memories of every doctor. Nonphysician readers will also appreciate the stories in their reality and their succinct and beautiful expression.
Included among the dramatis personae are several physicians who had intolerable frailties such as drug abuse. It is a relief that those who succumbed to chemical or sexual excesses, with which hospitals are traditionally thought replete, were nevertheless excellent and even talented caregivers whose care was never compromised by their addictions. One was a surgeon whose ditched paramour besieged him with audible, highly sexual beeper messages while he was on rounds with the housestaff: "His pager took both numbers and voices. It was a little black card on his hip, with a green diode and a screen. It weighed almost nothing, and could vibrate or ring. He wore it all the time. The world entered him through it." After several explicit and deliberately inopportune pages, the surgeon, pragmatic as all physicians, changed to a beeper that took only numbers.
The only evidence in MEDLINE that Dr Huyler has written other medical material is an article about care in Nepal. He has had his poetry published in such periodicals as The Atlantic Monthly. The jacket of Huyler's book is illustrated with a photo from another book entitled The Knife and Gun Club: Stories From an Emergency Room. I liked Huyler's short stories much better; they are less cynical, and no less real.
I hope Dr Huyler will continue to share his experiences in medicine with us.
Stories: The Blood of Strangers: Stories From Emergency Medicine. JAMA. 2000;283(16):2171–2172. doi:10.1001/jama.283.16.2171-JBK0426-5-1
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