Frank Huyler may be competent as a physician, but he excels as a writer. These 28 medical tales, subtitled "True Stories from the Emergency Room", have been lightly sprinkled with a fictive coating and honed to a skeletal starkness that renders them as fleeting as cinematic takes. Chronologically following his early career from medical student to 32-year-old hospital doctor in Albuquerque, New Mexico, his evocation of a frequently harsh learning curve exposes space and stillness even in the claustrophobic intensity of ER. As an intern, he stitches a man's gashed face, and returns the next to day to admire his handiwork, only to realise, after a while, that it's now the face of a corpse. He saves another man's life by plunging a needle in his chest to relieve air pressure, then returns later, "savoring him, taking something for myself".
Such conventional heroic acts are balanced, if not exceeded, by mistakes. He misses a broken neck, and nearly kills a man by giving him antibiotics to which he's allergic, but he learns the value of instinct. The distance between the flesh and the person is constantly borne out: people he knows intimately, inside out literally, regain consciousness only to meet his attentions with blank indifference. It's enough to test the most durable soul, and it does. A fellow student murders his partner, and a neurosurgeon maintains a serious drug habit, practises voodoo and sleeps wantonly with bodies denuded of emotion. Blue is the colour, of their moods and the flesh and innards that splatter their working day. Huyler himself, in one of the bleakest moments, passes on the possibility of a relationship with a colleague, feeling only "this vacancy, this spending cold".
Predictably, critics have cited Raymond Carver and Chekhov in their praise. Huyler's writing stands the comparison. In his heady, sleep-deprived intensity, he seeks out poetic truths rather than clinical ones, reaching them through the visceral, and exposing them to our glance. The Blood of Strangers represents a brilliant, precocious debut, best taken whole, though probably not before meals. --David Vincent
--This text refers to an out of print or unavailable edition of this title.
Review
'Unforgettable.' Sunday Times 'Set to become a classic.' Independent 'A breathtakingly brilliant portrait, sketched so elegantly that if it were done in pencil it would only consist of a few sharp lines.' The Times 'One of the best writers to emerge since the death of Raymond Carver. He moves medicine out of the realm of science and into the domain of humanity.' Red 'Dr Huyler's short, intense book treats of only the most important matters: life and death. This is a young writer with a big mind and an even bigger heart.' Paul Auster 'If Raymond Carver had been a doctor, these are the stories he would have written. There are no untarnished heroes here. This is the world as it is: lovely and disturbing all at once.' Atul Gawande, New Yorker
Meditations on the human condition: an unusual series of quiet, concentrated stories from an emergency-room physician. Huyler is a published poet and surgeon in Albuquerque, N.M., and he doesn't have to shout to get his message across. Dramatic, desperate, baffling events abound, and Huyler easily draws us into the picture: a man transferred from prison, in a coma for weeks, with Huyler about to withdraw life support - watched by guards, family, and hospital staff. "He always looked the same, covered with tattoos, his arms pockmarked by years of shooting heroin and cocaine, his eyes half open to the ceiling, kept alive by the ventilator. . . . He was in for murder. Forty-five years old, with an abscess in his heart from shooting contaminated blood into his veins, it had finally come to this: my shift, my night on call, my job to turn him off." There are some intriguing oddities here: Huyler's medical-school anatomy-lab partner is arrested for murdering his lover; a catastrophically injured rodeo rider in the intensive-care unit completely recovers in spite of being treated on alternate days with either benign neglect or medical full-court press, depending on which of two attending physicians is on call. Throughout, Huyler's basic respect and admiration for others shows; he likes patients who are brave in the face of disaster - old women facing dire surgery who say they understand, "who smile and pat my hand and tell me to send their children in. I like the men who flirt with the nurses even though the EKG is unmistakable." And in the end, Huyler sums up the only lesson: "Odds whisper around us, wheels turn, molecules whir like bobbins. And then, maybe once or twice in our whole lives, events conspire, statistics align with the force of diamonds, against us, and they knock us out, there is no chance, the wind blows through us, we're gone." Utterly engrossing, moving, poetic accounts. (Kirkus Reviews)
Atul Gawande, New Yorker
'If Raymond Carver had been a doctor, these are the stories he would have written. There are no untarnished heroes here. This is the world as it is: lovely and disturbed all at once.'
--This text refers to an out of print or unavailable edition of this title.
Product Description
This collection of stories reveals a side of medicine where small moments interweave with the lives and deaths of the desperately sick and injured. It presents an array of characters - a trauma surgeon who unexpectedly commits suidice, and a man chased across the desert by a heat-seeking missile.
About the Author
Frank Huyler is an emergency physician in Albuquerque, New Mexico. His poetry has appeared in various journals and magazines in America. He is 33.
Excerpted from The Blood of Strangers by Frank Huyler. Copyright © 2001. Reprinted by permission. All rights reserved
THE PRISONER . "WHY DON'T WE PLAN ON withdrawing support tonight," the attending said, to settle the matter. "We'll give his sister time to get here." The sister was already driving, the family said, south from Colorado. She understood the urgency. The rest of the family had gathered for days, shuffling in to talk to him as he lay there on the ventilator. The guards were sick of them, bored, reading magazines in his room. It was protocol; all prisoners needed to be watched.
During the last few days of his life Mr. Garcia was watched all the time: by his family, by the prison guards, by nurses, by interns, and by me, the resident. He always looked the same: covered with tattoos, his arms pockmarked by years of shooting heroin and cocaine, his eyes half-open to the ceiling, kept alive by the ventilator. On his chest, stretching from nipple to nipple, was the green figure of the Virgin Mary, her hands pressed together in prayer.
He was in for murder. Forty-five years old, with an abscess in his heart from shooting contaminated drugs into his veins, it had finally come to this: my shift, my night on call, my job to turn him off.
The attending tried to be gentle with the family. "There's really nothing more we can do," he said, predictably. "His heart is not working any more, and he has abscesses all over his body, even in his brain." At some level they must have understood that their brother, father, and son was a drug addict and a murderer dying a slow death by his own hand, but that was not how they spoke of him. They talked reverently of the good life he had led, how he had suffered, how it was time to let him go, where he could rest in peace with the Lord. His daughters, young women with small children, cried, his mother cried, his brother shook his head, and the small waiting room outside the ICU filled with the sound of them long after we gravely shook their hands and left.
That night, tired as I was, their glib revision of him infuriated me. Their grief was real, but the words they used to describe it were not. It was a eulogy for another life, another man, a action, a wish. My anger was disproportionate, unseemly, I knew; but I was tired, I told myself, of staying up all night with bleeding alcoholics, overdosing drug addicts, murderers, and gang members, and I was tired of families who remade history for the convenience of personal loss. I was sick of giving my sleep and my thoughts to them.
But I did not want to turn Mr. Garcia off. The sister arrived, and the time came. The family crowded into the room, paying their last respects with Father Rivera, whose absolution I could hear as I waited outside. The attendings and residents from the day shift had gone. I had been left to do the job alone.
I leaned against the wall. My hands were shaking and weak where they rested on my thighs. I felt breathless and light-headed. By morning the man had to be dead. Otherwise there would be questions about costs and staffing, questions about me. It had to be done, but I put it off anyway. I checked on the other patients, called the laboratory, called my girlfriend. I would do it. He was hopeless, it was better for him, I wouldn't want that for myself, it wouldn't make any difference in the long run, he was expensive. Still an hour passed. Finally his nurse came up to me.
"I've drawn up two hundred milligrams of morphine," she said. "The family is in the waiting room."
The guard watched with interest. "How long do you think he'll last?" he asked. "I don't know," I said. "It's possible that he'll live for quite a while."
He was unchanged, lying still in the bed, exactly as he had been for the past weeks when we had been trying to save him. "Should I start the morphine?" the nurse asked.
I nodded. "Give him a fifty milligram bolus."
She pushed the syringe, and nothing seemed to happen. We waited a few minutes. The guard was rapt. "OK," I said. "Extubate him." She disconnected the ventilator, hit the button to silence the automatic alarms, and pulled the tube out of his mouth.
At first nothing happened. Then faintly he began to gasp for breath, his mouth forming a dark circle. "Give him some more," I said, and she did. The gasping slowed, eased by the morphine, and finally stopped. His heart was a different matter; it kept going, in strong, regular blips on the monitor, on and on for minutes until finally it too began to weaken. Strange rhythms appeared, a whole language written in the jumping green light: sinus bradycardia, idioventricular bradycardia, ventricular tachycardia, sinus bradycardia again, ventricular fibrillation, then astonishingly normal beats, more fibrillation, and finally the flat, faintly undulating line, unreeling for long minutes as we watched him.
His family met me at the door.
"He didn't suffer at all," I said. "It was very peaceful." They agreed with me. --This text refers to an out of print or unavailable edition of this title.
