Internal Medicine: A Doctor’s Stories By Terrence Holt
Liveright Publishing Corporation 288 pp.

A woman swallows needles. A man can’t remember that he’s been diagnosed with cancer. Another has a metal halo screwed into his skull. On the surface, these could be standard hospital storiesplotlines on a TV emergency-room drama. But in Terrence Holt’s capable hands, they delve much deeper.

Holt is a geriatrician and professor at the UNC School of Medicine. His new book of short stories, INTERNAL MEDICINE: A DOCTOR’S STORIES, follows a physician through the grueling years of his residency vis-à-vis his fleeting relationships with patients. At a recent reading, Holt said that wrote this book partly to disprove what TV shows would have us believe about hospitals: that they’re rife with meet-cutes and dramatic solutions, and that lives are usually saved. He wanted to convey what it’s really like to be a doctorthe confusion, the frustration and, most of all, the frequent sense of futility.

“Here’s a sad story,” Holt said before reading “The Perfect Code,” where a doctor longs for peace amid the relentless demands and incessant noise of the hospital. “Well,” he added, “I guess all of these stories are sad.”

Holt came onto the scene with his nationally acclaimed 2009 debut In the Valley of the Kings, a collection of literary fiction with shades of Edgar Allan Poe and H.P. Lovecraft. Though Internal Medicine is a bit more down-to-earth, Holt stays true to his lyrical ruminations on life, death and humanity, which flit through stories about bodies, illnesses and intravenous drips. That shouldn’t come as a surprise: In hospitals, such ruminations are inescapable, and Holt is the perfect person to explore them.

Each story focuses on a patient and his or her ailment. Harper, the doctora stand-in for Holtdevelops a relationship with the patient and tells of the illness, the treatment, the family, the breaking of bad news. Each story is like a case studyin medicine, but also in the human condition. The endings unfurl delicately to make us catch our breath and contemplate the bizarre, complex ways in which we live and die.

Of course, there is plenty of medical talk amid the poetic flourishes. In attempting to portray hospitals as they really are, Holt doesn’t shy away from jargon, providing a steady stream of abbreviations, instruments, medicines and scattered doctor’s notes.

Doctors and med students are bound to appreciate this book, but by no means is it only for those in the profession. Internal Medicine should speak to anyone who has considered questions of mortality, interpersonal connection or what we’re really doing on this planet. In short, it’s about being a person and all that entailsphysically, spiritually and emotionally. Beneath the harsh glare of hospital lights, it’s a beautiful shot in the arm. Iza Wojciechowska

Living Wages
By Michael Chitwood
Tupelo Press; 84 pp.

On the cover of Michael Chitwood’s latest book of poems, LIVING WAGES, a rusty old hand planer floats in a void. The image distills the book’s artisanal tone as well as its subject matter, the rituals and implements of labor. Labor of a certain type, anyway.

Chitwood, a UNC English professor who has published many volumes of poetry, is like Billy Collins by way of Ron Rasha friendly, plainspoken companion on the wandering byways of Appalachia. He comes from rural Virginia and has worked on construction sites and in textile mills, and you will find no laptops or syllabi here. Instead, there are odes to rakes, ladders, engines and cranes. Ordinary subjects are addressed in a clear, direct voice. The lines feel warm and woody, hewn by hand, each cut to fit its neighbor.

From domestic chores to blue-collar construction, Living Wages is concerned with the vocationssometimes rough, sometimes sacred, always unglamorous and hiddenthat keep whole ways of being alive. A construction worker curses at his “shovels, digging bar, mattock, pick.” A crew attends to a train under the cover of night. Chitwood becomes fascinated by how things work, but his true subject is what the cover leaves out: the people who use the ingenious devices, and how the things they rearrange the world with secretly rearrange them.

The book is colloquial in style, but its nimble phrasings and mutable concepts transcend the stock Biblical cadences, bucolic B-roll and folksy mannerisms of “Southern poetry” as a category. In “The Stairs,” an elderly woman remembers her younger self while putting up preserves. Chitwood deftly executes the conceit of writing about a hallway as if it were a stairway, evoking the long-term costs of domestic labor. The refrain “This could be done if done slowly” tolls through naturalistic lines, and a sonnet can be heard faintly beating in the background, sometimes almost breaking the surface: “each step a rest, / each one a chance to catch her breath, / to steady and study ankle and wrist.”

The richest poems use labor to probe familial dynamics from the vivid vantages of childhood, those “happy days full of meaningless shouts.” In “Handle,” a young narrator distractedly helps his annoyed father hang a door, wondering, “Isn’t it odd that use is what keeps the hinge vital?” but leaving tacit that through use, it breaks. “Finish Work” unpacks finely drawn metaphors and aphorisms from the life of a furniture-making grandfather who “ran his hand along a finish to know that it was done.” And “Repair,” the best poem in the volume, melds a stark memory of the zoo into a present tense where a heavy light becomes a burning hawk in a boy’s arms as his father repairs an engine. It’s an ecstatic transfiguration.

This profound and dreamy aura of memory, all thick gold light and cold crisp dark, is concentrated in the first and last sections. The heavy machinery is wheeled out in the middle, where hulking, noisy construction vehicles and chatty blue-collar characters take over. While the underground pipes that they bury lead to insights on the human condition, some of these poems feel narrower and more prosaic than the others. There are descriptions as thorough as operating manuals; I feel like I could maybe drive a backhoe now.

But with “The Song,” where various squeaks of transition (a grandmother’s sewing machine treadle, a father’s rolling IV drip) are linked with the squeak of a boy’s wagon, his “little load of nothing,” we come back into more ample terrain: life and death, youth and knowledge, use and obsolescence, all in a day’s work. Brian Howe