“A revelation.” –The New York Times
“Brutal and brave, DeForest's novel is one of the best in the ‘making of a doctor’ genre. And its plucky protagonist, casualty and hero, roars a universal truth, ‘We all hurt.’” ―Booklist, starred review
A Lit Hub Most Anticipated Book of 2022
A Publishers Weekly “Writer to Watch”
A young woman puts on a white coat for her first day as a student doctor. So begins this powerful debut, which follows our unnamed narrator through cadaver dissection, surgical rotation, difficult births, sudden deaths, and a budding relationship with a seminarian.
In the troubled world of the hospital, where the language of blood tests and organ systems so often hides the heart of the matter, she works her way from one bed to another, from a man dying of substance use and tuberculosis, to a child in pain crisis, to a young woman, fading from confusion to aphasia to death. The long hours and heartrending work begin to blur the lines between her new life as a physician and the lifelong traumas she has fled.
In brilliant, wry, and biting prose, A History of Present Illness is a boldly honest meditation on the body, the hope of healing in the face of total loss, and what it means to be alive.
Palliative care physician DeForest delivers a reflective debut about cadavers, family trauma, and perplexing ailments. During the unnamed narrator's term as a medical student, she tries to process her experiences as well as her history of abuse and neglect. She spends a lot of time by the bed of Ada, a younger woman with a slow encephalitis. Throughout, the narrator offers arresting reflections on the godlike powers doctors hold over their patients ("No one even dies until we let them"), on the desensitization that comes with seeing so much pain and death, and the pressure and competitiveness that often pushes residents to self-harming behaviors. Fascinating medical facts abound (for example: during an autopsy, fixative is used on the brain to preserve it), along with disturbing passages about the narrator's stepfather, who would lock her and her siblings in the basement. The tone remains detached, creating an atmosphere that echoes the narrator's "mechanical existence." There's not much of a story, but DeForest does a great job conveying the impact of the surroundings on her narrator, as well as how she learns the value of honesty with patients' families, after giving Ada's husband the unvarnished truth about her fate. This slim volume gives readers much to contemplate. Agent: Sarah Burnes, Gernert Company. Correction: An earlier version of this review mistakenly referred to the book's narrator as a medical resident.