Terrence Holt sat close as his father lay dying in a hospital bed. He leaned in and told his dad that he was going to be a doctor. “He couldn’t respond,” Holt remembers. “He just gasped for air. I think he heard me. I don’t know.”
Photo by Jason Smith. ©2010 Endeavors magazine.
Click to read photo caption. Photo by Jason Smith. ©2010 Endeavors magazine.
His father was the first person Holt told. For an entire year he had let family and friends think that he was working on a book. In reality, Holt was a premed student.
“I was thirty-nine years old,” Holt says. “I didn’t tell anyone I was changing careers because I wasn’t really sure I could do it. Even my mother was shocked.”
Holt had been teaching literature and creative writing happily at Rutgers University for ten years when he walked away. Today, he walks the halls at UNC Hospitals, stethoscope dangling around his neck, taking care of our fathers and mothers. He’s a geriatrician. And that was supposed to be the end of that story.
But along the way the plot took another turn. Being a doctor inspired Holt to write again. And thanks to a former student’s persistence, Holt did write a book — and published it to rave reviews.
Holt can’t recall a time when he wasn’t coming up with stories. He published his first in his elementary school “literary” magazine. “I was four years old,” he says. “I couldn’t write. Someone must have transcribed it. It was about a rocket taking off.” Space travel would play a role in Holt’s writing for years to come.
He majored in English and then pursued a master’s degree at Cornell, where he jumped at the chance to take an astronomy course taught by Carl Sagan. “One of his lectures was about the Voyager mission,” Holt says. “He told us that NASA had considered dropping a probe into Jupiter’s Great Red Spot. That idea captured my imagination. It reminded me of Edgar Allen Poe’s ‘A Descent into the Maelstrom’ — the idea that at the bottom of this enormous vortex you’ll find something terribly important, something hidden since the beginning of the world.”
Walking home after the lecture, Holt began composing a short story about a man isolated on a spaceship approaching Jupiter. He called the piece “Charybdis,” after the whirlpool in the Odyssey that has come to symbolize — along with Scylla, the monster that devours Odysseus’s crew — an existence between two dangers. Holt finished the story for his master’s thesis, but he had no idea of the role it would play later in his life.
MFA in hand, but concerned that he still didn’t fully understand his craft, Holt stayed at Cornell for a doctorate in British literature. “I felt like a complete freak,” he says. “That kind of move from creative writing to literary criticism didn’t happen very often, and those two worlds didn’t speak to each other. Lots of mutual suspicion and hostility,” he jokes. “But I’m glad I did it because I found myself with a couple of job offers.”
Holt chose Rutgers and stayed there, happily, for ten years. But during his mid-thirties, Holt was forced to spend less of his free time conjuring imaginative stories and more time in hospitals. Close friends and closer relatives were battling cancer, and Holt visited them often. His father’s health was failing. Holt was there, frustrated at his inability to help.
“I watched the doctors,” Holt says. “I saw them make these huge impacts on people’s lives and I was just so terribly impressed.”
This was not Holt’s first experience watching doctors work. His father had been a doctor. His mother, a nurse. His brother, a surgeon. Holt, though, had never wanted to be a doctor. He still liked teaching. The idea of becoming a doctor just stirred inside him, he says.
Holt is emphatic about one thing: there was no epiphany that triggered his desire to change careers. “Sometimes the most important things that shape our lives happen out of our sight and out of our conscious thoughts,” Holt says. “We don’t like to think that way. We’d rather imagine we’re in control, so we invent stories with dramatic turning points, moments of decision. Life isn’t really like that.”
One day, during a routine checkup, Holt asked his own physician what she’d think of him pursuing a career in medicine.
“I think that was the first time I actually voiced the idea,” Holt says. “She gave me the funniest look.” Holt didn’t know it at the time, but his doctor was on the med- school admissions committee at the University of Pennsylvania. “And then she said, ‘Yeah, go for it.’”
Holt took premed courses at night at Penn, but immediately he encountered resistance.
“My advisor looked at my dossier and said, ‘You’re too old,’” Holt remembers. “Then she listed a bunch of medical schools that had never even looked at a student who was over twenty-five. She said, ‘They can’t admit this because it’s illegal, but it’s the truth. Here’s what you have to do: get a 4.0, and do it in eighteen months.’”
Holt thought he’d never be able to take all the biology, chemistry, and physics he needed in a year and a half — not to mention pass calculus, a subject he had failed twice already in high school and college. But he did it. He applied to several schools, including Temple University, which requested a second interview. “I thought that was odd,” Holt says. “So I asked them why, and they said that some people on the committee were concerned that I was doing all this just to collect material for a book. I laughed. I had drained my savings, put myself through no end of stress, and when my dad and my wife’s father died within four weeks of each other, I’d barely been able to take my nose out of my books to go to them. No, I wasn’t doing this for grins.”
A few schools accepted him, including Penn, whose admissions committee told him they hoped that he would write about the school. But Holt, determined to devote his life to primary care medicine, chose UNC.
Then in 1996, during his second year of med school, everything changed. Again.
Junot Díaz, one of Holt’s former students, signed with a young agent named Nicole Aragi and published Drown, an instantly acclaimed collection of short stories. Soon after, Díaz gave Aragi a copy of the literary magazine TriQuarterly, pointed her to a story that Holt had written, and said, “Here is the best unpublished writer in America.”
Aragi read “In the Valley of the Kings,” a story about a dying Egyptologist who wanted to make one last big discovery.
“I hate to talk in clichés, but that story completely blew my mind,” Aragi says. “It’s one of those stories that kept me up at night. Just so creepy and wonderful and insidious.”
TriQuarterly didn’t have Holt’s contact information, but Díaz did.
“There was no one out there writing like Professor Holt and it seemed a travesty that this genius was not being recognized,” Díaz says. “I owed him a tremendous debt. He was the writer who got me firmly planted on the road to being a writer, and as soon as I was in a place where I could help, I helped.”
Aragi asked Holt to put together a collection of short stories, which he did. There were no takers at first, but Holt wasn’t concerned; he was busy with med school and gave little thought to writing.
In 2000, the year Holt earned his MD, Aragi placed one of Holt’s stories in Zoetrope, a quarterly literary magazine founded by Francis Ford Coppola. The piece, titled “O Logos,” is a modern version of Poe’s “The Masque of the Red Death.” Full of tension and fear, it’s a story rooted much more in the unknown than the known.
Throughout his residency Holt still had little time or desire to write. When his residency ended, the first thing he felt like doing — to his surprise — was writing. Except this time his work was completely different. Gone were the eerie, mysterious, imaginative stories set in the black vacuum of space or the dank tombs of pharaohs. Instead Holt wrote stories steeped in conventional mainstream realism.
“Very straightforward stories, almost always set in a hospital,” he says. “Stories where I try to arrive at some sort of understanding about situations that I was in during my residency. Not memoir or reportage. They’re fiction, but they’re as true as I could make them.”
Holt published one of them, called “Orphan,” in Boston Review in 2005. Another, “Bad News,” appeared in the same magazine a year later. And last summer Granta published “A Sign of Weakness.” With Aragi’s help, Holt joined Men’s Health as a contributing editor in 2006. He’s written two or three short pieces for the magazine every year since. Writing for a mass circulation audience was a new experience, and Holt began thinking that his foray into medical writing could have a positive impact.
“I don’t think medicine, especially hospital medicine, is well-represented in popular culture,” he says. “There’s a lot of pernicious mythology and mystification that surrounds it.” Television programs are most guilty, he says. “The way doctors on TV talk about their work — I mean, if real humans talked that way in a hospital I’d worry about them.”
Holt’s stories are never about patients. He can’t really know their stories and he says it would be wrong and harmful to convince himself that he could. “I write my story,” he says. “It’s the only one I’ve got to tell, and I think it’s worth telling because I think it would be helpful for people to know what health care looks like from the other side.”
In 2008, the same year Díaz won the Pulitzer Prize for The Brief Wondrous Life of Oscar Wao, W. W. Norton & Company decided to publish a collection of Holt’s short stories. Holt spent the next eight months rewriting old stories and writing new ones, and in 2009, Norton published In the Valley of the Kings.
The collection’s third story, dreamed up after that Carl Sagan lecture, is one of three set in the stark places of our solar system, where the main characters grapple with the consequences of technology and their own decisions. The other five stories are Earth-bound but no less imaginative and tense. They are, to say the least, very different from Holt’s current realistic stories.
“I’ve wondered if being a doctor has changed me somehow,” Holt says. “I don’t think it has, but when I sit down to write this is what comes out. I’m happy to find I can write in an entirely different mode.”
In February of 2010, while trying to finish a second collection of stories based on situations he’s faced as a doctor, Holt got a call from Aragi. The New Republic wanted to hire him as a contributing editor and website columnist. “Despite the additional demand on my time, the opportunity to write about medicine from such a platform was something I couldn’t turn down,” he says.
On a particularly cold day, amid a few interruptions from his two kids, Holt sat in his home office to gather thoughts for a column. There on his desk was the nameplate from his father’s old office door. Their relationship had never been easy. His dad, a complex man, had been difficult to know in the best of times.
“My mother tells me that my father would have been proud of me,” Holt says. “I take her at her word. And I do think of him. I wonder, sometimes, what he’d think of all this.”
But Holt has no second thoughts about anything. “I’m happy my life has taken a couple of right-angle turns,” he says. “They’ve been good. I suppose I could’ve said no to any of them and I’m glad I didn’t.”
