Our narrator is not one of them, having grown up on intimate terms with addiction and poverty. This makes her less like the doctors and more like the patients they are caring for, and it is what allows her to describe the social structure of the hospital with such merciless clarity, like a spy who has sneaked into the temple ... DeForest, a practicing neurologist and palliative care physician, at times seems to waver between the goals of imaginative fiction and bearing witness. A History of Present Illness offers us the perspective of a doctor who feels everything. Her writing is dreamlike and fragmentary, a sequence of vivid scenes that the reader must piece together, like a puzzle, to understand who exactly is telling us this story. The answer, tucked in the book’s last pages, is a revelation ... But what she has written is also prosecutorial, documenting life inside a system that is closed to most of us. To anyone caring for someone near the end of life, A History of Present Illness provides a powerful argument to push back against the juggernaut of the hospital, to wrest control of the process. At times I wished she had written something as straight and clear as an indictment.
... insightful ... This novel depicts many aspects of the medical field but also consists of in-depth book learning as well as the student acquires the skills on how to placate difficult patients or how to deal with scurrilous physicians, as well as how to stay cool in extreme situations and adjust to long hours and ever-changing schedules ... a powerful and somewhat complicated read of a story about a young woman dealing with the intensity of becoming a doctor while she also faces the ramifications of her past and current personal life. Though this is written as fiction it reads more like a memoir.
... a candid but anguished narrative ... Physician and first-time novelist DeForest goes all in on effect and energy here, less so on plot and denouement ... Underscoring the toll of medical training, the narrator comes clean on exhaustion, insecurity, futility, and the inescapability of death. Still she clutches empathy, truth, and hope. 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.'
... is like a great deal of current American fiction in that its absence of plot, humor or distancing irony make it impossible to disambiguate the narrator’s voice from the author’s. The accusatory tone of the writing creates the suspicion that its systemic critiques are really privately held grievances. There is a paradox here: The narrator presents herself as the sole empathetic caregiver in a heartless big-city hospital, but the only feelings she ever seriously contemplates are her own. It eventually becomes clear that the illness invoked in the title is not a general condition but the narrator’s alone. 'How do you recover from anything?' she asks. One hopes that this anguished book has helped in the process.
Exacting ... This is a book about the denial and eventual cynicism of the unsaid, a book about need. It is also a book that feels very much like hospital time—to the family of the patient. I devoured it, then had to keep it down.
... distinctive ... DeForest’s fast-paced, tell-it-like-it-is story describes medical school in harrowing detail, with all the niceties stripped away. Essential insights for lay readers.
... reflective ... Throughout, the narrator offers arresting reflections on the godlike powers doctors hold over their patients 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 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.
... unusual, quiet, but dark ... The tone can be abstract, musing on poetry or anatomy, at other times, revelatory of medical norms and modes of expression ... The case of Ada, a patient with slow encephalitis, intersperses the short text and showcases the gamut of process, endurance, loss, and, above all, care and its complex shortcomings ... An original, disturbing new version of hospital fiction.
