White Hot Light

White Hot Light by Frank Huyler

Reviewed by Danielle Ofri
The Pharos

Shortly after I completed my medical training at Bellevue Hospital in New York City, I found myself in a storefront family clinic in Farmington, New Mexico. The contrast could not have been starker. Manhattan’s frenetic bustle gave way to an arid landscape and a handful of early-closing burger joints that passed for a downtown. The nearest hospital could have fit comfortably on one floor of Bellevue. Even the pulse rate of the patients I examined seemed slower. But there was something intoxicating about the sparseness. Everything seemed whittled to the bone.

            When I stumbled upon Frank Huyler’s debut book, “The Blood of Strangers,” it resonated immediately. He was in the “big city”—Albuquerque—but the mournful desert permeated nevertheless. Huyler was different than the other doctor-writers I’d been reading. His patients weren’t named, not even with pseudonyms. They weren’t meticulously described with MFA-honed adjectives. His language seemed ordinary, his sentence structures plain. There was no thesaurus lurking just beyond the page. But it was not a literary laziness. It was a seduction, a carefully constructed doorway to a riveting tale, and before you knew it, you were wrenched into the drama of someone’s life, unable to stop reading until the chapter end slammed the door shut.

            Two decades later, Huyler has published, “White Hot Light.” It is another collection of economically written patient encounters, still set in the ghostly aridness of New Mexico.  I hesitated at first, wondering if it would be simply a sequel to “The Blood of Strangers,” the anecdotes that didn’t make the cut the first time around. But I shouldn’t have worried. “White Hot Light” matches its predecessor with its Carver-like prose, but etches its own spot in the medical-literary firmament with an understated urgency.

Now a physician in middle years, Huyler eyes his profession differently. He’s been practicing emergency medicine for a quarter of a century now. The movements, the diagnoses, the procedures, the staff interactions—these are all second nature now, as instinctive as brushing one’s teeth. What’s different is the consciousness, the prowling reflection, the circumspection lurking at the edge of each of the well-trod steps he takes, the observation that “[t]ragedies are not entropy. They are competing forms of order.”  (pg 227)

In the story “The Mirror,” a young Native American woman shows up in the ER with an angry gash in her face, the end result of that well-known toxic admixture of testosterone, alcohol, and easily smashed bottles. Suturing of wounds is standard issue ER scut and normally falls to the intern; the attending physician is needed for too many other things. But Huyler can’t countenance this. “I can’t let the intern suture this wound,” he writes. “She’s a young woman, in her early twenties. The scar is waiting for her. It will be there in the mirror when she is eighty years old. The scar will be there long after I’m gone and forgotten.” (pg 243). The idea that our medical handiwork may outlive us is something that we doctors rarely think about, but as we become older than our patients it is an increasing reality.

At one point in the book, Huyler encounters the obituary of a teacher from his high school, a Canadian boarding school in Kobe, Japan. In “The Teacher,” Huyler is able to navigate between his teenage and now adult impressions of the teacher, spiritual half-brothers that coexist uneasily in his mind. “When you’re young, you don’t understand the humanity of adults. They might as well be another species entirely—adults, teachers, old people. You cannot see how weak they are, how small they can be, how full of desires and little hopes of their own and weaknesses that grow, rather than recede, as they age.” (pp204-5)

After his first year in medical school, Huyler worked with a  missionary in South Africa, a Scotsman who spent his professional life in laboring in a free clinic, treating tuberculosis of the spine, the only orthopedic surgeon in a tribal homeland of six million people. In the essay, “The Boy in the River,” Huyler reflects back on him now: “I can still picture the doctor…I can see him with perfect clarity. He was an intelligent man. He had given his entire life to this work, to this endless struggle, and now he is forgotten by all but the few. I think about him, a stranger, a man I hardly knew, because I am nearly his age now, and great amounts of time are gone, and yet it still feels somehow like the beginning. (pg 227)

Even when there is slam-dunk success, like “The Sleeper,” the construction worker with vague symptoms and a nondiagnostic EKG who nevertheless plunges into cardiac arrest. He’s lucky enough to have shown up when a cardiologist is on duty. He’s whisked to the cath lab and a clot skulking near the inscrutable posterior side of the heart is dissolved. A man who has died walks out of the hospital and back to his wife. It’s the stuff of TV medical dramas, but it’s also just another day. Huyler observes: “Glory, like failure, like so many of the black stories, is private and small in medicine. But there are moments of breathtaking greatness also, and they, too, pass unspoken like ordinary days…” (pg 240)

And of course we are ordinary too. Doctors, nurses, administrators, patients, families—we, too, pass unspoken. Our lives, our loves, our crowning achievements, our daily grind, our lingering insecurities—these all rattle by, urgent and looming in the moment, but tenuous and imperceptible in the vast desert expanse. Frank Huyler captures all these moments in this exquisite collection of essays. “White Hot Light” is not be missed.

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