Book Review: Frank Huyler, White Hot Light: Twenty-Five Years in Emergency Medicine

Frank Huyler is an emergency physician, father, author, and poet who has spent the last quarter century working in the ER of a large teaching hospital in Albuquerque, NM. White Hot Light consists of 30 vignettes; most involve patient encounters, but not all. He also writes about his wife’s labor pain, his father’s heart disease, a prospective medical student he interviewed, and several people he encountered while attending high school in Japan. The format follows the one used 21 years ago in The Blood of Strangers, when Huyler was fresh out of residency. The doctor has changed; the patients are the same. But you needn’t be a physician, nurse, or paramedic to appreciate the format and subject matter. He writes for understanding, not simply to be understood. He “shows” rather than “tells.” The writing is concise and economic. Every word counts.



These are tales of small victories and huge defeats; heroic effort and tragic loss; moments of solitude amidst the hum and thrill of the department; and tales of collective purpose speaking to a deeper contemplation. It’s all wonderful. Weakness and strength. Frailty and resiliency. Wasting and healing. These are the ingredients Huyler uses to weave his tapestry. Chekov updated for the new millennium.

On chemotherapy: “If you are very lucky, the protocols work. But they are scorched earth, and bring you close to death. You lose your hair. You vomit. Your mouth fills with bleeding sores. For a time, you have no immune system at all and an otherwise harmless bacterium or virus can kill you. So you cannot get too close to other living things. You can’t be around flowers, or grass, or children.” The message conveyed but left unspoken is that, for a time, you can’t be around the things that make life worth living.

On a trauma surgeon, called in to assist with a patient suffering from a self-inflicted gunshot wound: “He’s an odd figure, the surgeon, polite in person, dismissive behind your back. He seems attentive and cheerful, but he isn’t, not really. In fact, he’s far away, and is getting tired … He’s from the past, and uses the judgment of the past, which is often superior to the judgment of the present … He’s always calm, as if no amount of death can touch him. His home life is a blank space. Without surgery, he would have no natural power; surgery, for men like him, is freedom.” That’s a lot of truth packed into a small space.

On his own shortcomings when confronting yet another alcoholic: “He’s vomiting blood, but not that much. He’s shaky and trembling, and I can see the story before me again … Sometimes I think I’ve given great bloody pieces of my life to people like him, and it feels like a tragedy for us both. At other times, I think I’m doing imperfect work that must be done in a decent world.” Difficult, necessary work.

On heroin and the frailty of others: “The beauty is what makes it impossible. The beauty is why they turn to their legs when their veins are gone and force the needle in anywhere, why they steal and cry and reduce themselves so completely.” Though repulsed by the drug, he understands the allure, and so will you after reading White Hot Light. This is extraordinary writing filling with empathy and presence. The Serenity Prayer in prose. And I should know; I’ve been an emergency physician for even longer than Huyler.

(Review also appears in Goodreads)

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