What I Just Read: A D.S. Marquis Book Review of Heart Like A Hole by Paula C. Deckard

Updated: Sep 6

Paula C. Deckard’s psychological horror novel is a mind twisting allegorical read told in first person narrative from the perspective of junior heart surgeon, Dr. Ellen Parker.

For mature readers and lovers of gruesome, graphic, sexual stories, this one is for you. Two words, blood and heart, appear on most pages. Everything comes back to the symbolism of the same offering a broad and deep meaning to the fine line between sanity and insanity, and the struggles between love and hate, life and death, the physical and emotional, and attachment and detachment.


I was drawn into the mind and heart of the protagonist on page one, where I was immediately smacked with the blood and heart motifs in a gory scene. I counted twelve references to heart and blood on the first page. Lots of medical terms and medical lust run through the story in the thoughts of the protagonist and her dialogue with colleagues.


In eighteen chapters, I sensed the sights, smells and sounds of New York City’s hospital Mt. Sinai, patients’ bedsides, the operating theatre, lovers’ bedrooms, bars and restaurants, and the suburbs of Connecticut. Then through numerous flashbacks I journeyed through Dr. Parker’s childhood and adolescence.


On the matters of the heart, I sensed Deckard exploring ancient Greek philosophers’ thoughts on the belief that the organ of the heart houses the strongest of human emotions and seals secret dreams and pleasures there. The evidence lies in Dr. Parker’s thoughts in Chapter 1 as she reflects on a conversation with another doctor, who is also a relative. “The anatomy of the thorax has always been my favorite. He said that each heart could be fixed, but I didn’t believe him. He said that life needed a purpose and that mine would be to heal hearts, and only this way could I mend my own. All the emotions that I’ve ever known felt crushed under the weight of a human pain…” In Chapter 8, Dr. Parker continues to hold tight to this preoccupation. “Fixing their hearts makes me visualize my own open thorax on the operating table. I see my pumping heart behind the gates, and I wonder who will ever have the power to break through them and save me.”


I identified with Dr. Parker’s humanity in the aforementioned. She is aware of her brokenness. Despite her disturbing thoughts and actions, I questioned, is she just a surgeon trying to cope with the daily pressures of holding patients’ lives in her hands? Is she on the verge of a nervous breakdown? Is she on the autism spectrum? Or is she a sociopath? Are her streams of consciousness nightmares? Delusions? Memories? Reality? Fantasy? or the results of Exhaustion?


One of Deckard’s supporting characters chooses only to see the medicine in Dr. Parker, not her poison. It’s this character's opinion that had me guessing through the end of Chapter 17 whether Dr. Parker’s benevolent side or malevolent side would win. Wanting the answer kept me turning the pages to reach the satisfying retort in Deckard’s final chapter of Heart Like A Hole. In the end, this work reminded me of Shakespeare’s idea that there are both poison and medicine in us all, “and where the worser is predominant, full soon the canker death eats” us up. (Romeo and Juliet Scene III) ☮


HEART LIKE A HOLE is available on AMAZON.

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