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Tuesday, September 01, 2009

Through Doctor's Memoir, Bellevue Will Have Its Way With You, Too

(Image from Barnes & Noble)

"I thought I knew what crazy was. Then I came to Bellevue."

- Julie Holland, M.D.

Every day, New York City's sickest, most pathetic residents troop through the doors of Bellevue Hospital's psychiatric ER. It's a desperate parade of sociopathic inmates, abandoned street folk, suicidal everymen and psychopaths of every stripe. Some want a listening ear, others a safe place to sleep; some enter souped up on drugs, others have been off their meds for months; some want real treatment, others desire only the free painkillers. Each shift brings fresh neuroses, new problems, unique challenges. In short, Bellevue's the perfect workplace for a hotshot young psychiatrist like Julie Holland. An adrenaline junkie who loves nothing more than playing with fire, she gets a sometimes frightening, ofttimes enlightening, always fascinating up-close look at how the brain functions - and malfunctions.

Weekends at Bellevue (which will be published in October) details all the crazy Holland encountered in the 9 years she spent treating patients in the ER, as well as the path that led a would-be rock star to become an honored psychiatrist, professor and author. She describes her growth from a nervous "third-year" who "spent most of my time feeling like I was in either a gory movie or a well-written medical drama" (31-32) to a more confident resident and finally, to an experienced psychiatrist and expert psychopharmocologist. Along the path, she encounters her share of dangerous patients, harmless whack jobs, successes and failures. Her experiences oscillate from outrageous to hilarious to heartbreaking. What makes the book most profound, however, are the truths Holland discovers about humanity and about herself. By the time burnout forces her out of the chaos of emergency medicine into the relative calm of private practice, Holland has come to a startling conclusion:

The reality is this: All of us, to some degree, are mentally ill. We get paranoid, anxious, depressed, and insomniac. We alternate between delusions of grandeur and crippling self-doubt, we suffer from paralyzing fears and embarrassing neuroses. We have compulsions to do things we know we shouldn't, and there are millions of us with addictions, whether to gambling, drinking, dieting, or playing Second Life. Every one of us has psychiatric symptoms, many of them serious enough to warrant attention, even if they are not incapacitating. But few of us are willing to let on that we are suffering. This secrecy and shame compounds our avoidance of those who have been officially diagnosed as mentally ill (293).

Holland's account is undeniably gritty, unapologetically honest, and absolutely fascinating. Through it all, what really comes through is her humanity. She shows us the woman who can crack dirty jokes with the raunchiest of men, but melt into a puddle when facing a father who has beaten his baby to death. She gives us a tough-as-nails doctor who confronts the most dangerous sociopaths without blinking an eye, but shakes for days after taking a punch in the face. Ultimately, it's Holland's emotional state that takes her away from Bellevue - this is also what makes her voice so beguiling. More than anything, the reader gets Holland's heart and soul - the virgin purity that compelled her to spend her life helping the most helpless among us. She ends her book with this nugget:

My nine years at CPEP [Comprehensive Psychiatric Emergency Program], like an extended gestation, helped to make me what I am -- a better doctor, a better mother, and a writer. I walked into that asylum one person, and I walked out another. I didn't alter the machine -- I'm not sure anyone could have -- but it surely had its way with me (306).

While we may never step through the doors of the psychiatric ER, Holland's unforgettable narrative brings it to us in living color. It's not an easy read or a comfortable one, but I guarantee that after reading this book, Bellevue will have had its way with you, too.

Grade: B

If this were a movie, it would be rated: R for language, sexual content and disturbing situations.


  1. Oh man. I can't remember where I first heard of this book, but it has been on my list for at least a month. I can't wait until this comes out. For some reason I am so fascinated by medical drama (probably why my favorite shows are Grey's Anatomy and House!). Thanks for the great review!

  2. Susan at Carolina Gal02 September, 2009 14:26

    I have not seen a doctor's memoir working in a psychiatric hospital before.. I can attest it is a very
    hard place to work. I was a nurse on a psychiatric hospital myself in Miami, Fl. I worked in a VA hospital with mostly men that were admitted. Locked units, you had psycotic patients talking to themselves, thinking they were g-d. It is a very scary difficult place to work at time. There were times that I was attacked and you had to call a code green. Green is a call for help. A team of peope trained to respond to difficult and combative patients. A team that is experienced to put the patient down. Like I said there were times that it was terrifying. But I would not have given it up because it was satisfying.
    What you quoted in back of the book about everyone is crazy is so true. Everyone has symptoms but most of us control it and can do something about it. It is the mentally ill that at times can't control themselves.

    Thank you for your post.

  3. I got this from LibraryThing and it's my next read! Yay.


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