Wednesday, October 28, 2009

Let Me Tell You About My Days

By last night, I felt like I was supposed to blog about this. Several people mentioned a book to me that was written by a Bellevue psychiatrist-- Julie Holland-- and an NPR Interview they'd heard. One pretty much convinced me I might want to actually read the book (reading about psychiatry isn't quite my idea of a leisure activity). So I get home and check my email: there's a link to the NPR page and interview about this book. There's an e-mail from Clink about how this is stuff kind of looks like the stuff from the book we're in the process of writing. I read a little of the Fresh Air piece and think, wow, this does sound kind of like our stuff. Sort of.
So go for it: Dr. Julie Holland writes about her work as an ER psychiatrist.
Okay, I only read a few paragraphs, and there was more of an edge to it than I want for our book.

For nine years, psychiatrist Julie Holland ran the psychiatric emergency room at Bellevue Hospital in New York City on Saturday and Sunday nights. Along with treating patients, she served as liaison to the medical ER and the toxicology department.

Holland says one of the hardest parts of her job was figuring out which patients were manic or schizophrenic and which were high on cocaine or methamphetamines. An expert on street drugs, Holland spent her college years researching and writing Ecstasy: The Complete Guide. Her new memoir is called Weekends at Bellevue: Nine Years on the Night Shift at the psych ER.

See what you think.


moviedoc said...

I read the editorial reviews and a couple of sample pages on Amazon. I found no preface. Thus, I found no disclaimer like Shrink Rap's indicating that the cases are fictionalized or that Dr. Holland obtained authorization from her patients to publish them. And if she did could it have been freely given? Likewise Richard A Friedman, MD NYT article (10/20/2009) in which he describes 2 cases in sufficient detail that it seems the patients or their families or friends could identify them.

Can this practice be legal? ethical? Why has the APA not issued a clear ethics opinion regarding whether it is OK to ask a patient for authorization to publish their case?

tracy said...

Hey, i'm reading this.

Rach said...

Isn't it really horrible for your circadian rhythm to work a night shift for 9 years? (I haven't read the book... this was the first thing that came to mind when I read your post, Dinah!)

Anonymous said...

I'm with moviedoc regarding the consent issue. I can't think of a more coercive environment than a psych ER. I'm sure I would agree to pretty much anything if I thought it would help me get out of there more quickly. If a shrink asked me to be a part of her book and she was signing my discharge orders I'm sure I would say yes. Eek!

Incidentally there was a documentary made about Bellevue hospital which seemed very exploitive to me. I wish I hadn't seen it. I won't be buying this book.

Elbee said...

Sounds good, but your book sounds better from the things you mentioned in your blog. Can't wait to read it!

Anonymous said...

I wouldn't think it would be difficult to tell the difference between MI and substance abuse. Sure behaviors are superficially similar but I imagine that substance abuse has more obvious medical complications (unstable vitals and pupils and such) since they affect the general body whereas MIs are more localized to brain dysfunction.

tracy said...

i like the book.
Not nearly as much as i loved "In a House of Dreams and Glass" by Robert Klitzman, MD, about his years in Psychiatric Residency (ironically and very sadly, his sister would later die in the Twin Towers. Which prompted a newer, also good book "When Doctors Become Patients")...and the classic "Mount Misery"....loved it!!

One of the things i found interesting in "My nights...." is the doctor explaining how she gradually has to "harden" herself against all the pain and misery surrounding her....the only way to survive in any branch of medicine, i imagine. Makes me wonder about my own psychiatrist...

@ Rach She worked Saturday and Sunday nights.

tracy said...

oops, i mean "Weekends at Bellvue"...should put the proper title! "Meds!!"

Sunny CA said...

"""Holland says one of the hardest parts of her job was figuring out which patients were manic or schizophrenic and which were high on cocaine or methamphetamines. """

This is 100% opposite to what she said in person on the NPR interview. She said that she prided herself in instantly knowing who had what. If anything the live interview gave me the impression that she jumped to conclusions without adequate evaluation because she said black tee shirts pointed to one diagnosis (I think it may have been a particular drug). She said she looks at eye pupils for dilation or contraction, and at what the patients are wearing. She said that bipolar mania presents as "writing manifestos" to give to the world while schizophrenics feel that everyone can read their mind and have a paranoia that BP patients don't show. She said that she puts the patients to bed and if they wake up manic then then it is not drugs. I have not read the book, but that is from the interview.

I am interested in reading her book, but don't consider it the same as yours. This is her memoir, not an inside peek into the workings of psychiatry. She admitted a tough stance with the patients that got her punched in the face once. She felt she softened when she had two children. Four of her 9 years there she was either pregnant or nursing and the softening opened her up to increased pain from the job which eventually led her to quit. For Rach who's worried about the woman's circadian rhythm, she only worked weekends.

Sarebear said...

I liked what I read, then I googled her.

Interesting, uh, opinion on recreational marijuana use there, miss Doc.

scroll down she's quoted in two paragraphs farther down.

Totally ruins any interest I had in reading her book, for me. With opinions like those, ugh.

word verify is evilypu no kidding

Sarebear said...

oh, and it's this link, right at the top, that confirms she's also the author of this book; the Today Matt Lauer link doesn't mention that. Just to confirm it's the same person.