Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER

I agree with previous reviewer Dusty Love of New York City. I too was surprised to read other reviewers comments claiming that the author is self absorbed, callous and uncaring. Nothing could be further from the truth. It might be that these reviewers have never themselves worked on a psychiatric ward let alone in a psychiatric emergency room of a public hospital. Only someone who has no such experience would be so attacking. I know this because at one time I was a psychiatric social worker on a double locked ward at one of the oldest public hospitals at the time, the now destroyed-by-Katrina Charity Hospital of New Orleans. I can testify how stressful it was to work in a place where many of your patients had been so violent on the streets that they had to be "escorted" to our psychiatric emergency room courtesy New Orleans Police Department (NOPD). The head psychiatrists whose job it was to "staff" newly admitted patients would ask us on a regular basis what the "level of tension" was. Their concern was not only for the patients but also for each one of us, dedicated staff members, who at any time could be physically assaulted by unpredictable patients. Like Dr Holland I came to really appreciate our psychiatric technicians who seemed to have "eyes in the back of their heads" in their protectiveness of the rest of our staff. I can honestly say that to survive in such an environment one would have to have developed some form of thick skin. Additionally any one who has ever worked in such an environment, or similar such as in a prison, or in a context where death is routinely experienced, such as the case might be with an EMS worker or a police officer. could inform those who do not know better the psychological protectiveness of "gallows humor". Compassion fatigue can take its own toll. For those who have not worked in such an environment it is very easy to judge those who have (AND survived) negatively.I think this is a fascinating book. It is not supposed to be about psychiatry per se but about one psychiatrist's experiences working weekends in a public hospital. It is an intensely powerful and extremely revealing look not for the faint hearted or those with weak stomachs. To me Dr Holland comes across as a very deeply caring professional, frustated however as many of us are, by the manner in which our society cares for our mentally ill. People forget that the purpose of psychiatric units in public health hospitals is to evaluate and "stabilize" a patient for discharge. It is up to the patient's family and the community from which the patient came to provide for his or her continuity of care. Unfortunately as Dr Holland explains: "We avoid dealing with psychiatric patients because we hate to see things in others that we don't want to see in ourselves: weakness, need, despair, aggression. Our experiences with the psychiatrically ill often fill us with dread; they confront us with our own terror of reaching a catastrophically altered state from which there is no return. We should be compassionate to those who stumble out of our lockstep. Yet in our culture, the mentally ill are demonized and shunned....Families who would typically care for their own turn their backs on children or siblings who have lost their grip on reality. It is too frightening and emotionally draining to tend to their needs. These persistently, chronically ill patients are then left to fend for themselves, relying on the shelters,hospitals and soup kitchens to become their caretakers--their new makeshift families. This is how America does it. The hospitals and outpatient clinics substitute for their parents, who are unable or unwilling to tend to their own psychiatric casualties." Dr Holland offered an alternative in her description of a country she and her husband visited where the mentally ill were treated differently: "The 'patients' were kept with their families, absorbed within the community, their impact diluted among its healthiest members. I would discover them in the villages, where they were assigned menial jobs and managed and attended to by their peers. It is a better system than ours, which lumps all mentally ill together and concentrates them in state hospitals, nursing homes and adult homes, where they feed off the insanity of their neighbors. Instead of integrating them among us, we shutter our psychiatric patients away so that they we will not have to be reminded of all that can go wrong with our own minds and brains."Reading this book made me remember my days as a newly discharged Navy Hospital Corpsman in my first social work position after the military. Working at Charity Hospital was an experience I never forgot. Like the author I genuinely cared about my patients. My frustation, likes hers, lied in my helplessness in being unable to do more to help. I had many a patient who could have used a suitable group home placement after discharge from the hospital. Unfortunately it was nearly impossible to hold a patient long enough on an inpatient ward to facilitate such a placement. Most group homes, for instance, had a waiting list of two years when the hospital could only afford to keep a patient for less than a month!

THIS. IS. AN. AUTOBIOGRAPHY.There are bound to be narcissistic and/or self-absorbed moments in ANY autobiography. Autobiographies ARE about the author of the book. They ARE about the AUTHOR'S experiences. Are there parts of this book that are better left unwritten? Sure... but having said that, I think that there are a LOT of autobiographies that suffer from this particular problem (having things in it that are better left out of the book).*I* LOVED this book. This book was an unflinchingly honest look at the life of a psychiatrist at one of the nation's busiest psychiatric units. I LIKED the personal narratives about her life, inside and outside of Bellevue. I found the story thread about her friend, Lucy, particularly poignant. I think we all tend to shy away from people who are terminally ill, even if they are our friends, simply because interacting with the terminally ill reminds us about our OWN mortality. Does it stink that she didn't go see Lucy more often? Absolutely. Should Dr. Holland be crucified for that? I, personally, don't think so.I also found her interaction throughout the book with the hospital police ("HP") to be, at times, humorous and, again, at times, witty as all get out. Dr. Holland doesn't seem to let much slip by her without making some sort of wisecrack, which, as a result, keeps this book light-hearted and easier to read, in the sense that you're not drawn into a world of emotional exhaustion with hundreds of gut-wrenching stories about seemingly hopeless cases.There were other parts of the book that made me stop and think... in particular her (admittedly sparse) commentary on our society's way(s) of dealing with the mentally ill. I particularly found this prose in the book enlightening: "We avoid dealing with psychiatric patients because we hate to see things in that we don't want to see in ourselves: weakness, need, despair, aggression. Our experiences with the psychiatrically ill often fill us with dread; they confront us with our own terror of reaching a catastrophically altered state from which there is no return. We should be compassionate to those who stumble out of our lockstep. Yet in our culture, the mentally ill are demonized and shunned. They are ostracized and marginalized as a by-product of our primal fear of going crazy ourselves."Holland, Julie (2009-10-05). Weekends at Bellevue (p. 212). Bantam. Kindle Edition.I think a LOT of people misunderstand PSYCHIATRY in today's day and age. PSYCHIATRY *isn't* about "couch" or "talk" therapy in this day and age. "Couch" or "talk" therapy, in MY opinion, is BEST left to PSYCHOLOGISTS in this day and age, and NOT because psychiatrists are not qualified to engage in "couch" or "talk" therapy, but because psychiatrists are MUCH better qualified and/or trained to deal with the MEDICAL aspects of the mind... finding and prescribing the right medication for the schizophrenic or bipolar person that will help alleviate their symptoms so that they can ACTUALLY FUNCTION in today's world, and then following up with that particular person to ensure that the medications prescribed ARE helping the affected person.The ONLY problem *I* had with this engaging book was that the ending seemed to have come out of nowhere. Yes, there WERE subtle hints and vague inferences made in the second half of the book that alluded to Dr. Holland's slow descent into burnout, but at the end, I was left LITERALLY wondering, "Wait... what just happened, and why???", which is why I "only" gave this book four stars. I felt Dr. Holland could have and should have explored or explained her burnout better than she did in the prose. I honestly felt as if her publishers said to her, "We're allotting you 'x' many pages to write this book.", and that the 'y' factor (no pun intended) came too close to the 'z' point of the book. I was left wanting more of an IN-DEPTH explanation as to WHY Dr. Holland chose to leave Bellevue behind. That said, that is really my ONLY criticism of this insightful and otherwise excellent book.

I would have liked it to have focused more on the patients & their diagnosis & treatment plan

A great read

Great and mind blowing stories just wish there was a little more detail in them.

Interesting read. Learned a lot from the inside of a Psych ER. Makes you think about what medical personal deal with and you end up respecting what they do so much more.

I read this entire book in her voice! A few times it’s hard to follow, but makes sense at the end. Really enjoyed this quick read!