Wednesday, May 19, 2010

Weekends at Bellevue: Nine Years on the night shift at the psych ER by Julie Holland, M.D.

Julie Holland went through Medical School because she was fascinated with the diseases of human bodies and minds and wanted to help and heal people. But as she went through Residency and worked in various places, she found that what made the minds of people tick, and the various diseases. obsessions and changes in brain chemistry that came with the ingestion of various drugs was the area of study that most appealed to her.

When she finally moved out to go on her own, she had two choices- go to Columbia and take part in a medical study there, or go to work for Bellevue, the place where anyone in Manhattan and the Bronx was sent if they had psychological problems or if they were behaving in an irrational manner. Eventually, Bellevue's Rubric would expand, until it was the psych hospital for the entire city, all five boroughs, and the increased number of patients and cases strained the hospital until it creaked and groaned at the seams.

But the time at Bellevue changed her. From a cocky young Doctor who believed she had all the answers and whom nothing could touch because she was teflon-coated, dealing with the patients there killed her optimism and innocence. and an attack on her person made her far more physically cautious when it came to her physical well-being. Falling in love, marrying, and having two children, as well as the death of one of her colleagues from cancer, the one she felt closest to both intellectually and as a friend, changed her personality, from warrior to Den Mother, causing her to eventually burn out and leave her job for private practice as a psychopharmacologist.

But it is the stories of her experiences that will give you the greatest insight into the human mind and what the staff at Bellevue do on a daily basis, and how the experience of other countries with regards to their mentally ill show what we can learn from them- in fact, need to learn from them, to better deal with those in our country who snap mentally. And then there are those who try to game the system, from the Sociopathic sharks, who manipulate everyone around them for their own jollies, to those who quite understandably can feel themselves sinking into the morass and check themselves into the hospital for their own safety and the safety of others, you'll come to understand what criteria is used to determine who gets in, who gets out, and who needs to go in immediately.

Anyone who has seen a crime show set in New York City will recognize Bellevue- it's the place where the possibly mentally ill criminals go to be evaluated. But in reality, it's far more than that- it's an entire psychiatric hospital that not only takes in those mentally ill who have committed crimes, but also other New Yorkers in desperate need of psychiatric care. In fact, it's not just a psychiatric hospital, but a full-service hospital. It just seems its best known for its psychiatric care. There are others, like St. Vincent's, Mt. Sinai and Beth Israel, but Bellevue seems to be the most popular and best known, probably because it is considered the best.

Hospital psychiatric care is a draining business, with a high incidence of burnout. Doctor Holland, though her month-long vacations and working only the weekend shift (admittedly 15 hours over two days), did a lot to stave off her own eventual burnout, lasting an unheard of 9 years as CEP at Bellevue. In that time, she survived many traumas, both physical and emotional. She even reveals the real reason why so many psychologists are themselves in therapy- to help them deal with the stresses of the job and to keep themselves on an even mental and emotional keel.

I found this book to be very interesting, and when I had to go to the hospital myself, I found myself almost laughing in the triage station of the Emergency Room because there they asked me several of the same questions that I would have been asked in Bellevue, had I gone there. For helping readers understand why Doctors ask the questions they do, and bringing interesting stories of patients and fellow staff, I would recommend this book highly. Invaluable for understanding psychiatric hospitals.

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