liveonearth (liveonearth) wrote,

Books: Weekends at Bellevue

The author is Julie Holland. I heard her interviewed on NPR and knew that I wanted to read her book. Weekends at Bellevue refers to her 9 years of Saturday and Sunday night shifts as the attending physician in a psychiatric ER in New York City. Bellevue was the first hospital established in the US, and has a long and glorious history in the psychiatric arena. Holland's stories begin when she is a medical student, and later as a resident. Since I am currently a student of medicine, reading it was like eating candy to me.

The book delves into cases and patterns she saw, the drugs that people used to self-medicate and how they present in the ER, the procedures at the CPEP, and much more. Dr Holland was a butch and tough girl at the beginning of her career. She needed a shell to protect herself from the horrible reality around her. Her role at Bellevue is primarily to decide if patients are dangerous to themselves or others, because if they are, they get admitted. Otherwise they are "a T&R", that is, treat and release. Treatment involves medication enough to quiet down the voices in their heads, or blunt their mania, before she sends them on their way. She is pretty crass to some of her patients, and sometimes they get back at her.

But in the course of the story she changes. She has a couple of babies. She spends some time in therapy. She discovers that maybe she doesn't need the constant excitement of an emergency department heavily laden with nutcases. It's an easy read, lots of stories, a few educational moments. She has one chapter in which she discusses all the types of suicide attempts and what they mean. By the end of the book she has shifted over to an entirely private practice in which she can keep in touch with patients and help them to forge a new and happier life.

I think Holland might have some more books in her. And I think she may live to regret having allowed this one to be published. But there it is, her story, in my view a worthwhile read.
Tags: books, emergency, pharmacology, psych, suicide

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