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Monday, August 2, 2010

Weekends at Bellevue Discussion

Weekends at Bellevue

by Julie Holland, M.D.

genre: memoir

Meet Dr. Holland. Witty, smart, compassionate, full of gumption and somewhat abrasive. From med school to her tenure at the infamous Bellevue Hospital in New York, we are given a peeping tom's seat into her world. For many of the us, the population of those that crossed the line into the mentally ill spaces of life are somewhat distant and separated from our own lives. These are the people that either wander the streets talking to their own invisible companions or spend their lives in hospitals where we are shielded from their reality. But here we get a sense of how imminent mental breakdown is in all of us, a fact which the author fixates on quite a bit. We also get to see the afflicted from the medical point of view and even a little from the police who deal with them.

I was surprised to learn how much bravado gets thrown around as a tool for protection. Knowing it happened didn't compare to really understanding how much it affects the people in these fields. In some cases, it went to the point of scary. I spend much of my life in the happy bubble of thought that those employed to protect and aid us (police, doctors) are altruistic humans with only our good in mind. I know of course how naive that is. But seeing just how human those people are caused a bubble burst of larger proportion than I expected. As for the author, I liked her and I didn't. I appreciated how honest she is. I thought that her dealings with her coworkers seemed borderline pathetic and childish. Then again, I've been out of the workplace long enough to gloss over just how ridiculous work politics are. Oh, the stalker guy part was creepy wasn't it? And her chapter on the summer of residency sex was fun.

In all, I'd say this book has a little of everything: fun, enlightening facts, a bit of the scary and overall some damn good voyeurism from a safe distance. Could you ask for more?


de said...

This book was right up my alley! I love medical dramas, forensic mysteries, insanity...

I absolutely agree with your assessment that you "liked her and didn't." I had decided by page 62 that I was in love with her, but not much later, I changed my mind. I think, though, that the tone of the book is to blame. It turned out to be much more of a biography than an exposé, which, given doctor-patient confidentiality, is understandable, but disappointing for me the reader. Additionally, I was left with many questions about Dr. Holland, so she certainly didn't exhaust her subject.

Overall, I enjoyed the book and would recommend it, especially to a blog-reading audience, for it's diaristic style.

Can't wait to find out what's next!!

jaded said...

Writing a memoir entitles an author to present a personalized version of the truth, revealing as much or as little of herself as she chooses.

It read like an homage to ego accompanied by the trappings of conflict, and continual assertion to establish oneself as the alpha, and that's before considering the plight of the patients and the limited resources public health has to provide services for the mentally ill. The story (if you want to call it that) isn't so much plot driven as it is documentary in nature. And the documentary part? Has less to do with the patients and treatment and everything to do with a personal journey to transform from power wielding masochist to a more willing listener who assesses patients needs based on knowledge and interviews rather than assumptions. Some might be disappointed with the lack of humility from the author after making some serious mistakes, but I am inclined ignore this, given over-confidence and assertiveness are mandatory for physicians.

This book does little to boost confidence about the treatment of mental illness. It would be easy to blame the author and her colleagues for the callousness, and fast food service mentality that pervades the approach to triage and choosing who merits versus help, versus who is simply not dangerous enough to help, but such is the ugly side of limited resources. When faced with the deluge of needy, and little or no feedback as to patient progress, it's a wonder the physician turnover rate at CPEP wasn't higher.

Would I want this person to assess and treat my grandmother? No. But the ideal physician, for grandma wouldn't last 2 shifts in this ER. The sensitivity and compassion would have burned one out in an instant. Like it or not, the heavy armor and rough demeanor permitted Holland to remain in this capacity longer than most physicians. We want sensitivity and compassion in others but the truth is few of us could maintain these high standards we set for others.

meno said...

Oh ack! I'm not finished with this one yet.

I am liking what i have read so far. Will step it up and get back to you.

Bad meno!

Gordo said...

I just finished it and loved it. She's a complicated, conflicted, person. Just like everybody else we know. I'm not sure what to make of her pronouncement that we all suffer from some form of mental illness, though. It strikes me that she's seeing patients everywhere.