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, by Julie Holland M.D.
Download Ebook , by Julie Holland M.D.
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Product details
File Size: 3193 KB
Print Length: 322 pages
Publisher: Bantam; 1 edition (October 5, 2009)
Publication Date: October 6, 2009
Sold by: Random House LLC
Language: English
ASIN: B002RLBKT0
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Amazon Best Sellers Rank:
#28,384 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
As a practicing emergency physician I was curious to read this book.The good: Dr. Holland is clearly a competent writer and her descriptions of psychiatric patients in the emergency setting are spot on. She is also transparent about her limitations as a physician, especially regarding empathy, and her personal struggles when faced with certain patient types.The bad: The book does come across as indulgent. I was much more interested in the professional content than I was the details of her personal life. Further, in my humble opinion, she seems too enthralled with pharmacologic management of the human psyche. I suppose one should expect this from a psychopharmacologist, but I am very much a believer in the power of caring, see book Hippocrates Shadow (Newman) and in the perils of Overdiagnosis (Brownlee) and Overtreatment (Welch). We are too quick to abandon non-pharmacologic approaches to wellness, and too quick to look for answers in a pill bottle.The ugly: I find her sexual escapades during her training, including an affair with a married physician, to be exceptionally base. In all my years of training (medical school and two residencies) there was one rumor of a tryst that was wholly frowned upon and nearly shut down all sharing of scarce call rooms in the hospital. The vast majority of medical trainees keep their heads down, work very hard, and avoid all such nonsense. I want all laypersons reading her book to understand her behavior to be the gross exception that it is. And I’d like to point out that sexual harassment is a problem across industries, including in the house of medicine; that she responds by having sex with those who harass her perpetuates a huge problem for women in our society!
I was interested in the stories of the people who came to or were sent to Bellevue. By the time I was 1/4 of the way through the book I developed a great dislike of the author. I found her self absorbed, cruel, uncaring and spoiled. Oh, to be able to work 2 -3 days a week and live well off of that. To take such umbrage at being asked to do scheduling that would take a day more of her time or take a pay cut and she chose the pay cut because she wanted to only work 2 days a week. Her inability to get along with her supervisor once her buddy who gave in to her was no longer there. A complete inability to comfort a dying friend - her "best" friend - in her finally months making only 2 visits to her. Not being able to comfort a co-worker whose young daughter dies in a car accident... because you know, "does it even matter if you try to console someone?" Coming from a psychiatrist? Really? Yes. Dr. Holland, it DOES matter - it shows that person people care. I wanted to skip over all her whining to get to the next patient story. Her almost pride at taunting prisoners cuffed to wheelchairs "just because she could" was distasteful to me. Being content in a 1 day a week private practice where she basically just handed out prescriptions - psychopharmacology was it? - was disturbing to me. When she describes her reasons for finally leaving and finally shows some compassion and humanity - it is just too late for me, I already dislike her too much to find any of those final comments redeeming. All in all, it is an interesting account of how weekends run at Bellevue - or at least did during Dr. Holland's time there.
This book should be required reading for all aspiring psychiatrists. Why? Because NO ONE should ever treat their patients this way. This woman is culturally incompetent, racially insensitive, contemptuous of all of her Bellevue patients and completely lacking in empathy for those seeking her help. She treats those at Bellevue with such hatred and condescension, and then when she starts her private practice and caters to well heeled patients she dispenses happy pills and discovers her inner "humanity".UGH. UGH. and UGH. This book was so upsetting on so many levels that I wish I had not read it. It was like watching a horrible car wreck.
Holland is the opposite of everything you want a physician to be. The fact that her patients are poor or substance abusers, criminally accused or homeless, does not mean her lack of empathy and narcissism should be overlooked as she sells us a book that invites us to feel better about ourselves by voyeuristically reducing their lives and struggles. As a medical student, I wanted a book that gave me a compassionate and critical look at our system for treating patients with mental illness and the struggle of those patients. Instead, I read a book that was mostly about Holland and her self righteous disdain for many of her patients. She does occasionally show some empathy for patients that get past her "armor," but this is by far the exception that proves the rule. While I'm sure she would condescendingly dismiss my critique as naive, I sincerely hope I never come close to the callousness she shows her patients. Holland is not the rebel against the system she tries to cast herself as. She is a big part of what is wrong with the system in the first place.
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