In a House of Dreams and Glass [Mass Market Paperback]

Robert Klitzman M.D. (Author)

Book Description

Publication Date: June 1, 1996

"EXCELLENT . . . I recommend [Klitzman's] book as a valuable account of one particular kind of training that goes into becoming a psychiatrist."
--The Washington Post
Fresh from medical school, Robert Klitzman began his residency in psychiatry with excitement and a sense of mission. But he was not prepared for what he found inside the city psychiatric center where he was to spend three grueling years.
In truth, as Dr. Klitzman's absorbing account of his apprenticeship reveals, he never ceased to be surprised--by his patients, by the senior psychiatrists' conflicting advice on how to help them, and by the unpredictable results of the therapies, both psychoanalytic and biologic, that he and his fellow residents practiced.
Nights in the emergency room, professional controversy, the minefield of hospital politics, the stress of his own therapy--everything is here, in a passionate and illuminating analysis of a doctor's struggle against tremendous odds to banish his patients' demons.
"[AN] INSIGHTFUL MEMOIR . . . RECOMMENDED."
--Library Journal
"A thorough diagnosis of contemporary psychiatry's intellectual lacunae, as well as its personal and institutional warts."
--Kirkus Reviews

Editorial Reviews

From Publishers Weekly

Klitzman, a New York City psychiatrist who described his medical internship in A Year-Long Night, now offers an involving, highly revealing look at the chaotic world of psychiatric practice in this account of his three-year residency at an unnamed psychiatric hospital, part of a sprawling university medical center. Among his patients are Nancy Steele, a suicidal artist; Ronald Bramsky, a homeless drug addict who has endured more than a dozen operations for bone cancer; Blanca Diaz, a woman with dementia who believes she is in "the House of God, the Gateway to Heaven" and numerous schizophrenics, psychotics and depressives. We watch as Klitzman wrestles over whether to use psychological approaches, which frequently disappoint him; biological, drug-based treatments, which have helped many patients more than he expects them to; or a combination of approaches. Hospital politics unfolds in a clash of physicians' personalities and therapeutic styles, to the point where each ward constitutes a different social environment. Too often, observes Klitzman, patients are pigeonholed into narrow categories, given drugs and then blamed for their failure to improve.
Copyright 1995 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

From Library Journal

Having described his first-year medical residency in A Year-Long Night (LJ 2/1/89), Klitzman continues with this account of his three-year psychiatric internship in a New York City university teaching hospital. Assigned rotations in short-term in-patient wards, emergency rooms, and out-patient clinics, Klitzman learned to diagnose mental disorders and administer treatment ranging from psychodynamic therapy to electric shock. He is a deft observer of the interactions between patients, residents, supervisors, and hospital staff, Klitzman makes us equally aware of his personal struggles to deal with the pressures to conform to training that discourages questioning and to understand an institutional system that appears to benefit staff rather than patients. Reminiscent of Mark Warren's The Making of a Modern Psychiatrist (Doubleday, 1986), this insightful memoir is recommended for public libraries.
Lucille Boone, San Jose P.L., Cal.
Copyright 1995 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

See all Editorial Reviews

Product Details

• Mass Market Paperback: 333 pages
• Publisher: Ivy Books (June 1, 1996)
• Language: English
• ISBN-10: 0804114366
• ISBN-13: 978-0804114363
• Product Dimensions: 6.8 x 4.2 x 1.1 inches
• Shipping Weight: 5.6 ounces
• Average Customer Review: 4.8 out of 5 stars  See all reviews (4 customer reviews)
• Amazon Best Sellers Rank: #2,671,937 in Books (See Top 100 in Books)

More About the Author

I am a Professor of Clinical Psychiatry at Columbia University, where I direct the Masters of Bioethics Program.

Customer Reviews

Most Helpful Customer Reviews

1 of 1 people found the following review helpful:

5.0 out of 5 stars Passionate, Informative, October 5, 2010

By 

LH422 (Washington, USA) - See all my reviews
(VINE VOICE)   

This review is from: In a House of Dreams and Glass: Becoming a Psychiatrist (Paperback)

This book is Klitzman's memoir of his time in residency, training as a psychiatrist. There are many memoirs of medical training in print, and this one does bear some similarities to the others, but there is plenty of original content too. Like most memoirs of residency, Klitzman's training brings into stark relief the inadequacies of the mental health system, and the inability of well-meaning practitioners to deliver the best medical care.

Some of the issues, dealing with insurance companies, nurses, and other doctors are shared across disciplines. But psychiatry presents a whole new set of issues, and Klitzman's treatment of these make this book well worth reading. While medical memoirs are full of tales of senior doctors mistreating students, the psychiatrists seemed to be using their students as experiments. Klitzman notes that residents were frequently treated like patients. Where Klitzman is at his most eloquent is in his discussion of the difficulties of treating the mind, rather than the body. Serving a patient population that does not necessarily want to get well, navigating disagreements about drug vs. behavioral therapy, these issues provide new challenges Klitzman had not faced in treating the body.

This is a well-written, passionate memoir. Much has changed in psychiatry in the fifteen years since this was published. Prozac was the new wonder drug when Klitzman was writing. This is still a book well-worth reading. The drugs may have changed, but many of the issues remain.

3 of 4 people found the following review helpful:

4.0 out of 5 stars Great account of the realities of a psychiatric residency., November 23, 1999

By 

[e-mail] (Toronto, Canada) - See all my reviews

This review is from: In a House of Dreams and Glass (Mass Market Paperback)

I am considering studying to be a psychiatrist and I found this account extraordinarily informative. The author does a great job highlighting the frequent challenges and infrequent rewards of a psychiatric residency.

3 of 5 people found the following review helpful:

5.0 out of 5 stars Very Insightful Account of Mental Health Treatment, August 26, 2000

By A Customer

This review is from: In a House of Dreams and Glass (Mass Market Paperback)

This book is interesting reading for anyone who wants to know more about the mental health treatment 'industry' as displayed at one hospital. Dr. Klitzman's frank account from the perspective of a resident in training gives honest and open insight and opinions into the various treatment methods he learned to administer. He also explores his responses, perceptions and disagreements with these methods. However, the accounts are not overly-clinical, but are told from a very humane perspective.