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Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER [Hardcover]

Julie Holland
3.5 out of 5 stars  See all reviews (145 customer reviews)

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Book Description

October 6, 2009
Julie Holland thought she knew what crazy was.
Then she came to Bellevue.

New York City’s Bellevue Hospital, the oldest public hospital in the United States, has a tradition of “serving the underserved” that dates back to 1736. For nine eventful years, Dr. Holland was the weekend physician in charge of Bellevue’s psychiatric emergency room, a one-woman front line charged with assessing and treating some of the city’s most vulnerable and troubled citizens, its forgotten and forsaken—and its criminally insane. Deciding who gets locked up and who gets talked down would be an awesome responsibility for most people. For Julie Holland, it was just another day at the office.

In an absorbing memoir laced with humor, Holland provides an unvarnished look at life in the psych ER, recounting stories from her vast case files that are alternately terrifying, tragically comic, and profoundly moving: the serial killer, the naked man barking like a dog in Times Square, the schizophrenic begging for an injection of club soda to quiet the voices in his head, the subway conductor who watched a young woman pushed into the path of his train. As Holland comes to understand, the degree to which someone can lose his or her mind is infinite, and each patient’s pain leaves a mark on her as well—as does the cancer battle of a fellow doctor who is both her best friend and her most trusted mentor.

Writing with uncommon candor about her life both inside and outside the hospital—her professional struggles, personal relationships, and the therapy sessions that help her crack the hard shell she’s formed to keep the pain at bay—Holland supplies not only a page-turner with all the fast-paced immediacy of a TV medical drama but also a fascinating glimpse into the inner lives of doctors who struggle to maintain perspective in a world where sanity is in the eye of the beholder.

Frequently Bought Together

Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER + Danger to Self: On the Front Line with an ER Psychiatrist + The Center Cannot Hold: My Journey Through Madness
Price for all three: $73.44

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Editorial Reviews

Amazon.com Review

Amazon Exclusive: Julie Holland on Weekends at Bellevue

No one is immune from mental illness. After working at New York City’s Bellevue Hospital for nine years, as the psychiatrist in charge of admissions at the psych E.R. on Saturday and Sunday nights, I came away knowing this for sure. Over the years, I admitted heiresses and art dealers, altar boys and college students, homecoming queens, studio executives, bankers, lawyers, correction officers, and the list goes on. No matter who you are, what you do for a living, how much money you have in the bank, or how often you go to church, circumstances can transpire that will bring you to Bellevue. This is one of the hardest lessons for our patients to learn.

My years at Bellevue taught me many things, life lessons I could never have hoped to receive elsewhere, but the main take-home message was this: cherish your sanity, for it can be lost in the blink of an eye. Sometimes I saw the same patients repeatedly, alcoholics and addicts who were hitting bottom in regular cycles, showing up when their funds ran out. Other times, however, I met patients with no psychiatric history, who ended up at Bellevue when a bad break-up led to a suicide attempt, or a shared cigarette at a bar led to a PCP-induced psychosis. There are so many ways in which a life can suddenly unravel, and many of my patients could specify just when that started to happen for them--whether it was joining the army, leaving home for college, or living through the death of their child.

Many of the people I encountered at Bellevue tried strenuously to convince me that they did not belong there. Or vice versa. A big part of my job was learning how to separate the genuinely disturbed from the fakers (some people actually wanted to be admitted to Bellevue, if only for the promise of a clean bed and three meals a day), and to identify the people who had been misunderstood, misdiagnosed, who weren’t mentally ill at all. After a few years of Bellevue experiences under my belt, I developed a sixth sense for what real crazy looked like, sounded like, and yes, smelled like. One night a young man was brought in to the E.R. because he was found on a street corner preaching to passersby to give up their worldly possessions. I knew enough to listen and wait, and not rush to judgment, even though it might have seemed a no-brainer to admit him. Once I was able to draw him out, I learned that he had taken psychedelic mushrooms and then spent time in a Chelsea art gallery known as COSM, which I myself had been to and knew to be an intense, inspirational and potentially overwhelming experience, something that might well unhinge a person on mind-altering drugs. I spoke with him gently as his trip slowly ebbed, helping him to navigate his re-entry in the city hospital where he had landed with no money or identification. He stayed in touch with me for months afterwards, grateful that I was there to protect him when he soared--however briefly--beyond the boundaries of normal behavior.

There is a diaphanous membrane between sane and insane. It is the flimsiest of barriers, and because any one of us can break through at any time, it terrifies us, causing us to turn our backs on those who remind us of this painful reality. But spending so much time with people who marched out of the lockstep of sanity has made me less forgiving of the way the mentally ill are ostracized and shunned. We owe them something better. And we should remember that the barrier separating "them" from "us" is not nearly as secure as we might think.--Julie Holland

From Publishers Weekly

In this disjointed memoir, Holland describes her nine-year odyssey as a doctor on the night shift at New York City's Bellevue hospital, a name that has become synonymous with insanity. Holland met a bewildering assortment of drunks, sociopaths, schizophrenics and homeless people malingering in hope of a warm place to crash. As the physician in charge of the psychiatric emergency room, the hard-boiled Holland acted as gatekeeper, deciding who would be sent upstairs to the psych ward, to Central Booking or back to the streets. The book also covers Holland's personal life from her student days as a wannabe rock star to her psychotherapy sessions, her sexual escapades and her marriage and birth of her children. Holland captures the rhythms and routines of the E.R. with its unbearable suffering, petty jealousies and gallows humor. She is less successful at maintaining any kind of narrative continuity. Chapters generally run only a couple of pages and often depict random anecdotes that most likely sound better than they read. (Oct.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Product Details

  • Hardcover: 320 pages
  • Publisher: Bantam; 1 edition (October 6, 2009)
  • Language: English
  • ISBN-10: 0553807668
  • ISBN-13: 978-0553807660
  • Product Dimensions: 6.5 x 1 x 9.6 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 3.5 out of 5 stars  See all reviews (145 customer reviews)
  • Amazon Best Sellers Rank: #624,299 in Books (See Top 100 in Books)

More About the Author

Julie Holland, M.D., is a psychiatrist specializing in psychopharmacology. An assistant professor of psychiatry at NYU School of Medicine, she spent her weekends running the psychiatric emergency room at Bellevue Hospital for nine years. She is the editor of Ecstasy: The Complete Guide-A Comprehensive Look at the Risks and Benefits of MDMA. She lectures widely and has been quoted in Time, Harper's, Slate, the Los Angeles Times, and The Wall Street Journal. Holland has appeared as a medical expert regarding mental illness and drug use on numerous television shows, including Today and Good Morning America. She runs a private practice in New York City and lives with her husband and two children in the Hudson Valley.

Customer Reviews

Dr. Holland truly cares very deeply about her patients and it shows. Robynne  |  17 reviewers made a similar statement
Most Helpful Customer Reviews
101 of 109 people found the following review helpful
3.0 out of 5 stars Doctor, heal thyself! October 11, 2009
By Amy
Format:Hardcover|Amazon Vine™ Review (What's this?)
"There is a diaphanous membrane between sane and insane. It is the flimsiest of barriers, and because any one of us can break through at any time" - Julie Holland, author of Weekends at Bellevue

This autobiography details some of the more interesting cases seen by Julie Holland, a pyschopharmacologist, as she worked weekends for 9 years at the Bellevue Hospital in Manhattan, where the psych cases are taken. Unfortunately, it reads like a case of narcissitic personality disorder, where an individual has a pattern of grandiosity, needs admiration, and lacks empathy.

She has a machismo attitude, is sexually aggressive and competetive, and ignores the illness of her good friend. Holland flaunts and honors her difficulties with authority, although she does not tolerate challenges to her authority. As she relates the stories of her cases, Holland doesn't seem to empathize with her patients, or relate to them emotionally. Even then, the story focus is usually on her - how she reacted to the patient, how she should've reacted to the patient, or how she ignored the patient. Did readers really need to know she felt herself lubricate because there was a man in scrubs, and she was fixated on scrubs as a sexual object? Is this book about Bellevue and mental illness, or is it about her? She mentions how she was suggested for attending several times, but was unwilling to take it and give up her weekend hours. For story progression, it's not very relevant. It's out of fear of what could happen to her, with her family, that is part of what makes her quit the ER and move to private practice. She calls for patient follow-up once, hears that the person didn't do well, and "learned her lesson" not to inquire about a patient once they are discharged.

It also reads like a television spot.
... Read more ›
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71 of 78 people found the following review helpful
2.0 out of 5 stars Mad in Manhattan October 28, 2009
Format:Hardcover|Amazon Vine™ Review (What's this?)
If there's ever an indictment of the current education and training of psychiatrists, this is it. Are grades and self-absorption the only criteria for admission? The author writes like a tabloid journalist, not a medical professional. How did this woman get certified, I wondered. The first chapters, in particular, were painful because of the lack of empathy they betrayed, not to mention her open jealousy of her colleagues and her perpetual touting of her intelligence and sexual prowess. Yes, I know, there are guys just like her, but this is not something to celebrate.

And, as a fan of doctor-authors like Abraham Verghese, Jerome Groopman, and Oliver Sacks, I wonder if she's ever read their work and observed the craft and poetry they bring to it. They're in another league. Occasionally, there's some comment on the system and the underlying societal factors that create it, but they feel tacked on. An editor's suggestion, perhaps?

This is not a book about psychiatry in an urban setting so much as it is a book about the author and various assaults on her ego. It does get better as she goes into therapy, loses a mentor to cancer, and becomes a parent. Just about the time you think she's qualified for the work she does, she hangs up her hat and walks out.
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27 of 30 people found the following review helpful
2.0 out of 5 stars Physician heal thyself! October 13, 2009
Format:Hardcover|Amazon Vine™ Review (What's this?)
Having read quite a few autobiographies of doctors, I was looking forward to this one.
Having never read one from a psychiatric perspective, I was doubly looking forward to it.
What I found instead was quite disappointing.

ALL ABOUT DR. HOLLAND:
Dr. Holland's perspective was strangely ego-centric even for an autobiography. It was all about her, her ego issues, how she came across to others, how she excused some very non-caring behavior. I really didn't see any interesting cases, any real learning about treatments, nor personal growth.
From the beginning she spoke of her caustic interactions with difficult patients. How she baited those who could not retaliate. In fact she brought this fact up to her own therapist as a concern. Granted it might have been uncomfortable bearing her soul in a book of this type about these issues, but if you are going to do this, at least be honest about it. I don't think she pursued understanding of this for the patients benefit, but her own, as she was clearly putting herself in harms way.

JUSTIFICATIONS AND EXCUSES:
She also befriended another physician on staff that she considered a role model. When this friend became ill, she did what every best friend would do....Disappeared. I think not! She wallowed in her own self pity and explained her behavior. Only when the friend died, did she realize, she should have been there and only then for her own edification.
I found myself wincing at her justifications and explanations.
When her colleague's felt she deserted them at 9/11 rather than realizing there may be reasons they felt this way, she continued to hide behind the convenient excuse of her family. I'm sure other's could have done the same but didn't.
... Read more ›
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34 of 39 people found the following review helpful
1.0 out of 5 stars Tells more about the doctor than the patients November 18, 2009
Format:Hardcover|Amazon Verified Purchase
I began reading this book from the perspective of a person who has spent many hours in locked psychiatric wards with a family member who had repeated episodes of psychosis beginning when they were elderly. After reading the first few chapters of this book, I was disturbed by the doctor's approach to her patients and other staff and became deeply grateful that she was not the first person I encountered at the time my relative was in so much pain and the family was reeling from the shock and grief of dealing with the delusions. By the grace of God, most of the psychiatric professionals we encountered during that time were deeply compassionate and helped my family to navigate in a world that had suddenly been turned upside down. Early on I wanted to give this book an unfavorable review but did not feel that it was fair to the author to do so until I had read the entire book. Although she asserted repeatedly that therapy had given her greater insight and compassion in dealing with her patients, that simply did not ring true for me. I feel that this book is much more insightful of the doctor's psychological challenges than a heartfelt look at this most vulnerable population.
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Most Recent Customer Reviews
5.0 out of 5 stars THE HEAD OF THE EMERGENCY ROOM OFFERS HER INSIGHTS
Author Julie Holland is a psychiatrist and professor of psychiatry at NYU School of Medicine, who spent her weekends running the psychiatric emergency room at Bellevue Hospital for... Read more
Published 7 days ago by Steven H. Propp
4.0 out of 5 stars worth the read
Quite Entertaining and insightful. I couldn't put the book down, super quick read. Hope the Doc writes a few more!
Published 29 days ago by brett kasenetz
4.0 out of 5 stars Blunt and Engaging
I have just started reading hospital memoir since I now have been working at a city hospital for the last three years. Read more
Published 2 months ago by Pamela S. Hogeweide
1.0 out of 5 stars Shallow, Boring and Sick
I guess I was expecting to learn from a Dr.'s perspective just what goes on in the E.R., who comes in, what is their problem, how did they get to where they were, how were they... Read more
Published 2 months ago by Kelly Smith
4.0 out of 5 stars Very interesting read
This book was definitely an interesting read - lots of neat case stories. My one issue was the other - she basically viewed herself as God in the ER. Read more
Published 2 months ago by lucy
4.0 out of 5 stars Front lines of urban insanity
This book reads like a novel. At times it is a page turner, a suspense novel and a historical text book. Read more
Published 3 months ago by Lbr
5.0 out of 5 stars Excellent
The author is wonderful and insightful. I could not put the book down. She takes a hard look at herself and the situations she was in and makes it a lesson to be learned.
Published 3 months ago by Valerie M. Bowman
4.0 out of 5 stars Interesting
Most of the book is a fascinating look into the making and the practice of a psychiatrist. At times the author becomes a little too introspective and for a few paragraphs it... Read more
Published 4 months ago by Lizzietish
1.0 out of 5 stars This Dr needs serious psychiatric help
I am surprised and appalled that a person so self absorbed, selfish,arrogant and utterly insensitive to the feelings of others could have lasted so long in a "helping field". Read more
Published 4 months ago by Talita
3.0 out of 5 stars Historical Mistake
I am a person with bipolar disorder and was really looking forward to reading this book. Unfortunatley, I did not enjoy it all that much. Read more
Published 5 months ago by Jane Thompson
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