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3.6 out of 5 stars
Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER
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126 of 137 people found the following review helpful
TOP 1000 REVIEWERon October 12, 2009
Format: HardcoverVine Customer Review of Free Product( 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. Chapters are short, disjointed, and not in linear sequence, which would be fine if the sequence had any flow. The only pro for this approach is that a reader can pick up the book after a long absence, and not be lost. This book would have improved with a lot more red ink from the editor's pen. However, Holland is pretty unflinchingly honest about her shortcomings, and sees a psychiatrist herself, although perhaps not long enough.

The book's strongest point comes in the last few chapters. Holland brings her stories to conclusions about our healthcare system, especially our mental care, continuity of care, and the potential instability of all of our minds. Even given the interesting case stories, it was too difficult for me to get past her unempathetic and self-absorbed approach for me to rate this book higher.
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86 of 96 people found the following review helpful
VINE VOICEon October 28, 2009
Format: HardcoverVine Customer Review of Free Product( 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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42 of 47 people found the following review helpful
on October 28, 2009
As a psychiatrist, the question this book poses for me is how someone can get so far as a psychiatrist with so many glaring empathic and intellectual deficits. It shouldn't take an assault by a patient or years of therapy for a psychiatrist to understand that everyone has feelings - even people with handcuffs on. If you would like to read a manual on how not to be a psychiatrist, this is the book for you. That the author has allowed herself to be pictured on the cover of her book in pseudo reality-show style underlines how much she has yet to learn and how unaware she seems to be of her deficits as a professional. Really, it is an indictment of our profession that something like this can come to be.
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43 of 49 people found the following review helpful
VINE VOICEon October 14, 2009
Format: HardcoverVine Customer Review of Free Product( 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.

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.

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. Over and over again, I found myself intensely uncomfortable, as if I was complicit in her excuses.

Her current line of work, psychopharmacology, gives me pause. She was proud that some yuppie, touted her as bling and now feels she can do the work she was best at and make some really changes in people's lives. Give me a break! Her description of her current job sounds like really hands off doctoring and what often gives psychology a really bad name.

I don't know if it is the way she described things or the topics that were covered but this book really left me cold. I'm not impressed by Dr. Holland or her approach to psychology. I'm not waiting for the next book, that's for sure.
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40 of 46 people found the following review helpful
on November 18, 2009
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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44 of 51 people found the following review helpful
on October 24, 2009
Who would have thought a book about such a richly textured and dark place could be so boring? Dr. Holland, as we are reminded all too frequently, is uber-smart and knowledgeable about psychiatric meds. That's about it. Her personal life is of a stereotypical smart suburban girl who is just edgy enough to take the requisite post-college 1-year detour before tackling the real world where she has a serious profession, a stable husband, an Upper East Side apt. AND a country house, and eventually two kids. The stories of her patients are too short to distinguish one from another. Perhaps that is the result of her job - she sees patients long enough to treat or street and that's all we learn, too. We learn more about the details of the Bellevue Diner food than we do about her patients. Most of the book dwells on her idolization of her boss who dies of cancer. Anyone expecting interesting patients or insights is out of luck.
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27 of 30 people found the following review helpful
on December 22, 2009
I think Ms Holland should have left Bellevue many years sooner than she did. Early on a person could tell she was not suited for the job she held. I wanted to read about the patients/medications/treatments and outcome. Mostly what I read was Ms Holland complaining of too many patients, inadequate co-workers, complain, complain complain. She wrote of how 9/11 affected her and sitting in her tub with her young daughter Molly. What I remember is she didn't go into work and she should have! She also speaks about needing to be "macho" to fit in. Maybe that is why she did not fit in. I think she treated co-worker Lucy terrible. I am just totally disappointed in this book and am very sorry I spent the $25+ for this book. I strongly suggest she cease writing books and close her practice.
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18 of 19 people found the following review helpful
VINE VOICEon October 16, 2009
Format: HardcoverVine Customer Review of Free Product( What's this? )
Bellevue, although a large public hospital in New York, the term, at least for New Yorkers, is synonymous for a nut house of the first order. Having myself had a few visits to the normal ER there in the late 80's and thinking of other `belly of the beast' autobiographies such as Bourdain's "Kitchen Confidential," I thought the memoir from the psych ER there would be interesting. Ah, wrong.

In stead of revealing the down and dirty or the real humans with in the stereotype Holland comes across as self absorbed, selfish and ultimately unaware. It is all about HER and everyone else, friends, patients and co-workers exist just to reflect her without a life of their own.

Sure the stories she tells are entertaining but instead of painting an evolving picture of a life they come across as detached vignettes, like stories she might tell you at a party, "Oh let me tell you about this guy I had come in last night." There is no sense of her life unveiling before you. There's no overall thread to theme to the book. A few threads stretch over more than one chapter, a friend's cancer, fighting with a boss and finally her burning out, but there is still a little sense of perspective. For example when she goes into labor and feels her doctor doesn't understand her, she suddenly empathizes with a patient who struck her "years ago" but from the way the book rolls you feel that event was only months ago, not years and this only stresses how all the different stories exist out of context and without any true theme.

You can't even say it's her life that connects them because things happen outside of that which only get mentioned long after the fact, such as when a co-worker becomes ill, she sends her private patients to Dr Holland's private practice leaving the reader to say "Oh, when did she start a private practice?" this happens repeatedly, she buys a house in upstate New York and other in Cape Cod? Her bio on the book says she teaches at NYU When? Why? This makes you wonder why write a memoir if you aren't telling your story?

It isn't even the story of the ER because, again it's all about her but only how other people exist for *her.* After 9/11 she called in and was told she wasn't needed and could stay home. She later learned that no one else called, they just came in. she knows she screwed up but doesn't tell the reader if there was any sort of feed back from the other doctors whom she failed.

In closing she goes on how the line between mental health and illness is perilously thin but it isn't. If it were far more people would be tripping over the line and they aren't. She's completely unable to detach herself from the fact that in her profession of course she sees a higher proportion on mental illness than say a veterinarian or a gourmet chef, it's her job and she can't relate to the rest of the world because, of course, to Dr Holland, it's all about HER. And this is the final feeling you have of the book.

There are some entertaining stories but little else. Nothing to learn, nothing to affect the reader, except how not to be like Dr Holland. This may be harsh. She did spend 9 years dealing with the people talked off ledges by police, failed suicides found by EMT's and violent homeless people. It wasn't charity work, she was very well paid, but she earned that money, let's be very, very clear on that. She did hard work in a high stress, potentially violent environment getting up close and personal with the type of people most of us avoid, in an attempt to improve their condition. That is very good work. Unfortunately her telling of the tale isn't very good. It manages to simultaneously be self absorbed and head blind at once. She wants to tell her story, but is unwilling to open up and really tell it, which means the good doctor has failed to recognize she's distancing herself from her own autobiography.

Oh and the view of New York? Forget it. Unless she's telling you about what rolls through the door Bellevue could be sitting on a cloud or through a dimensional portal, you'd never know 1st Ave is just outside the door, neighborhoods with homes, diners, restaurants and people.
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22 of 24 people found the following review helpful
on November 27, 2010
I was interested in this book and I am sorely disappointed. It's like a kick in the gut to anyone who has ever suffered from any kind of mental health problem. It makes me want to be as far away from psychiatry, not to mention the author, as I can get. Luckily, I don't see us coming into contact any time soon, if ever again. That being said, I am grateful that other reviews have comprehensively covered the ins and outs of _Weekends at Bellevue,_ by Julie Holland, M.D. I thank the reviewers immensely. I want to bring up three issues -- or maybe they are points, perhaps issues and points -- that disturb me more than does the shabbiness of the book as a whole.

1. "If you have ended up in this book, please do not take offense. I never meant to betray your confidences, only to enlighten others with educational or entertaining stories. And we had some laughs -- Didn't we?" (vii)


Imagine yourself reading a book, that you are likely to read -- considering that you are highly intelligent, you had a stint at Bellevue, and you recognize the author... Imagine finding out that you were considered not as a human being, but as an educational aid, an enlightenment object, or worse -- as entertainment for the shrink on duty. And it is obvious that the shrink still views you this way, for she wants to share her view of you, of your antics, with the rest of the reading population. Antics that you displayed while you were ill, out-of-control, and very vulnerable. And yes, she does mean to betray your confidences or she would not have written this book.

Can she be more arrogant, condescending, unethical, or stupid?

Holland claims to cite most of her dialogue with patients word-for-word. I do not suspect that she had release forms available to the chosen patients -- "oh, in case I include you in my book..."? No. Holland writes her own notes at the end of the weekend as a way to "exorcise the demons of the previous two days at work" (vii). Her demons? The patients as demons? One and the same? She doesn't elaborate. Doesn't she have an editor to point out that words such as "demons" and "patients" offered in such close proximity are words ill-chosen?

If I found myself on Holland's pages, I would sue her. And I would sue the publishing company. For a lot of American money. I feel like suing her now for idiocy. (sp?) But unfortunately, there is a lot of that in psychiatry, judging by my own experience. Anyone, however, may query the AMA and the psychiatric equivalent (whatever that may be) as to the apparent breach of confidentiality, unsound ethics, and... questionable professionalism of Julia Holland, M.D. as evidenced by her own words.

2. I continue to use the "Note to the Reader," as a jumping off point. Holland states there that she will only describe the most extreme, colorful, violent patients -- entertainment value -- for she doesn't believe a reader will be interested in the garden-variety (her term) cases of depression and anxiety. That Holland feels readers will not be interested in these cases seems bizarre to me, as more people are diagnosed with depression and anxiety than probably with any other problem. Holland's deletions make me wonder: are psychiatrists not interested in patients who suffer from depression and anxiety?

I think it would have made for a better book, had Holland include the "boring" cases of anxiety and depression and other cases she left out. Because without them, she paints a disjointed freak show out of the reality of the Bellevue psych ER. Oddly, according to radio interviews and claims of praise, this portrait she creates passes *as* the reality -- not only of Bellevue psych-ER, but of mental illness and the mentally ill population in general. Thanks a lot. After so much money has been spent on debunking that myth and erasing the stigma, this book reinvents both. May the reader have a better understanding of how the American stigma and myth about mental illness came to be in the first place.

3. Holland documents her interest in the brain and how it lead to her becoming a psychiatrist. She reveals her unquestioning belief that psychotherapy is not so useful because it is all about medications these days (and she seems proud of this belief, which I find repugnant)! But there is an extreme (if you will) contradiction in her book, and in her beliefs about "good medicine" that she doesn't explain. Holland (like most doctors I know) does not take medication.

Far more than I want to know her personal sexual escapades, I want to know why she doesn't take medication. Does she know something about it that makes her outright refuse? And why does she make such a big deal about refusal?Perhaps not taking medicine help her to keep in place the "boundaries" she is always mentioning that get blurry between (mental) illness and health. But if medicine is no good for Holland, why does she consider it the best treatment for mentally ill patients? I did mean for that question to be rhetorical.

I hope that Holland's current and potential future patients read this book. And I hope they are enlightened. I certainly am -- just not in the way that Holland intends.
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30 of 34 people found the following review helpful
on February 6, 2010
I do exactly what Dr Holland does (i.e. I do psychiatric evaluations in a big city Emergency Dept.) I found her memoir to be sad and pathetic. Ms Holland is clearly Narcissitic with some Histronic features thrown in as well. She is vain, shallow, often uncaring and virtually always concerned only for herself.

I found myself feeling sorry for the patients that had to be evaluated by her. At one point she talked about a colleague who had "a narcissitic injury to the ego." That should have been the title of the book because it is clearly where Ms. Holland operates. There was another section where she talked about "feeling grandiose" and then falling in to self-critical dispair. This is perhaps the most succinct definition of narcissitic personality disorder I've ever read. Unfortunately Ms Holland doesn't have the insight to realize this is her pathology. I guess it's all because her daddy didn't love her or pay attention to her special needs. Whatever. Her patients shouldn't have to suffer.

She talks at length about taunting her patients or showing a lack of empathy and then wonders why. She talks about failing her oral clinical boards because her clinical/patient skills are so poor, yet doesn't realize how poor they really are.

The good thing is it sounds like her practice now is basically handing out pills. God knows she lacks the clinical skills or empathy to do any kind of therapy.

I give this two stars because the situations she describes in the book are real. It truly is what it's like to work in a psych ER. The problem is this woman should have never been working in it to begin with.
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