Customer Reviews

Weekends at Bellevue

5 star:		(33)
4 star:		(39)
3 star:		(18)
2 star:		(17)
1 star:		(16)

 

 

"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.

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.

I wouldn't want the author's job, and I wouldn't want her for my doctor. If you're hooked on medical memoirs,you'll probably love this. Otherwise, not so much. The author seems to flaunt her
difficulty with authority, though she herself is pretty authoritarian. She doesn't seem to relate very well to her patients on an emotional level. She does treat some interesting (and usually very sad)
patients, but the focus seems to be mostly on herself, not herself as she relates in a therapeutic setting.

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.

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

HANDS OF PSYCHIATRY
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.

NOT LOOKING FOR MORE:
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.

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.

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.

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.

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.

There is something rather sick about a medical doctor's memoir, that uses stories of the weakest among us, the mentally ill to cash in on a book sale. These are the people a truly caring doctor would guard the privacy of--these are not the people to laugh at---as in how amusing to see a person outed by their mental illness. New York Post ethics. Tacky, and nothing like outstanding book, THE UNQUIET MIND by Kay Jamison Redfield, who detailed her own PERSONAL mental illness. Avoid this 'memoir' like H1N1 flu.