5 of 5 people found the following review helpful
This review is from: Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis (Hardcover)
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I really enjoyed this book. The author, a hospital psychiatrist, tells a mix of stories about her experiences with patients. There are a number of stories throughout, such as about a women who eats objects (such as steak knives, forks, broken glass) when she is stressed, a women who thinks she might kill her son, and a man who believes his perfectly normal face is so scarred that he obsessively schedules surgeries. With these, and the other cases mentioned, the author discusses the patients lives and her attempts to work with them, as well as general background -- what the disorder might be, theories on its causes or cures, other related cases. For example, the discussion of BIDD (where people want to get amputations) is particularly interesting.
Besides being interesting and emotionally gripping -- because the reader gets caught up in the tragedy of the patients' lives -- the book also discusses and has the reader experience the short falls of the medical system. For example, the woman who swallows knives goes through very expensive treatment every time she comes in to the emergency room (which is often) yet is denied out patient care. As a result, she'll never have the support or counseling needed to get better, and a single hospital visit costs far more than a year of preventative treatment.
With the various cases you see the struggle the author goes through as a doctor -- we know very little, relatively speaking, about how the mind works so she has to rely on intuition to know whether a patient is faking it to get opiates, is bipolar or psychotic or obsessive -- yet at the same time she has to make regular decisions on treatment and whether the patient is a danger to themselves or others. The way the author deals with this ambiguity is particularly moving. In the book, as with the author's real life, we don't know what happens to patients. The author never knows if the patient she releases stays on medication and gets cured, or goes on to a life of misery or suicide. As a reader we want to know what happens, and not knowing makes the book all the more interesting.
A good read.