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Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER Hardcover – October 6, 2009

3.7 out of 5 stars 213 customer reviews

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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.

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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
  • Average Customer Review: 3.7 out of 5 stars  See all reviews (213 customer reviews)
  • Amazon Best Sellers Rank: #544,201 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Hardcover Vine 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.
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Format: Hardcover Vine 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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Format: Hardcover
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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Format: Hardcover Vine 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.
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