"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.
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."
In this admittedly disjointed memoir, Holland reveals just what it takes to run the weekend shift at one of America's most famous mental hospitals for almost a decade. Not one to sugarcoat reality, Holland paints a disturbing picture of our current mental healthcare priorities, and quite frankly of herself. I'll admit there were plenty of aspects of her life and personality which I found off-putting, but the raw honesty she displays is a testament to her commitment. I'm not sure I'd choose Holland as a friend or as a doctor, but suspect it was her ability to compartmentalize that made it possible for her to do her job and do it fairly well for 9 years.
Ultimately, I would have preferred a slightly more cohesive narrative structure; the book reads like a series of unrelated vignettes until close to the end. That said, this is certainly a book worth reading if you are in the mental health field. Though I could wish for a more sympathetic narrator, I suspect that Holland's rather grim portrayal of herself reflects the real truth about those battling on the front lines of the mental heathcare system- too little time, too few beds, and too little follow-up must wear down even the most optimistic of practitioners.