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Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER - Softcover

Holland, Julie

 
9780553386523: Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER
Softcover
ISBN 10: 0553386522 ISBN 13: 9780553386523
Verlag: Random House Publishing Group, 2010

Inhaltsangabe

“A gem of a memoir . . . Holland takes us for a ride through the psych ER that is at once wild and poignant, a ride that leaves deep tracks in even the healthiest of minds.”—Katrina Firlik, M.D., author of Another Day in the Frontal Lobe

Julie Holland thought she knew what crazy was. Then she came to Bellevue. For nine eventful years, Dr. Holland was the weekend physician in charge of the psychiatric emergency room at New York City’s Bellevue Hospital. In this absorbing memoir, Holland recounts 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 helplessly watched a young woman pushed into the path of his train. Writing with uncommon candor, Holland supplies not only a page-turner with all the fast-paced immediacy of a TV medical drama but also a fascinating glimpse into the inner lives of doctors who struggle to maintain perspective in a world where sanity is in the eye of the beholder.

Praise for Weekends at Bellevue

“An extraordinary insider’s look at the typical days and nights of that most extraordinary place, written with a rare combination of toughness, tenderness, and outrageous humor.”—Andrew Weil, M.D. 

“Unforgettable . . . tells a mean story.”—New York Daily News

“The tension between [Holland’s] macho swagger and her shame at the harsh way she occasionally treats patients gives this memoir extra intrigue.”—Psychology Today

“A fascinating portrait . . . Holland is a good storyteller with a dark wit.” —New York Post “Equal parts affecting, jaw-dropping, and engrossing.”—Booklist

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Über die Autorin bzw. den Autor

Julie Holland, M.D., is a psychiatrist specializing in psychopharmacology. An assistant professor of psychiatry at NYU School of Medicine, she spent her weekends running the psychiatric emergency room at Bellevue Hospital for nine years. She is the editor of Ecstasy: The Complete Guide–A Comprehensive Look at the Risks and Benefits of MDMA. She lectures widely and has been quoted in Time, Harper’s, Slate, the Los Angeles Times, and The Wall Street Journal. Holland has appeared as a medical expert regarding mental illness and drug use on numerous television shows, including Today and Good Morning America. She runs a private practice in New York City and lives with her husband and two children in the Hudson Valley.

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Chapter One


Mother Nature’s Son  

On a warm day in early spring, two New York City cops and two EMS workers roll a gurney down the hallway, escorting a man to the entrance of Bellevue’s psychiatric emergency room, where I work. Lying on the stretcher underneath a white sheet, with a head of dirty blond hair beaded and dreadlocked, he is naked, sunburned, and screaming. I walk out to greet my new patient as the drivers hand me his paperwork to sign.
 
“What’d you bring me?” I ask eagerly. I can see he’s a live one. I love the live ones.  


Over the shrieking, one of the EMS guys gives me “the bullet,” the few pieces of relevant information when introducing a patient to a doctor: age, chief complaint, pertinent history. “This is Joshua Silver. Twenty-three. No significant medical history, no allergies, no meds. Also, he denies a psych history,” he says archly, shooting me a look.  

“And how’d he get to you guys? Who called 911?”  

“NYPD called in an EDP.” This is cop-talk for a psychiatric patient: emotionally disturbed person. “He’d taken off his clothes in Times Square and was parading around, barking like a dog. And growling,” he adds.  

This gets the patient’s attention, and he interrupts the driver to clarify, “It was my way of showing them that I was not an animal. I am not a dog!”

  Barking and growling to prove he is not a dog? His logic is lost on me, but at least he’s stopped yelling and started communicating.

  “You can talk to me,” I say, turning my full attention toward him.  

“See, there were some guys from Nation of Islam preaching on the corner, and they told a woman who was arguing with them that she was just a dog—God spelled backwards—to which I took offense.” He then explains to me, as he did to them, that all people are art. “ ‘Thou art art,’ I told them. ‘Once you accept that all people, all objects, are art, you will live in heaven as I do.’ ”  

“You know what, Joshua?” I ask, having decided it is time to move out of the triage area and into the locked area. “I think you and I should go talk about this inside.” I want us to sit in an interview room so I can try to get some more history, and I don’t feel like standing over him while he lies on a stretcher. I can already tell he’s an admission and will need to be in the detainable area for patients awaiting beds upstairs.

I let EMS and NYPD know that they are free to leave, and I grab my new patient some hospital pajamas. I help him off the stretcher, wrapping his sheet around him, and walk him into the larger, locked part of the ER. As I escort him through the entrance, the door clicks definitively behind us, and I hope he doesn’t notice that he is now locked in. Because he is naked, we can dispense with the contraband search, which is good. The search is often the point where people become uncooperative and agitated, ending up restrained and medicated.  

Prior to entering the detainable area, a patient must remove his belt, shoelaces, rosary beads—anything that can be used to hang himself or choke a fellow patient. Inevitably, the patient will insist that he is not suicidal or dangerous, but it doesn’t matter; these items are not allowed in the detainable area. Neither are cell phones, crack pipes, backpacks, knives, pens, wallets, and the list goes on. The patient has to give up just about everything along with his freedom.  

Luckily, Joshua is oblivious. I show him to the bathroom where he puts on the pajamas quickly. I alternate between keeping an eye on him and setting up the interview room. There are several windowed rooms within the detainable area, each with a desk and two chairs. I put my chair closer to the door. As we settle into our talk, the first thing I notice is that although he is disheveled, he seems well-educated with an impressive vocabulary. He tells me he has written a twenty-eight-page manuscript, which he calls a prose-poem, based on his newly embraced credo that everything is art. He is hoping to reach millions of people by delivering his manifesto on the Howard Stern show on K-ROCK, a radio station in the city.  

“I am a holy man,” he tells me, explaining how his writing has elevated him to this level. “I feel like King Arthur in a tower of Babel.” He is hyper-verbal, spewing non sequiturs. I try to keep up with him, playing follow the leader, as if we are hopping from rock to rock in a rushing stream, but he is pulling far ahead of me. Eventually, I have to tell him he’s not making a lot of sense.  

“Joshua, you need to slow down. I want to understand what you’re saying, but it’s difficult for me. I’m focusing on the illogical connections that you’re making…”  

It sounds like “theological connections” to him, and his smile beams; he’s pleased that I’ve grasped his religious message. I don’t bother to correct him.  

Being preoccupied with religion is a classic manic symptom, and mania is the better-known half of manic depression, now called bipolar disorder. In a manic state, people have less desire for sleep; they will talk more, create more, do more. Commonly, bipolar patients get hyper-religious in their newfound frenzy and sometimes end up on a street corner and then a psych ER explaining that they are Jesus or the Messiah, or that they’ve discovered a new religion. They’ve been touched by the Lord who spoke to them. They’ve had a vision, an epiphany, and they want to share it with the world. Their grandiosity can be charismatic and alluring. Religions and cults are formed around this kind of energy, and I’m happy to warm myself by Joshua’s fire during the interview.  

In March and April, our ER becomes crowded with manic patients. For many bipolars, there is a seasonality to their symptoms. Just as more people get depressed in the winter months, increased exposure to bright sunlight can elevate moods. Also, the air is heady with religious themes during spring, when Easter and Passover coincide. The resurrection is reenacted in the budding trees and sprouting flowers, miraculously coming to life where once lay a blanket of snow. We get multiple Jesuses in the ER this time of year.  

Joshua’s pressured speech is another sign of his mania. It rambles hither and yon, like a butterfly dancing merrily among the flowers, setting down briefly on the themes of religion and art as if they were particularly colorful blossoms. I try to join him in his wordplay, to engage him gently in the hopes of learning more about him: where he’s from, where his parents are, and whether he’s stopped his medication, which is a good bet. Most of the manic patients who come through our doors have gone off their meds. The mood stabilizers have significant side effects, and people are often resentful about having to use them. Also, mania usually feels better than being medicated, at least for a while. It’s a bit like surfing, knowing it has to end with the inevitable wipeout, but loving the balancing act required to keep it going.

  Most of our patients battle with their need for medications. When they start to feel better, they abandon their treatment plan, thinking they’re cured. Even if they know they’ll get sick again, they hate taking the pills so much that they stop anyway. Coming through our doors is a painful and humbling lesson in how to manage their illness.  ...

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Verlag
Random House Publishing Group
Erscheinungsdatum
2010
Sprache
Englisch
ISBN 10 
0553386522
ISBN 13 
9780553386523
Einband
Taschenbuch
Anzahl der Seiten
320
Kontakt zum Hersteller
Nicht verfügbar
Verantwortliche Person
preigu
mail@preigu.de

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