The Book of the Week is “Weekends at Bellvue” by Julie Holland, published in 2009. This is a personal account of a psychiatrist who, for nine years, managed weekend admissions to Bellvue, the New York City mental hospital.
Prior to Bellvue, Dr. Holland did her residency at Mount Sinai Hospital in 1992. On her first day, she was put in charge of a patient who believed he was God. Later, she joked to her mother, “…I am starting my medical career at the very top… I am God’s doctor!”
She describes the office politics at Bellvue, why she admitted or released all kinds of patients, including criminals, crime victims, the homeless, addicts, malingerers and people truly in need of help. Colorful vignettes are alternated with details of her personal life. She discusses the growth of her personal relationships– with a close colleague, and with her own psychiatrist, with her eventual life partner, and children. She also relates her fears of being the victim of retaliation by a former employee, and dangerous patients.
There were some extreme stories. At the occurrence of the World Trade Center disaster, a manic Iowa man rode a bus all the way to Ground Zero to help with the recovery effort. There, he was somehow able to get inside and operate a backhoe. He told Dr. Holland, “They need my help.”
Dr. Holland realized she was frustrated that she was able to help patients only temporarily. Bellvue is a revolving door of sorts. Some patients return again and again, because they lack a support system to lift them permanently out of their bad situations, such as addiction, homelessness, or their going off their medication. If Dr. Holland judged that their situations warranted admission to Bellvue, they might get detoxed or restarted on their medication, and/or a comfortable place to sleep in the short term, but once released, would return to the same situation again.
In the end, Dr. Holland left Bellvue because she felt she could be of more assistance to patients in private practice in that she could establish a one-on-one long-term treatment program with them.