Weekends at Bellevue CD

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

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 Bellevue's psychiatric emergency room. Deciding who gets locked up and who gets talked down would be an awesome responsibility for most people. For her, it was just another day at the office...

In an absorbing memoir laced with humor, Holland provides an unvarnished look at life in the Psych ER, recounting stories from her vast case file that are alternately terrifying, tragically comic, and profoundly moving. 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.

Writing with uncommon candor about her life both inside and outside the hospital, Holland supplies a fascinating glimpse into the inner lives of doctors, struggling to maintain perspective in a world where sanity is in the eye of the beholder.