Posted by dj on January 18, 2000, at 14:54:58
In reply to Re: Movies, posted by Elizabeth on January 17, 2000, at 23:13:20
in the psych-lit vein:
In a House of Dreams and Glass : Becoming a Psychiatrist
by Robert Klitzman
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Editorial ReviewsFrom Booklist , February 1, 1995
Klitzman affords a highly personal look at his four-year psychiatric residency. Not the usual first-year resident, Klitzman had spent time at the National Institutes of Health and in Papua New Guinea studying kuru. On his first night on call, he was abruptly exposed to a violent patient requiring physical restraints and the quiet room. His at first fumbling but increasingly more comfortable experiences with outpatients, inpatients, and ultimately his own patients gave him opportunities to mature as an individual and as a practicing psychiatrist. He learned from street person Ronald Bransky as well as from a variety of neurotic, borderline, and psychotic patients and was able to help some of them in making sense of their torn lives. One of the hardest things to learn was knowing when to question the authority, even domineering, of his supervisors and administrators. Klitzman concludes his story with pleas for more openness and flexibility in psychiatric education and for greater understanding of the relevance of social problems to psychiatry. William Beatty
Copyright© 1995, American Library Association. All rights reservedBTW, if you check out the rest of the reviews of this interesting read at http://www.amazon.com
you'll see more of the text of Kay Redfield Jamison review in The Washington Post Book World (March 19, 1995), a bit of which follows:"While I feel that Klitzman overstates the degree of subjectivity involved in psychiatric diagnosis and treatment, there is no doubt that such subjectivity is a very real problem. He describes its consequences: "In medicine, for example, failures were ascribed t! o patients' high sodiums or low potassiums. When disaster ! occurred in psychiatry, I had nothing to blame but my subjective impressions that had led to my decisions - not objective factors."
Klitzman ultimately directs a great deal of his anger at his clinical supervisors who, he felt, from the beginning, engaged in "a process of equating residents [doctors in training] with patients that would come to shadow much of my training." His accounts of the inconsistencies in diagnostic and treatment practices that he encountered in his different supervisors gives a realistic picture of what can happen when a teaching hospital encourages a diversity of theoretical orientations, but no cohesive clinical viewpoint is presented. Klitzman reserves particular spleen for the psychoanalysts, whom he regarded as condescending, aloof, unsupportive and cold: "Those who most talked about and professed the importance of feelings - the psychoanalysts - were often the coldest and least feeling toward their patients and supervisees! ."
In a House of Dreams and Glass is an excellent account of a not-so-excellent education; it illustrates the vulnerabilities of a less than perfect teaching system, as well as the strengths that come about from a total immersion into clinical responsibility. It would have been interesting to know a bit more about Klitzman himself, as well as his life outside the hospital, but I recommend his book as a valuable account of one particular kind of training that goes into becoming a psychiatrist."
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An interesting read from a patient's perspective as well as a good overview of small town life in Altlantic Canada, in this case is: Strange Heaven by Lynn Coady. This award winning first novel does NOT even appear on the amazon.com site however here's a brief portion of a review from
(http://www.indigo.ca/cgi-bin/bookrec.cgi?bn=0864922302) of this book which is semi-autobiographical:
"Bridget Murphy, Strange Heaven’s emotionally bedraggled anti-heroine, spends the first half of the book in the psychiatric ward of a Halifax children’s hospital, recovering from the trauma of giving birth to a baby who was immediately given up for adoption. Depressed and apathetic, she responds to all questions about her welfare with a toneless “I dunno,” but she seems positively healthy next to most of her fellow patients. There’s Kelly, who’s recovering from anorexia, and Maria, who’s dying from it; foul-mouthed, tattooed Mona, who has a habit of running away from her wealthy father, and Byron, an acne-ridden geek with bizarre delusions of grandeur. As described by Coady, life on the ward is both nightmarish and laugh-out-loud funny; it’s like a Janet Frame novel reconceived by Adrian Mole author Sue Townsend.
When Bridget returns to the town her friend Alan finds so poignant, to her noisily dysfunctional family and her gossipy, hard-drinking friends, she’s like a castaway from another planet. Numb and detached, she regards the people she’s known all her life with sudden incomprehension. Seen through her bemused gaze, mundane and uncomfortable events – a rancorous Christmas dinner, a boozy house party, a visit to a family mourning their murdered daughter – become surreal and blackly hilarious. What’s surprising is that even though home is at least as nightmarish as the psych ward, it turns out to be a better place for Bridget’s wounded psyche to heal."This book was reviewed by: Quill & Quire
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URL: http://www.dr-bob.org/babble/20000112/msgs/19156.html