Holy cow. This was the most disgusting book I have ever read. The fact that someone as abusive, sadistic, narcissistic, and offensive as Julie Holland decided to write a memoir BRAGGING about these qualities astounds me. I knew I was in for a terrible ride when the first sentence talked about being surrounded by "insanity" and the next page thanked the NYPD. I highlighted everything that was offensive which ended up being around 60% of the book. I have 130 highlights and they were exclusively things that I found especially disgusting.

She spent the entirety the book doing any of the following:
- Laughing at people's worst days and sharing their trauma with the world
- Smugly kicking people out of the ER who she unreasonably deemed shelter-seeking and "not actually sick" (AKA not white, middle-class, employed people)
- Unnecessarily drugging patients for her own convenience and to get on cops' good sides
- Talking about how "butch" she is for being a heartless piece of crap
- Making massive generalizations based on diagnoses (schizophrenia, bipolar disorder, and sociopathy for the most part)
- Laughing at sexual harassment in the workplace
- Abusing her patients, going to therapy to try and figure out why she's so sadistic, blaming it on her non-existent daddy issues, and then deciding she's done with therapy even though she's still a sadist
- Equating mentally ill people with animals and talking about "T&Rs" or "zookeeper's guilt"
- Using words like the r-slur
- Seducing patients to get information from them

The lack of respect with which she discusses homeless people, incarcerated people, transgender people, and-- get this-- mentally ill people, is disturbing, especially as she details her interactions with said groups. She describes a transgender woman as "one humongous she-male!" and misgenders her throughout the entire story.

These were just a few of the things that stood out to me, but I could talk for hours about how disgusting this book was. I am furious that this was ever written or published and that someone like this worked in a psychiatric institution for so long. She deserves to have her medical license stripped and her name tarnished for life. I don't generally hate authors for writing bad books, but I hate her for being a bad person.

HORRENDOUS. If I could give this zero stars, I would. ( )

Dr. Julie Holland is a psychiatrist and psychopharmacologist who worked in the psychiatric ER at New York's Bellevue Hospital from 1996 through 2005.

This memoir wasn't exactly the collection of wild stories the cover blurb seemed to promise, and it also wasn't quite the nuanced and thoughtful exploration of the treatment of mental illness that I was hoping for (although it does certainly have some of the latter). What it was, mostly, was, well, a memoir. Holland spends a lot of time talking about herself, her relationships of various kinds with other doctors, her own psychological issues, and the insights about herself she's taken from psychotherapy. Part of me can't help but find some of that a little self-absorbed or over-share-y, although I do appreciate her ability to be honest about her own faults, and those personal ruminations do both tie into the larger issues of mental health support and illuminate some of what it's like to do this particular job.

Whether it's quite what I expected/wanted to read or not, I did at least find this interesting as a glimpse into this world, with all its medical and emotional complexities. But, perhaps unsurprisingly, it's also pretty depressing, since it's crystal clear throughout that the systems we have in place for dealing with mental health crises and substance abuse problems are pathetically, horrifically inadequate (something Dr. Holland definitely appreciates, even if she's mostly fairly low-key about addressing it). ( )

This book rocked my socks off. I worked in the same professional mental health environment a few years earlier than Holland, overlapping her (in the same neighborhood) by a couple of years.

I know how being injured from a patient can have a deep and lasting effect on you. I was picked up, thrown into a wall and required stitches for a deep head wound. It still aches during cold weather. It was the beginning of my burn out in social work.

The only flaw I found was what she learned about the years of deinstitutionalization. I was working in the field for most of it. I turned off the lights in one of them. I worked in a couple of the community based options. Her explanation for their failure was far too simplistic.

Some of it was NIMBYism, yes. Absolutely. However, some of it was out of genuine concern for the individuals and their choices and wishes. For some individuals, their world became far more restrictive when they moved from an institutional setting to a community setting. I went to endless meetings with individuals who wanted their long term care to remain institutional and separate from the outside world. We're not talking about criminals here. We're talking about people who wanted control over their environment and they couldn't have that in the community based options.

In the outside world their medications were focused on controlling socially inappropriate behaviors. Some became the walking dead. Their personalities disappeared. When they were institutionalized the staff could deal with their odd behaviors (and occasional nudity) and the medical restraints were kept to a minimum. We could work with their socially inappropriate behaviors because we could see them and address them. That wasn't the case when they were stuffed to the gills with sedation.

Back to the book - Mostly I identified with Holland's lack of desire to advance within the field. More important, she knew when to leave the setting that was exhausting her of all sympathy. In the mid-90s the term was 'crispy-fried'. My own burn out was a simple lack of caring what happened day to day. I knew I had to exit the field.

I've read some of the other reviews slamming her for her attitude here - Just wait until you've worked in the system in NYC for a few years. It chews you up and spits you out. ( )

I'm not sure why I thought this would be a good read. Maybe the title snared me as to expect quirkiness and such from the nature of those who drift into the Psyche ward of Bellevue hospital. I was disappointed. Though there are a few intriguing cases mostly the book is about Dr. Holland's life experiences. That said the title might will have been, "Dr. Holland, A Life."

We are taken through her experiences coming out of school and into the fray of a large hospital. But the book relates more to her coming of age, getting married, finding a mentor, having children, and a huge political squabble for power and control with one of her colleagues.

Interspersed she does talk a bit about how our healthcare system when dealing with the many in need of mental care is lacking. Also briefly referring to the private practice she developed and how prescribing the medications that drive psychopharmacology I found interesting. The entire book though did not have much to offer in any way. ( )

Seemed to be a personal rant or confession rather than a cohesive narrative ( )