CRAZY ALL THE TIME

Disorder and chaos at Manhattan's world-famous Bellevue Hospital Department of Psychiatry, told with bold first-person gallows humor by its scooter-riding chief psychologist since 1980, and by Kahn (the deftly eloquent Beyond the Double Helix, 1985). The title tells it all: life is crazy all the time at Bellevue's psych ward, in part because budget cuts make timely processing of paperwork impossible, leave no money for forms, pencils, Rorschach tests—Dr. Covan has to replace his typist with toneless, wall-staring Yolanda, a paranoid schizo outpatient who is Josephine (``Yolanda's not here today''). Meanwhile, Covan crunches through black farce every minute of his day, with five calls waiting, people pulling on his sleeve, hospital services collapsing—even the floor splits open like gunfire. We follow his monitoring of the training of nine doctoral candidates in clinical psychology during their internship, with each chapter opening up one or two cases. First intern is David Anderson—cocky, clean-cut, gym-fit, and vitamin-fed—who needs to be loosened up so he can relate to patients like Matthew, a Pentecostal ``failure at independent living'' who's cut off his penis, just had it sewn back on against his will, and won't talk with David, who must break through Matthew's defenses within his 35-day hospitalization or see him return with another penisectomy. Trainee Keisha Wright faces a manipulative guy on the psychiatric prison ward who swallows razor blades, nuts and bolts, whatever—is he faking madness to land an insanity plea to keep him out of prison? And so it goes: interns learn to feel deeply about other people and face their own feelings in dealing with them. Dr. Covan shows great natural wisdom while reality-testing his coven of trainee shrinks. Memorable, indeed.