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Psychiatrist Holland recounts nine years working the weekend shift in the emergency room of one of the nation’s iconic psychiatric hospitals.

When she started her job at the Bellevue psych ER, 30-year-old Holland (editor: Ecstasy: The Complete Guide, 2001) was single, intelligent and tough. Prisoners in chains, battered women, the homeless, desperate and delusional—all became an exercise in how quickly a patient could be treated and released. Readers meet an endless procession of these broken souls, some more sympathetic than others, and get a sense of the difficulty of the author’s job. Holland describes how the staff competed to identify which patients were feigning symptoms to score a warm bed and hot meal, until the author, shaken after a scary incident, realized that “even the lying patients are still coming to the hospital because they are in need. Don’t send them away empty-handed.” Unfortunately, few of the patients’ stories are particularly memorable, and Holland misses countless opportunities to make them so. Because she is so focused on her journey from tough girl to “working mother of two with a heart of mush,” the take-home message from each of these vignettes, when there is one, almost always relates only to the narrator—who, despite this, does not come across as a particularly self-aware storyteller. There are some moving moments of genuine insight, but they are dulled by so much extraneous detail that everything starts to feel arbitrary. A more focused narrative, with half as many patients whose stories carried twice as much weight, would have made for a much stronger book.

Despite a promising premise and a few fascinating stories, the book is ill-focused and overlong.

Pub Date: Oct. 6th, 2009
ISBN: 978-0-553-80766-0
Page count: 310pp
Publisher: Bantam
Review Posted Online:
Kirkus Reviews Issue: July 15th, 2009