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Danger to Self: On the Front Line with an ER Psychiatrist
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The psychiatric emergency room, a fast-paced combat zone with pressure to match, thrusts its medical providers into the outland of human experience where they must respond rapidly and decisively in spite of uncertainty and, very often, danger. In this lively first-person narrative, Paul R. Linde takes listeners behind the scenes at an urban psychiatric emergency room, with all its chaos and pathos, where we witness mental health professionals doing their best to alleviate suffering and repair shattered lives. As he and his colleagues encounter patients who are hallucinating, drunk, catatonic, aggressive, suicidal, high on drugs, paranoid, and physically sick, Linde examines the many ethical, legal, moral, and medical issues that confront today's psychiatric providers. He describes a profession under siege from the outside - health insurance companies, the pharmaceutical industry, government regulators, and even "patients' rights" advocates - and from the inside - biomedical and academic psychiatrists who have forgotten to care for the patient and have instead become checklist-marking pill-peddlers. While lifting the veil on a crucial area of psychiatry that is as real as it gets, Danger to Self also injects a healthy dose of compassion into the practice of medicine and psychiatry.
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Audible Audiobook
Listening Length: 8 hours and 2 minutes
Program Type: Audiobook
Version: Unabridged
Publisher: Audible Studios
Audible.com Release Date: October 8, 2012
Whispersync for Voice: Ready
Language: English
ASIN: B009N9WXHC
Amazon Best Sellers Rank:
If you were repulsed by "Weekends at Bellevue", you will find not only much humanity but much substance (briefly and concisely presented) in Linde's book.Since I've been an um...customer.. in the very same facilities Dr. Linde has worked at, I was most eager to read the book. I've also worked with the mentally ill as well. The way that he frames very crucial issues was really important and vital to anyone who wants to understand the challenges of dealing with mental illness in the US today, especially issues of homelessness, "Free Will", compliance and non-compliance, and the tricky judgement calls that doctors have to make often with sparse information at hand.There is one sad tale of how he misjudged the suicidality of a patient; and another white-knuckle story of how he had to advocated for a liver transplant for a suicidal patient, a "high risk", as judged by the team that assess who will receive a life-saving transplant- and who will not. It's situations like that that make one say "I wouldn't want your job for the world". The burden of responsibility is great. How reassuring it is to know that someone as caring as Dr. Linde is in that position, as psychiatry is a field highly susceptible to abuse and neglect-- there is a long, sad history of how we arrive at the deinstitutionalization movement that resulted in the droves of ill homeless people we see today.It's very informative to the layman, without being too technical, in terms of laying out the legal, ethical and practical issues of mental health care. As Linde states, professionals may want to refer to more in-depth sources for full coverage of the issues. But I think the general public needs to have better understanding of these matters, so that they can get a sense of why we don't just "lock up those crazy people" and how psychiatrists can't be psychic, and how human rights in this area are quite tricky. Fixing the problem is much easier said than done. Some people in my city (the so-called "homeless capital of America") say that not enough care is out there, that it's a matter of neglect. What they don't realize is how extensive our services are (I've worked in them, and used them) but how the day-today challenges, not to mention legal and philosophical dilemmas, don't make for an easy fix to often intractible illnesses.I hope that everyone who read the best-selling "Weekends" takes the time to get a deeper understanding, as Linde presents it, and not just a 'crazy people freakshow' as some readers seem to want.
This book has a lot of information that I found usefull and interesting but there was a lot of quotes from other people and books, sometimes even a page worth of direct quotation, I felt it took away from the story. The title is misleading because it involves more about the history and legal rigamarole involved in practicing than about being on "the front line." I realize the importance of this infrmation I just think the title did not portray what the book was about.
This book does a great job of giving real world examples of emergency room visits dealing often with mental health.
Dr. Paul Linde, a psychiatrist at SF General Hospital, provides a fascinating glimpse into the mental health issues, patients, and practitioners of an urban psychiatric emergency room in DANGER TO SELF. Loaded with interesting medical information, Linde's first person narrative is presented as a series of stories that are highly readable and convey the various roles asked of psych emergency doctors and nurses (e.g., jailor, jury, or clairvoyant). Written for the educated lay reader, the book not only gives a sense of the atmosphere and problems encountered in psych emergency, but also provides a context in which to understand the complex decisions and value judgments that acute care psychiatrists must make. Dr. Linde has a good grasp of the historical and legal contexts in which decisions need to be made, e.g., how does one protect an individual's civil liberties while maintaining the public's need for safety? When is it morally justifiable to revoke a person's right to freedom? Analysis of these issues and others offer much for the reader to think about further.Dr. Linde writes in the Preface that his intention is to humanize psychiatrists, other mental health professionals, patients, and their loved ones and that it is okay at times to laugh, to swear, to self-reveal, and to cry with patients. Linde's stories convey the humanity and compassion of the doctor-patient relationship in a truly engaging and engrossing manner. In my opinion, Dr. Linde has clearly succeeded.
Very intersting read! I liked Paul Linde's writing style -- he opens a view to the challenges of his work, but his compassion and empathy for his patients really comes through. I'd hope if I ever end up in a clinical psychiatric situation, I would be lucky enough to be treated by someone like Dr. Linde.
This outstanding, informative, and soul-searching work should be required reading for ALL mental health professionals.Thank you for stepping out of the white coat and laying your cards on the table. It takes incredible courage to be vulnerable.Well written Dr. Linde. We need more souls like you in the mental health field.Again thank you.
I enjoyed reading this book. It is not exactly filled with much stories, no much medical information, but rather is the thinking aloud on very tough and controversial subjects of patient's care. I should point to humanity and attentiveness of the author. The majority of his subjects are regarding the least attractive for population situations as homeless people, suicide and malingering, as well as prison medicine. He gives rich thoughts about those subjects, which should be very important for those, who are studying psychiatry and medicine. However, it doesn't really reflect the nature and atmosphere of ER, thus could be a bit misleading. I wish, more specific psychiatric stories could continue this book. The style is very sincere, lively and pleasant.
I thought this was a fairly interesting book but I don't think I could recommend it. I never felt any connect with the author (doctor). He was much too clinical unlike a lots of books I have read lately by physicians.
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