Danger to Self: On the Front Line with an ER Psychiatrist / Edition 1

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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 readers 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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Editorial Reviews

San Francisco Chronicle

“This fast-paced book feeds our fascination with the world of medicine and our interest in the lives of others.”
Science News

“A gripping, and at times unsettling, account.”

“At times witty and humorous, it is also enlightening and can help to synthesize the many elements of current cultural dilemmas of psychiatric care.”
Publishers Weekly
Linde (Of Spirits and Madness), clinical professor of psychiatry at the University of California–San Francisco medical school, performs a remarkably successful balancing act by presenting both the theory and practice of emergency room psychiatry in a compelling manner. He personalizes his cases and demonstrates how essential the human dimension is in high-quality care. Using 10 fascinating case studies from his 17-year career—with patients manifesting symptoms from suicidal behavior to catatonia—Linde discusses the medical, legal, philosophical and ethical implications of treatment options. He brings the reader along as he is forced to make almost immediate diagnoses and determine courses of treatment, including incarceration, that have the potential to shape (or end) these patients' lives. It becomes abundantly clear that there are rarely simple, straightforward answers. Linde quotes a professional bromide: “[t]he only thing that two psychiatrists can agree on is that a third one is wrong.” He's a talented writer and a compassionate doctor who understands what works best for him and his patients: “while my head works pretty well, my real strength as a physician comes from the heart.” (Jan.)
Library Journal
In this moving book, Linde (psychiatry, Univ. of California; Of Spirits and Madness: An American Psychiatrist in Africa) relates the challenges, joys, and potential gut-wrenching errors of his work as an emergency room psychiatrist at a public hospital, who is encountering those on the margins of society in the midst of illness. Few of the many recent books on therapy, psychoactive medications, and American mental health services put human faces on their subjects as Linde does. He writes with grace, honesty, and humility about the psychiatrist's task of judging the mind and heart of another human being while remaining convinced that medicine can play a role in restoration and healing. VERDICT Those who enjoy the writings of Oliver Sacks and Sherwin B. Nuland will be enlightened by Linde's compassion and carefully wrought prose. Students of health policy, counseling, and psychology will find insight here as well.—Aaron Klink, Duke Univ., Durham, NC
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Product Details

  • ISBN-13: 9780520249844
  • Publisher: University of California Press
  • Publication date: 1/7/2010
  • Edition number: 1
  • Pages: 253
  • Product dimensions: 5.90 (w) x 8.30 (h) x 1.10 (d)

Meet the Author

Paul R. Linde, MD, is Clinical Professor of Psychiatry in the School of Medicine, University of California, San Francisco and the author of Of Spirits and Madness: An American Psychiatrist in Africa.
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Table of Contents

Preface. Nowhere to Hide

1. The ER Doc: Who's Calling the Shots?
2. The Rookie: Bruno's Man Down
3. The Scrambler: How to Prevent a Murder
4. The Psychodynamo: Learning to Listen with a Professional Ear
5. The Jailer: If You Want to Go, You Have to Stay
6. The Jury: Playing the Suicide Card
7. The Clairvoyant: Whose Life Is It Anyway?
8. The Speed Cop: Talking to Tina
9. The Witness: Trauma Underlies the Pain
10. The Judge: Playing God from a Psychiatric Standpoint

Epilogue. Straight from the Heart

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Sort by: Showing all of 2 Customer Reviews
  • Posted June 7, 2010

    I Also Recommend:

    Danger to Self: On the Front Line with an ER Psychiatrist

    This book is in the top five books I've read in the past year.

    This is not quite an entertainment, so those who look for "hot stories about crazy people" will probably be a little disappointed. The author does not display people in distress like the human circus; he tells their stories in a calm and compassionate manner with respect for who they are and where they come from.
    Psych ER is a highly stressful environment with insanity pushed to its limits; patients represent a danger to self, or others, and to keep oneself not just calm and professional but respectful and sensitive to others' pain is a gift.
    I like how Dr. Linde places main focus on his patients and the hospital/city environment, not himself; this allows seeing unfolding dramatic stories in a context of a bigger picture of current medical/urban reality. At the same time there is a strong author's presence in this book, and his personality gradually reveals itself through little phrases, observations, and humor.
    I enjoyed every story and I highly recommend this book to those who are in the process of becoming mental health professionals or just curious what it is like to be a psych doctor in ER.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted September 15, 2010

    No text was provided for this review.

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