In a House of Dreams and Glass: Becoming a Psychiatrist

Overview

When Robert Klitzman and his fellow psychiatric residents began their training at a large city hospital, they were not prepared for what they would face over the next three years. Learning by trial and error, they struggled to help patients overcome depression, banish paranoias, and escape inner demons. In a House of Dreams and Glass recounts in dramatic detail the true story of a young psychiatrist's grueling training. In fascinating stories we see Klitzman as he battles the inexact nature of the "science" of ...
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Overview

When Robert Klitzman and his fellow psychiatric residents began their training at a large city hospital, they were not prepared for what they would face over the next three years. Learning by trial and error, they struggled to help patients overcome depression, banish paranoias, and escape inner demons. In a House of Dreams and Glass recounts in dramatic detail the true story of a young psychiatrist's grueling training. In fascinating stories we see Klitzman as he battles the inexact nature of the "science" of psychiatry, conflicting advice from the doctors serving as his supervisors, and the patients themselves. The young residents must come to grips with the realities of the profession they have chosen. They are treated by the staff doctors much as if they were patients, undergoing psychotherapy and being tested. Patients infiltrate the residents' lives. Trainees are caught between their patients, the staff, and the more senior hospital physicians as they literally attempt to learn psychiatry by practicing it. The suicide of a patient, grueling nights in the emergency room, the stress of treating demanding patients, the minefield of hospital politics, and the despair at treatment that fails - all are portrayed with sensitivity and at times even humor. From the slick, glitzy promotional campaigns of drug companies to the squalor of a homeless shelter, Klitzman shows the excesses that characterize his field. Even as it illustrates the controversies and questions of psychiatry, ultimately In a House of Dreams and Glass is the story of a young doctor struggling to help patients in the face of sometimes harsh hospital bureaucracy, an overworked hospital staff and doctors, and the patients' own mental demons.

"...author of A Year-long Night, Dr. Klitzman recounts his three-year residency in psychiatry, which gives the reader a fascinating look into a profession which does not always have all the answers & is also a hotbed of hospital politics

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Editorial Reviews

Publishers Weekly - Cahners\\Publishers_Weekly
Klitzman, a New York City psychiatrist who described his medical internship in A Year-Long Night, now offers an involving, highly revealing look at the chaotic world of psychiatric practice in this account of his three-year residency at an unnamed psychiatric hospital, part of a sprawling university medical center. Among his patients are Nancy Steele, a suicidal artist; Ronald Bramsky, a homeless drug addict who has endured more than a dozen operations for bone cancer; Blanca Diaz, a woman with dementia who believes she is in "the House of God, the Gateway to Heaven" and numerous schizophrenics, psychotics and depressives. We watch as Klitzman wrestles over whether to use psychological approaches, which frequently disappoint him; biological, drug-based treatments, which have helped many patients more than he expects them to; or a combination of approaches. Hospital politics unfolds in a clash of physicians' personalities and therapeutic styles, to the point where each ward constitutes a different social environment. Too often, observes Klitzman, patients are pigeonholed into narrow categories, given drugs and then blamed for their failure to improve.
Publishers Weekly - Publisher's Weekly
Klitzman, a New York City psychiatrist who described his medical internship in A Year-Long Night, now offers an involving, highly revealing look at the chaotic world of psychiatric practice in this account of his three-year residency at an unnamed psychiatric hospital, part of a sprawling university medical center. Among his patients are Nancy Steele, a suicidal artist; Ronald Bramsky, a homeless drug addict who has endured more than a dozen operations for bone cancer; Blanca Diaz, a woman with dementia who believes she is in ``the House of God, the Gateway to Heaven'' and numerous schizophrenics, psychotics and depressives. We watch as Klitzman wrestles over whether to use psychological approaches, which frequently disappoint him; biological, drug-based treatments, which have helped many patients more than he expects them to; or a combination of approaches. Hospital politics unfolds in a clash of physicians' personalities and therapeutic styles, to the point where each ward constitutes a different social environment. Too often, observes Klitzman, patients are pigeonholed into narrow categories, given drugs and then blamed for their failure to improve. (Mar.)
Library Journal
Having described his first-year medical residency in A Year-Long Night (LJ 2/1/89), Klitzman continues with this account of his three-year psychiatric internship in a New York City university teaching hospital. Assigned rotations in short-term in-patient wards, emergency rooms, and out-patient clinics, Klitzman learned to diagnose mental disorders and administer treatment ranging from psychodynamic therapy to electric shock. He is a deft observer of the interactions between patients, residents, supervisors, and hospital staff, Klitzman makes us equally aware of his personal struggles to deal with the pressures to conform to training that discourages questioning and to understand an institutional system that appears to benefit staff rather than patients. Reminiscent of Mark Warren's The Making of a Modern Psychiatrist (Doubleday, 1986), this insightful memoir is recommended for public libraries.-Lucille Boone, San Jose P.L., Cal.
William Beatty
Klitzman affords a highly personal look at his four-year psychiatric residency. Not the usual first-year resident, Klitzman had spent time at the National Institutes of Health and in Papua New Guinea studying kuru. On his first night on call, he was abruptly exposed to a violent patient requiring physical restraints and the quiet room. His at first fumbling but increasingly more comfortable experiences with outpatients, inpatients, and ultimately his own patients gave him opportunities to mature as an individual and as a practicing psychiatrist. He learned from street person Ronald Bransky as well as from a variety of neurotic, borderline, and psychotic patients and was able to help some of them in making sense of their torn lives. One of the hardest things to learn was knowing when to question the authority, even domineering, of his supervisors and administrators. Klitzman concludes his story with pleas for more openness and flexibility in psychiatric education and for greater understanding of the relevance of social problems to psychiatry.
From Barnes & Noble
An unflinching depiction of a young resident psychiatrist's training and his struggle to help patients in the face of hospital bureaucracy, an overworked staff, & and the patients' own mental demons.
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Product Details

  • ISBN-13: 9780804114363
  • Publisher: Random House Publishing Group
  • Publication date: 6/1/1996
  • Format: Mass Market Paperback
  • Pages: 333
  • Product dimensions: 4.12 (w) x 6.80 (h) x 0.96 (d)

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