Sunday, September 15, 2013

Compassionate Medicine

ISBN-10: 1594203938
ISBN-13: 9781594203930
Published: Penguin Press HC, The, 08/01/2013
Pages: 256
Language: English
Well into the 18th Century, Bethlem Royal Hospital in London was partially funded by visitors who paid to gawk at the mentally ill inmates living there in unconscionable conditions. Today, mental healthcare is thankfully much-improved, but remains a controversial, difficult field. Christine Montross capably illustrates the various medical and moral quandaries encountered during her career as a mental healthcare professional in her new book Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis. Not coincidentally, Montross will be visiting Flyleaf Books tomorrow at 7:00 pm to discuss her book-- 10% of the proceeds will be going to the N.C. Children's Hospital.

Falling Into the Fire loosely falls under the genre of memoir but-- while it does contain autobiographical details and a healthy dose (pun intended) of the author's personal concerns and beliefs-- the book is far less author-oriented than the genre label might lead you to expect. Montross loosely structures the book around her experiences with five different patients, each of whose particular case provokes an inquiry into the ethics and efficacy of different types of treatment. Montross also provides fascinating discourses on different aspects of medical history-- she does not shy away from psychiatry's checkered history, or from the horrific abuses committed by whatever you might call its predecessors (the word "bedlam" is derived from Bethlem Royal Hospital). Instead, Montross makes a convincing case for the compassionate, rational care of ill individuals, something we frequently fail to provide even today.

Montross does not fit the pervasive stereotype of the cold, Nurse Ratched-esque physician/psychiatrist/scientist. She is able to draw upon a wealth of research and data without dehumanizing her particular patients-- among them, a man so depressed he doesn't respond to pain, a woman who compulsively swallows knife blades and other dangerous objects, and a man who claims to be experiencing a dramatic spiritual awakening. Each case is tragic and disturbing, but also evocative of a particularly difficult concern in psychiatric medicine. For instance, in Falling Into the Fire, Montross discusses the merits of involuntarily admitting patients, examines the sometimes-tricky line between intense spirituality and madness, and even debates the morality of murky issues such as elective amputation of healthy limbs (you really have to read the book to understand why that's even a debatable issue). Ultimately, Montross poses more questions than she can provide definitive answers, a testament more to the complexity of her chosen career than to her own insight, which is extraordinary. 

Personally, I think Montross has done more than enough by shining a light on a number of issues that we might be more comfortable ignoring. I hope to see you at the event tomorrow night-- I expect the Q and A segment will be lively.

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