In a House of Dreams and Glass

Book excerpt: A psychiatric resident's firsthand account reveals his struggles with the homeless, suicidal, and paranoid, and his frustrations with hospital politics and the limitations of an inexact science. Fresh from medical school, Robert Klitzman began his residency in psychiatry with excitement and a sense of mission. But he was not prepared for what he found inside the city psychiatric center where he was to spend three grueling years. In truth, as Dr. Klitzman's absorbing account of his apprenticeship reveals, he never ceased to be surprised—by his patients, by the senior psychiatrists' conflicting advice on how to help them, and by the unpredictable results of the therapies, both psychoanalytic and biologic, that he and his fellow residents practiced. Nights in the emergency room, professional controversy, the minefield of hospital politics, the stress of his own therapy--everything is here, in a passionate and illuminating analysis of a doctor's struggle against tremendous odds to banish his patients' demons.