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Danger to Self

On the Front Line with an ER Psychiatrist

Paul Linde (Author)

Available worldwide

Paperback, 280 pages
ISBN: 9780520269835
January 2010
$24.95, £20.00
Other Formats Available:
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.
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
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.
“Immerses the reader in the at times raw, often maddening and messy arena of a psychiatric emergency room doctor's life . . . . Linde's fast-paced but well-detailed accounts supply the wild, loud, chaotic, smelly and dangerous but also mostly moving ‘scripts’ that could easily be a TV show.”—San Francisco Chronicle
“Performs a remarkably successful balancing act by presenting both the theory and practice of emergency room psychiatry in a compelling manner. . . . He's a talented writer and a compassionate doctor who understands what works best for him and his patients.”—Publishers Weekly
“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.”—Library Journal
“A gripping, and at times unsettling, account.”—Science News
“Psychiatrist Paul Linde takes readers to places few have been. In a book that may humor, shock, or enlighten, readers are taken into the jails and emergency departments that deal with the interface between the institutions of society and citizens in emotional crises. . . . At times witty and humorous, it is also enlightening and can help to synthesize the many elements of current cultural dilemmas of psychiatric care.”—Jama
“This fast-paced book feeds our fascination with the world of medicine and our interest in the lives of others.”—San Francisco Chronicle
“An engaging and well-written book that comes across as genuine and heartfelt.”—Canadian Med Assc Journal (Cmaj)
“Provides an accurate, prescient account of real-life psychiatric care, eschewing a dramatic tell-all format in favor of warts-and-all faithfulness to the experience. This provides a true insider’s perspective, one that readers both within and outside the medical community will find relevant and engaging.”—Foreword
“A study in empathy charged up with adrenaline, and functioning against very long odds.”—Inside Higher Ed
“Linde's Danger to Self is a warm, candid and appealing account of being an emergency room psychiatrist. Linde captures the non-conformist, hard-boiled style of the psychiatrists who work in this setting.”—Tanya Luhrmann, author of Of Two Minds

"Linde illustrates academic points with his personal experiences quite deftly. He comes across as a warm-hearted, thoughtful, dedicated physician doing a difficult job as best he can. His book offers an authentic behind-the-scenes look at how a psychiatrist thinks and practices." —Frank Huyler, author of The Blood of Strangers

“In this provocative first-person account, Danger to Self, psychiatrist Paul Linde takes us to the troubling front lines of America's mental healthcare crisis. With one in three people experiencing some form of mental illness in their lifetimes, this is a story that needs to be told. Linde waves a red flag that can't be ignored.”—Kemble Scott, author of SoMa and The Sower

Danger to Self is an excellent account of treating acute mental illness. Dr Linde presents powerful stories of disturbed minds and circumstances, of lives in upheaval due to psychosis, addictions, and despair. It is also the story of the story of a psychiatrist who tends to those who are ill enough to warrant treatment in a psychiatric emergency room. This is a well-written book, compassionate, and well worth the reading.”—Kay Redfield Jamison, author of An Unquiet Mind

2010 Media Award, Northern California Psychiatric Society

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Interview with the author, Paul R. Linde, MD

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