Bedlam’s Door: Mark Rubenstein
A piece of blown glass is very fragile and if placed in the wrong spot or on the edge of a table it might crack into many different pieces. The outer shell of an egg when cracked to prepare a dish will often fall apart into many different segments not able to be put back together again. People are often placed in situations which make them fragile, afraid, fearful or just scared of what life holds in store for them and need the support and understanding of family, friends and maybe even a therapist to rebuild them and hopefully prevent them from falling into pieces that the outer shell of an uncracked egg or a piece of blown glass that has been created as a work of art. Within the pages of this book you will enter the halls, corridors and rooms in Manhattan Hospital and hear the voices of many who will relate their stories to you and hope that you will find comfort in realizing that nothing is lost, people can find their way back and if you have any of the similar problems or issues as described by the doctor and the patients in this book you will seek the help you need. Welcome to Manhattan Hospital your help is on the way!
We meet Nathan first as he is running through the streets claiming to be the King Of Puerto Rico. When the therapist begins talking to him at first he is closed mouth but then as the session wears on he begins to remember what happened 40 years ago as a prisoner in Auschwitz and dealing with the atrocities and indignities inflicted upon him and the loss of his family. Imagine knowing that while you survived in a grave way that your ability to create furniture would help you to live through the worst time of your life but when you can no longer create them because you are injured what happens to Nathan causes him to snap and relive the horrors he chose to forget in the past but cannot in the present. As Nathan described his memory of being in the camps the doctor listened and for the first time he felt a wave of relief and possibly with the right care and treatment plus going back to his carpentry in a different way he might live his life whole again. After the case study is discussed the author explains the terms related to his illness and how doctors should treat someone like Nathan.
The Head Doctor was really one of my favorite case studies as a patient asks to see a Head Doctor and the nurses misinterpret his request by sending in the author to speak with him. But, it took almost a whole day for him to receive the request and upon talking with the man he reveals that he was left in the dark about his physical condition, the hernia operation that he had and no follow up information was forthcoming and he feared what else might be wrong with him. After carefully listening and explaining what had been done, why and how the man’s face eased up and then a startling revelation was revealed. See if you the reader can figure out the meaning of HEAD DOCTOR. Once again the author presents an enlightening summary or afterward which focuses on the fact that many doctors have no time to really listen to their patients and why the nurses on this man’s ward or floor disregarded his wishes to an extent, had no real idea about his issues and from the conversations the author had with them no real regard for anything but finishing their paperwork. A sad commentary on the medical profession but one unfortunately I do have to agree with for the most part. Doctors no longer a lot an hour or even longer to see patients when they want to fill their time with as many as possible often making quality care less and superficial more the norm.
The two cases of the two women who are hearing voices and who realized that they both needed help are quite compelling. This is a classic case of doctors not hearing the voices of patients who in this case as the title of one case study says: Knows more than the Doctor does. When doctors discount a patient’s voice and thoughts sometimes they throw themselves in front of a train and lose a leg. When the malpractice suit comes why do they always look surprised? The cases are all different and the outcomes not the same as the author describes what happens when his patient has a connection to the mob and he is faced with a serious moral dilemma as to the definition of confidentiality and moral ethics to determine continuation of care. The end result proves that sometimes another opinion, which is more objective, will put things into perspective.
The case study titled A Man Of Means is has a touch of humor as a police officer brought in a man named Mr. Smith with no means of ID and thinking he was in plush hotel in a special suite. He had no idea that he was in a mental hospital and claimed he had tons of money in the briefcase he was holding. Stating they would violate his civil rights if they tried to open it or take it away. As the author describes him you would never think of him a rich or classy yet his manner of speech and his demeanor might seem otherwise as he carried a copy of The Wall Street Journal beneath his left arm. Was he a millionaire or simply an itinerant soul needing a place to stay? Meet Mr. Smith and see what happens when he is taken by two attendants to his room. Yet after the exam and ending his session with him the author never really learned about this man’s family or who he really was but at that moment after this case is when he had the epiphany that he loved the field of psychiatry and realizing the uniqueness of each patient and as he concludes: Though sharing human commonalities –had a uniquely personal story. OCD is not uncommon and many people feel compulsions to do certain acts like Barbara C. who after a year of an escalating symptom realized she needed help. It started with a patch of white hair and some black dye and it snowballed into this person feeling that she had to clean away the dye and the dirt from just about everything and everywhere. She became so compulsive that need to cleanse everything. To find out what happened and why you need to read Dirty Little Secret.
Off the Wall focuses on a man who was seriously agitated and was strapped in a wheelchair in order to prevent him from moving or getting away. But, this was an unusual case and the author explains his mode of treatment and what he expected from the hospital staff to prevent him from hurting himself. Specific instructions to keep him hydrated every half hour and walking him but with someone holding on to him and the strait jacket in place so he could not hurt himself or get away. Sometimes a patient just might outsmart those in charge when you learn just what Off the Wall Means. The author describes what happened to this man and he explains the legal terms and legalities of what happens. Was the hospital negligent because the man died? Would the hospital have huge legal problems because they failed to provide a safe haven for this man? Find out when you read the story and learn the dramatic conclusion.
The author concludes his stories or case studies by explaining the history of mental illness and why there is a need to view these people as not insane or deranged but understanding them when they present undesirable behaviors. He explains the older treatments, the drugs and tortures that were used in the past and the hope for new modes of treatment and medications in the future. But, I would be remiss if I did not spotlight The story of Ralph titled A Short Memory about a man named Ralph and his girlfriend Laurel who spent their romantic interludes hurting each other and ending in violence. Just why he sought help and why he kept coming back to her for more you need to read it for yourself and learn what the author concludes at the end.
This book is a valuable resource for those starting out in the field, people who have family members suffering from some of these problems and anyone in general to understand that more research and funding needs to be placed to help those that are mentally ill. Filled with real life stories and human failings and successes once again author and Forensic Psychiatrist Dr. Mark Rubinstein scores high on the scale of caring and understanding. Bedlam’s Door: True Tales of Madness and Hope: Learn more when you enter Manhattan Hospital meet the staff and decide for yourself the quality of care and why in most cases it needs to be improved. With doctors like Mark there is more of a chance of hope and a lessening of madness.
Fran Lewis: Just reviews/MJ Magazine