Saturday, July 6, 2013

Compelling Psychiatric Cases and the Ethics of Treatment


Christine Montross presents a series of cases from her psychiatric residency and early clinical practice that raise issues not only of treatment, but the physician's response to treating patients. Several of the patients we meet in this fascinating book are not very likable: the woman who swallows light bulbs and other dangerous objects to relieve stress, the young mother who is afraid she'll murder her baby son, and the woman whose seizures are psychological in origin rather than physical. Each of these patients presents a unique aspect that requires sensitive treatment and forces the doctor to examine her own motives in providing care.

I highly recommend this book, if you have an interest in psychiatry or mental health. The cases are unusual enough to provide interesting reading, but for me the most important part was how the doctor felt about her diagnoses. Seeing a patient leave the hospital wondering if they are at risk for a psychotic break is harrowing, if you care about your patients. It is equally frightening to send a woman home when she feels that she may kill her baby. The question for the doctor becomes did you make the correct diagnosis and what harm will result if you didn't.

I was particularly impressed by Montross' desire to get as much information about the diagnosis and it's repercussions as possible. The book is replete with citations and quotes from journal articles. The is an exceptionally well written and more important well researched book.

I reviewed this book for the Amazon Vine Program.