Reviews and Press

Author and emergency room psychiatrist Dr. Paul Linde reflects on his book Danger to Self, being in the public eye, and the craft of writing. Read the Blog Post
University of California Press Blog | Monday, February 1, 2010

"Danger to Self feeds our fascination with the world of medicine and our interest in the lives of others. . . . 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." Read the full review
Herbert Schreier, Special to The Chronicle | Sunday, January 3, 2010

Linde writes with grace, honesty, and humility about the psychiatrist's task of judging the mind and heart of another human being. . . . Those who enjoy the writings of Oliver Sacks and Sherwin B. Nuland will be enlightened by Linde's compassion and carefully wrought prose. Read the full review
From LIBRARY JOURNAL, November 15, 2009

Linde 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: “while my head works pretty well, my real strength as a physician comes from the heart.”
Publisher's Weekly | November 2, 2009

Danger to Self

on the front line with an er psychiatrist

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.



Paul R. Linde, MD

Paul R. Linde, M.D., a San Francisco based author and clinical professor of psychiatry at the UCSF School of Medicine, has worked in several high-intensity psychiatric settings over the years. His first book, Of Spirits and Madness: An American Psychiatrist in Africa, was published by McGraw-Hill in 2002. Linde has also written for JAMA, the San Francisco Chronicle, the San Jose Mercury News, and DoubleTake magazine. He lives in the San Francisco Bay Area with his wife, two sons, and a rambunctious one-eyed dog. Dr. Linde's Bio



Articles

A Day in the Life of PES: Twenty-Four Hours at the Psychiatric Emergency Services Department of San Francisco General Hospital
David Elkin, MD; Paul R. Linde, MD; and Eric Woodward, MD | San Francisco Medecine, Journal of the San Francisco Medical Society | "Extreme Medicine" Vol. 82, No. 2 | March 2009

Excerpt:
It's 7:00 a.m., and a group of a dozen men and women-psychiatrists, social workers, nurses, and other mental health personnel-are gathered around a desk in the staff room, per- forming the daily ritual of the morning report in the Psychiatric Emergency Service (PES) at San Francisco General Hospital. A glowing LCD screen-one of few high-tech devices in an otherwise outdated and unadorned space-displays patients' names, diagnoses, and lengths of stay. Almost all of the twenty patients (an average case load) are in PES on an involuntary basis.

The State of California's Welfare and Institutions Code 5150 provides the legal justification for a person to be involuntarily taken into custody for up to seventy-two hours for an evaluation on the basis of being a danger to self, danger to others, and/or gravely disabled on the basis of a psychiatric illness. The PES at San Francisco General is open for business 24 hours a day, 7 days a week, 365 days a year. It is the only designated receiving facility in the city for people placed on 5150 psychiatric holds.

Often, working in PES can be compared to diving into the swirl of a cyclone and hanging on for dear life. The staff adjusts to the velocity and spin enough to manage as many as four equally compelling tasks at the same time. It helps to come equipped with an unusual combination of keen diagnostic skills, a sense of humor, tolerance for ambiguity, and the ability to react quickly to changing circumstances.

Read the full article (PDF)

More Articles and Reviews

Contact

Contact Paul at prlinde@hotmail.com