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In a House of Dreams and Glass: Becoming a Psychiatrist

"Having described his first-year medical residency in A Year-Long Night, Klitzman continues with this account of his three-year psychiatric internship in a New York City university teaching hospital. Assigned rotations in short-term in-patient wards, emergency rooms, and out-patient clinics, Klitzman learned to diagnose mental disorders and administer treatment ranging from psychodynamic therapy to electric shock. He is a deft observer of the interactions between patients, residents, supervisors, and hospital staff, Klitzman makes us equally aware of his personal struggles to deal with the pressures to conform to training that discourages questioning and to understand an institutional system that appears to benefit staff rather than patients."

--Library Journal


"Klitzman, a New York City psychiatrist who described his medical internship in A Year-Long Night, now offers an involving, highly revealing look at the chaotic world of psychiatric practice in this account of his three-year residency at an unnamed psychiatric hospital, part of a sprawling university medical center. Among his patients are Nancy Steele, a suicidal artist; Ronald Bramsky, a homeless drug addict who has endured more than a dozen operations for bone cancer; Blanca Diaz, a woman with dementia who believes she is in "the House of God, the Gateway to Heaven" and numerous schizophrenics, psychotics and depressives. We watch as Klitzman wrestles over whether to use psychological approaches, which frequently disappoint him; biological, drug-based treatments, which have helped many patients more than he expects them to; or a combination of approaches. Hospital politics unfolds in a clash of physicians' personalities and therapeutic styles, to the point where each ward constitutes a different social environment. Too often, observes Klitzman, patients are pigeonholed into narrow categories, given drugs and then blamed for their failure to improve."
--Publishers Weekly