'Danger to Self' a wild yet poignant look into the life of an ER psychiatrist
By Tom Larson
Paul Linde still wonders why he does what he does. In the myriad medical careers he had to choose from, why psychiatry? And as his career in the field unfolds, why, in middle age, does he still venture daily into the chaotic, soul-chilling and often dangerous world of a big-city hospital's psychiatric emergency room?
University of Minnesota, Morris students and the Morris community will have a chance to hear Linde answer those questions and others during the author's visit Feb. 24 at UMM.
Linde's book, "Danger to Self -- On the Front Line with an ER Psychiatrist," is a vivid look at the patients, staff and politics alive in an environment most people can scarcely imagine, much less ever experience first-hand.
Linde will discuss the book and his career with a UMM psychology class in the morning, and during a book-signing and reading engagement at Briggs Library at noon.
The public is welcome to attend the gathering at Briggs.
Linde has ties to the Cyrus and Starbuck areas. His grandfather was Dr. Herman Linde, who lived and practiced medicine in the Cyrus area for more than 50 years.
Paul Linde grew up in Hastings and attended medical school at the University of Minnesota before moving to the San Francisco area.
"Danger to Self" was almost 10 years in the making. Linde first pitched the idea after writing his first book, "Of Spirits and Madness," which chronicles his experiences as an American psychiatrist in Africa. He proposed "Danger to Self" in 2001, just after the 9-11 attacks.
"I had the drive to write the first book and I thought it would be easy to sell the second - it's a sexy subject, psych emergency," he said. "It was the perfect niche. This is what I do."
But the book proposal was turned down by 25 editors. He revised it and pitched it again in 2002. This time, it was rejected by 20 more potential publishers. Even his agent quit on trying to push it.
"I sat on it for three years," Linde said. "I revised it and sent it out again. It became kind of an obsession. I was trying to figure out why I stayed in medical school - writing was my first love. Why psychiatry? Why psych emergency? I really wrote it as a catharsis."
Linde said much of the self-examination in the book was edited out, but what's left - especially in the context of his day-to-day interactions on the job -- is compelling. The stories in it bring readers inside the walls of the psychiatric emergency room and among a cast of living, breathing "characters" - patients under the influence of drugs, alcohol, paranoia and other physical and mental illnesses.
He tells gripping tales of professionals trying to control patients and alleviate their suffering while at the same time trying to maintain some sense of normality in their own lives. Woven throughout the book are glimpses of a profession in peril due to the influence of health insurance and pharmaceutical companies, the government and even other psychiatrists who are more concerned with procedure than care.
Linde's intent was to tell realistic, unvarnished stories that, when combined, widen the scope on acute mental illnesses and those who suffer from them.
"I think it helps make the seriously mentally ill less invisible," he said. "I hope it increases awareness of what people are going through. And, politically, I hope it changes the way commitment laws are written."
While delving deeply into his demanding work, Linde said he's not felt himself slipping.
"Thank God, no," he said. "I know there's the possibility that stuff happens and you lose it. I think I have problems and then I go to work and I'm with people who are so gummed up with alcohol, drugs, getting beaten as a child. My life's good. It makes you appreciate what you have. It causes gratitude."