Into the Abyss: A Neuropsychiatrist’s Notes on Troubled Minds

A handful of case studies provide the jumping-off point for this fine debut memoir from David, longtime consultant psychiatrist for Maudsley Hospital in London. Displaying intellectual curiosity and pragmatic compassion, David focuses on cases in which the physiological and the psychological converge. These include a traumatic brain injury that led a patient to believe life was unreal, an eating disorder triggered by an awareness of historical atrocities, and a neurological disorder provoked by family stress. David quietly builds understanding and respect for his patients, always stressing that their behavior, even when objectively nonsensical, makes sense to them. He also candidly addresses the challenges of being in the role of medical authority, whether noting his peers’ lack of sympathy for those with self-inflicted injuries, managing the unwillingness of the U.K.’s National Health Service to approve specialist treatment, or resisting a father’s desire to discontinue his child’s treatment for non-epileptic seizures. Readers will come away from this thoughtful work feeling a sense of connection to both the patients profiled and the practitioners who aim to understand them. (Mar.)