Saturday, June 7, 2008

Review on Amazon

The Cockroach Catcher has a full review on Amazon.

Here is the full review:
BOOK REVIEW, by Peter Chang.

Reading this book was truly a trip down memory lane for me.

Not only was I in the same medical school as the author (hereinafter referred to as "Zhang"), he and I were assigned to the same study group in our 5-year sojourn at the University of Hong Kong. I too caught cockroaches in my matriculation years in order to practice the dissection of their salivary glands and digestive system, just as Zhang describes in the book. After we graduated in 1968 with the degree of M.B.,B.S. (Bachelor of Medicine and Bachelor of Surgery, we served as "housemen" (known as "interns" in North America) for one year in different hospitals. In 1969, Zhang and I, together with several other classmates, went into Castle Peak Hospital, the only mental hospital in Hong Kong at the time, to work as "medical officers", which was essentially an apprenticeship in psychiatry. We both took the examinations of the Royal College of Physicians in London, England, to obtain the D.P.M. (Diploma in Psychological Medicine) around 1972.

Although Zhang settled in the United Kingdom, and I in Canada, I can identify with much of his experience as a psychiatrist. This book helps to demystify mental illness and humanize the doctor-patient relationship. I am very impressed by Zhang's down to earth approach to problem solving. The secret to his success in therapy is the respect that he gives to his patients, their families and his colleagues. Just by listening to his patients and believing in their stories, Zhang is able to perform miracles, such as the "Seven Minute Cure" (Chapter 1), Ping Pong (Chapter 24), and "Bullying" (Chapter 23).

Zhang has a special talent for engaging difficult patient in therapy, as exemplified in "Wrong Foot" (Chapter 12), "Hiccup Boy" (Chapter 13), "Failure" (Chapter 34), and "Yellow Card" (Chapter 46). As Zhang finds coercive treatment distasteful, such as force feeding an anorexic patient, he is good at negotiating with patients so that they would voluntarily eat again to achieve their own individual goals. For instance, the patient in Chapter 34 started to eat again because she did not want to be "sectioned" (meaning certified under mental health laws) which would prevent her from going to the United States to pursue higher education.

While most doctors are content with taking a medical history, Zhang would listen to his secretary and cleaning staff to learn about the milieu, thus gleaning useful information that can help his patients. It reminds me of Confucian humility. Confucius says: "When three men walk together, I have a teacher among them".

As Western trained psychiatrists with Chinese heritage, Zhang and I are not confined to particular schools of thought. Neither of us has felt the compunction to subscribe to a particular theory, such as being Freudian, Jungian or a behaviorist. We aim to be "eclectic", that is, to use whatever that works. In 1970's, psychoanalysis dominated training institutions for psychiatrists in U.K. as well as in Canada. I can see in the book that while Zhang is educated in psychoanalysis, he is not bound by it in his practice. His creative and innovative approaches to clinical problems remind me of the now popular "C.B.T." (cognitive behavior therapy).

Zhang laments the dawning of the age of red tape in psychiatry, which is the same all over the world. The emphasis on "guidelines", also known as "evidence based medicine", and artificial restraints on access to services, have changed the landscapes of our practice. If everyone practices cookie cutter type of medicine, where will we find new thinking and new treatments?

This book is a "must read" for all professionals in the mental health field, and for all interested individuals. It is a kaleidoscope of life seen from the eyes of the therapist who genuinely cares about his patients as people. Zhang provides an in-depth understanding of the human condition.

In my view, this book gives us a glimpse into the soul of psychiatry, into holistic medicine at its best.

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