Chapter 1: The Transformation from Student to Psychiatrist

What does it truly mean to become a psychiatrist? How can one gain insight into another's thoughts and feelings? This memoir by Adam Stern delves into these complex questions, chronicling his evolution from a pre-med student to a practicing psychiatric professional.

We accompany young Dr. Stern as he moves from an unremarkable hospital in New York to the prestigious halls of Harvard Medical School. His incredulity at achieving such success is evident.

"I felt like a fraud," Stern admits. Such self-deprecating comments punctuate the narrative, yet they often fall short of conveying true humility or humor. We are invited to share in his astonishment at overcoming his deep-seated self-doubt.

However, this connection doesn’t fully materialize. Stern's background—a privileged upbringing in Long Island with physician parents—implies a certain inevitability to his success, casting aside the notion of a true rags-to-riches story.

Nonetheless, this does not diminish the memoir's significance. Stern's compassion and adept depiction of his patients' battles elevate the story into a captivating intellectual exploration.

Despite its renowned status, Harvard Medical School enrolls students who begin with limited knowledge, learning through direct experience—an enlightening yet somewhat disconcerting reality. It resembles the apprenticeship of a mechanic. The narrative truly shines when Stern empathetically recounts his encounters with patients like Jane, who is battling anorexia nervosa.

We share in Stern's anxiety as Jane confides, "I don't want to die," during an early meeting.

"Any response that came to mind felt inadequate. You'll be fine. We’ll work through this. It’s okay. If Jane were a friend outside of work, I would have embraced her, but that’s inappropriate in my role.

I leaned closer, meeting her eyes. “I understand,” I replied.

It wasn’t much, but it was everything I had at that moment. We sat in silence for what felt like an eternity until my pager finally buzzed.

“Go,” she urged. “It’s alright.”

Leaving her felt wrong, yet I did it anyway.

Without revealing too much, Jane returns later in Stern’s residency, adding layers to his narrative.

As this memoir unfolds, it’s not merely a treatise on psychiatry; it also touches upon Stern's romantic life. His interactions with various women may endear him to readers or leave them questioning whether his awkwardness is genuinely relatable.

Towards the conclusion, Stern wrestles with a question many in psychiatric care encounter: Is this field truly legitimate? Psychiatry often lacks the precision found in other medical disciplines, frequently depending on the patient’s response to “What do you think?”

“Don’t just sit there” is an admonition for trainees in psychiatry. Yet, that is precisely what they are expected to do.

The foremost duty is to listen. But does this qualify as medicine? The author refrains from attempting to convince us of the professionals' expertise. After reading this account, one might ponder whether a chat with a local bartender could serve as a more economical alternative to therapy.

Ultimately, Stern finds comfort in small victories, reminding himself that even minimal help can be significant, regardless of whether his patients triumph over their challenges or not. Or perhaps not. We ought to demand more from our healthcare providers.

This introspective journey prompts profound questions about the essence of psychiatric practice and the intricacies of the human mind. It encourages us to reflect on the limits of our understanding and the importance of empathy in the healing process. While Stern’s journey may appear privileged, his candid exploration of psychiatry’s uncertainties and moral dilemmas provides valuable insights.

The memoir acts as a mirror, reflecting our uncertainties regarding the complexities of the mind and the approaches we employ to decipher them. It invites us to contemplate: How well can we truly understand others? And in the face of human suffering, can our presence, no matter how flawed, be the most effective remedy we have to offer?

With its victories and challenges, Stern's journey serves as a reminder that the quest to understand minds—both those of others and ourselves—is an ongoing endeavor. It is a journey characterized by humility, empathy, and the bravery to embrace uncertainty. Ultimately, it may not be about possessing all the answers but rather about being open to asking the right questions and genuinely listening to the answers.

Chapter 2: The Role of Empathy in Psychiatry

The exploration of empathy remains central to Stern's narrative, as he grapples with the ethical dilemmas and emotional challenges encountered in the field of psychiatry.