Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis

Falling Into the Fire is psychiatrist Christine Montrosss thoughtful investigation of the gripping patient encounters that have challenged and deepened her practice. The majority of the patients Montross treats in Falling Into the Fire are seen in the locked inpatient wards of a psychiatric hospital; all are in moments of profound crisis. We meet a young woman who habitually commits self-injury, having ingested light bulbs, a box of nails, and a steak knife, among other objects. Her repeated visits to the hospital incite the frustration of the staff, leading Montross to examine how emotion can interfere with proper care. A recent college graduate, dressed in a tunic and declaring that love emanates from everything around him, is brought to the ER by his concerned girlfriend. Is it ecstasy or psychosis? What legal ability do doctors have to hospitalize—and sometimes medicate—a patient against his will? A new mother is admitted with incessant visions of harming her child. Is she psychotic and a danger or does she suffer from obsessive thoughts? Her course of treatment—and her childs future—depends upon whether she receives the correct diagnosis.

Each case study presents its own line of inquiry, leading Montross to seek relevant psychiatric knowledge from diverse sources. A doctor of uncommon curiosity and compassion, Montross discovers lessons in medieval dancing plagues, in leading forensic and neurological research, and in moments from her own life. Beautifully written, deeply felt, Falling Into the Fire brings us inside the doctors mind, illuminating the grave human costs of mental illness as well as the challenges of diagnosis and treatment.

Throughout, Montross confronts the larger question of psychiatry: What is to be done when a patients experiences cannot be accounted for, or helped, by what contemporary medicine knows about the brain? When all else fails, Montross finds, what remains is the capacity to abide, to sit with the desperate in their darkest moments. At once rigorous and meditative, Falling Into the Fire is an intimate portrait of psychiatry, allowing the reader to witness the humanity of the practice and the enduring mysteries of the mind

 

“Thoughtful and deeply compassionate . . . a fluid meditation on the limits of medicine.” —Los Angeles Times

“Thought-provoking…Dr. Montross, an award-winning poet before attending medical school, is passionate about her work and her patients plight…She addresses these issues with intelligence; and by deftly intertwining her patients stories with historical facts, current research and ethical quandaries, she presents a moving and nuanced picture of the psychiatric patient and doctor relationship, and a riveting and thought-provoking look at mental health care.”—Pauline W. Chen, M.D., The New York Times  

“As good an account of the labyrinth of mental health care as youre likely to read.” --The Daily Beast

“Montross explores the practical, emotional, and philosophical challenges of working with patients whose illnesses of the mind are often intractable and deeply disturbing.” —The New Yorker

“A sympathetic portrait of seriously ill patients that could guide future practitioners on the art of helping, if not always healing, the sick.”—Kirkus

“…[Montrosss] intriguing analysis is anchored by the humble and empathetic voice of a psychiatrist working in a field wherein “every diagnosis is an act of faith.””—Publishers Weekly

Dr. Christine Montross is Assistant Professor of Psychiatry and Human Behavior, and Co-director of the Medical Humanities and Bioethics Scholarly Concentration at the Warren Alpert Medical School of Brown University.  She is also a practicing inpatient psychiatrist. Dr. Montrosss previous book, Body of Work, was named an Editors' Choice by The New York Times and one of The Washington Post's best nonfiction books of 2007. She and her partner, the playwright Deborah Salem Smith, live in Rhode Island with their two young children.