The glass house by Anne Buist and Graeme Simsion

Despite the image on the front cover, the glass house in Buist and Simsion’s book is the nurses’ station in a hospital’s Mental Health Service’s Acute Unit, but the image is very apt as the patients that go through the service are like exotic plants that may live or die according to the conditions they encounter. Hannah Wright is the new intern in the psychiatric ward, and she must make the decisions that could drastically impact people’s lives, comparable to the confronting edge-of-the-knife scenarios of the recent British medical comedy-drama television miniseries ‘This is going to hurt’.

We encounter the whole range of psychiatric cases - postpartum psychosis, suicide ideation, PTSD, morbid anorexia nervosa, schizophrenia, depression, histrionic personality disorder. It’s like reading short stories but they all link up and the reading becomes addictive as we go from one case to another. All of this is within the framework of a high pressure, underfunded medical service that has its own issues of bullying and unresolved trauma among the staff. And to keep us engaged there is also the subtle thread of a possible romance, if that’s possible between people working in the same pressure-cooker environment.

I really liked the way the authors give insight into the personal doubts and dilemmas of the main protagonist, Hannah, but at the same time we are shown how she steps up time and again to say and do the tough things required. She is a strong personality despite her misgivings, and all readers will wish her success in the career she has chosen. No doubt the authenticity comes from the lived experience of the author psychiatrist Anne Buist.

I found the book a little hard to get into at first; there seemed so many people to keep track of, but as I read on I became more and more engaged, as the evidence behind the cases is built up and the discussions between the young professionals and their personal experiences are elaborated. The patient scenarios are dramatic and one can’t help wondering how they will be resolved. It’s a book for the general reader but would also be of especial interest to anyone considering a career in psychiatry or related field.

One thing I have overlooked mentioning is the humour. Despite the serious issues, it is actually very funny, a modern tragicomedy. Buist and Simsion know how to toss in the humorous remark that undercuts the tension, the secret thoughts that belie the spoken words, and the mad-cap scenarios that escalate in the psychiatric communal areas. So there is much laughter amid the tears.

Themes: Psychiatry, Mental health, Counselling, Trauma, Suicide, Anorexia Nervosa, Careers.

Helen Eddy