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Published Online:https://doi.org/10.1176/appi.ps.651211

by Neary Patricia; Bloomington, Indiana, Xlibris Corporation, 2012, pps 352

The book Breach of Sanity is billed as a thriller, but it reads more like an autobiography. The author is a self-taught woman from Nova Scotia. Perhaps writing it was therapeutic.

Franki is a nine-year-old girl who loses her loving parents to a hit-and-run by a drunk driver. Then she loses her sister, who is placed in a separate foster home. Franki is abused by her foster parents, and by 15 she is homeless and winds up in a mental institution. She is failed by all the professionals, authorities, and systems that are supposed to protect and care for her. A nurse and a doctor embark on a crusade to save her while one seriously disturbed, sociopathic doctor is determined to harm her. The good guys are all women; the bad guy is a man.

Redeeming features include descriptions of the supportive husband of the overworked, good female doctor; the care of the unresponsive patient, including talking to the patient as though she were awake and engaging her in dressing, grooming, and playing music; a support staff that questions a doctor’s order when it seems abusive or dangerous; the negative attitude that many nonpsychiatrists have of psychiatry and psychiatrists; poisons and substances that cannot be traced in the system; and compassion fatigue and the need for staff to take care of themselves.

This “thriller” could use more suspense. One usually reacts to such stories with horror, but, intended or not, this book made this reader feel numb, like the numbness of psychological trauma. There seemed to be no medical or psychiatric consultation, and, curiously, references are cited in the text but not listed. The book reinforces many of the bad stereotypes of psychiatry in popular culture. This may not be such a good book to read on vacation; it might be too much like work.

Dr Gise is a clinical professor with the Department of Psychiatry, University of Hawai’i, Honolulu.

The reviewer reports no financial relationships with commercial interests.