book review: A Million Little Pieces

I was browsing one of my favorite used bookstores downtown and had heard a lot of great things about A Million Little Pieces by James Frey over the years so decided to purchase it. As someone who is considering going into psychiatry, I thought it would be a great opportunity to learn more about addiction because addiction and mental illness often go hand in hand. And addiction is a huge problem in the area I’m from, and hope to eventually settle down to practice medicine, so even if I do not go into psychiatry, I will still have patients who suffer from addiction.

Overall, I think the book is definitely a great read. I found myself staying up too late trying to just finish the chapter because I was so engaged. It evoked a lot of emotion – I found myself gasping out loud and physically cringing during some parts.

But other than it being an interesting read, it’s basically complete garbage as a ‘memoir.’ I’m not very far in my medical training but I can say that most of what Frey talks about in this book would never happen in the medical system in this country. I don’t want to spoil too much of the book for those of you who are planning to read it but I just want to say that patients who have a history of addiction still receive humane and safe medical care. I’m sure there are institutions where it may not be up to the same standard as a private community hospital but I highly doubt the savagery described in this book would be allowed. As with geriatric care, patients who are medically unstable with acute injuries would be in the care of health care professionals equipped to care for the illnesses and then transferred to nursing homes or rehab facilities.

Additionally, having worked with patients who suffer from addiction in my clinics, volunteering on the streets with the homeless population and volunteering in the prison system – I imagine that anyone who is suffering from addiction, which is a lifelong illness with no cure, would be incredibly offended after reading Frey’s narcissistic attitude towards battling addiction and the twelve steps of Alcoholics Anonymous. He maintains this high and mighty attitude throughout his time in rehab and denies the genetic and disease aspects of addiction, which can be extremely damaging to readers who also suffer from addiction. It can also be damaging for the loved ones who deal with addiction because the text makes it seem as though all you need to get past your addiction is six weeks in rehab and willpower.

There has been great controversy about the authenticity about Frey’s criminal activity in the book as well as the accuracy of the eventual death of some of the people he met in rehab. Everyone is, of course, entitled to their own story and their own way of dealing with their illnesses but putting out a work of fiction, while claiming it a memoir, can be extremely damaging and triggering for those who also suffer from addiction.

So, bottom line: it’s a great read if you treat it as a work of fiction but I find it extremely frustrating and disappointing as  a future health care professional who hopes to help patients work through their illnesses, including addiction.

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