Ben Cave has written a moving, witty and thoughtful account of his life in forensic psychiatry. Ben Cave is a pseudonym and he works at St Jude's, a composite of more than 20 hospitals he has worked in. In the same way, the numerous prisons become HMP Campsmoor and the high-secure hospitals become Bramworth. This is as true an account as we are likely to get of what it is like to practise as a forensic psychiatrist in Britain today. The lives of the patients we see and serve, the dedication and extraordinary commitment of the nurses we work alongside and the toll of clinical practice in a setting of diminishing resources on clinicians are usually concealed from the glare of the public. But Ben Cave exposes all this, guiding and showing the reader what psychiatry, really, is about.

Cave draws on personal life, family anecdotes, memory, using these, often as metaphor, to illustrate a clinical point. This method works; it domesticates what would otherwise be strange and distant events, clinical incidents, transmuting these into incidents that most people can relate to. In discussing a particular woman with catatonia, Cave situates the story (because these are all stories) within an incident from his own childhood when he poked at an inverted Anaglypta volcano to comic torrential effect. His aim always is to humanise the patient, to relate her life to his, thereby ensuring that we see her as another person who could easily be us.

Cave successfully transcribed one of the best examples of formal thought disorder, outside of textbooks of the late 19th or early 20th century, at a time when clinicians had little to offer aside from classical descriptions:

Thank you, Ben Cave, just for this alone.

Cave illustrates the symptoms of depression by discussing his own bouts, albeit mild bouts, of depression. This is public education at its best, focusing on the context of the symptoms, and shrewdly de-stigmatising mental illness. And it, often, is also just funny. He discusses early morning waking. His partner Jo asks ‘Why do you get up so early? It's like you're depressed or something’. This leads to an observation on junior doctor–doctor relationships, the tendency not to see one another much, and how they may need seven times as long to have normal relationships as other people.

My favourite is Cave's illustration of poor insight:

The book ends on a sad note. Cave becomes disillusioned with forensic psychiatry and throws in the towel. But thankfully he does not leave psychiatry. My plea to all psychiatrists is, read him. I await his next book with anticipation.