I was quickly put off by the main character. He is a brilliant psychiatry grad from a top university and the main reason he thinks he needs to use anonymous names is for his job prospects and respect for privacy, but no mention about the actual legal and ethical implications that would really make this problematic. He had a mother with schizophrenia, and he's a fantastic (albeit, not very modest) psychiatrist, but only when he starts working at the "asylum" does it dawn on him that he can't just "point out reality" to someone who has lost touch with reality. He describes a patient under his care as "bizarre" and "weird." Then we come to the physician's notes, that don't sound much like they were written by a physician (i.e. prescribe "some basic therapy"). This one just doesn't ring true.