OF SPIRITS AND MADNESS: An American Psychiatrist in Africa

A San Francisco–based author and doctor, Linde offers a moving account of the meeting place of modern medicine and "the ever-present nuances of the Spirit World on display in Zimbabwe" as he describes his year practicing psychiatry in Harare. Linde centers each of 11 chapters on a single patient, each of whom shows "courage and resilience... daily in the face of poverty, physical disease, and mental illness." With his patients facing problems ranging from manic depression and catatonia to self-mutilation and AIDS dementia, Linde is hindered not only by there being only a half-dozen psychiatrists for the nearly two million people in greater metropolitan Harare, but also by the fact that many of his Shona patients "are devout Christians who simultaneously hold traditional, culturally sanctioned beliefs in ancestor spirits and witchcraft." In a case of postpartum catatonia, therefore, his "nascent understanding of the basic tenets of traditional Shona culture, animism, and evangelical Christianity proved to be as important... in approaching this case as... the nuances of modern obstetrical care and clinical psychopharmacology." But Linde's descriptions, far from clinical, are full of delightful observations, pointed political reflections, sensitivity to his hospital colleagues and the diverse cultural needs of his patients. This fascinating and entertaining book should be required reading for anyone (especially in the medical profession) interested in the politics and personal stories of the cultural divide. (Oct. 2)

Forecast:As Africa's AIDS crisis worsens, expect Linde to become a media figure. The soaring word-of-mouth success of Anne Fadiman's The Spirit Catches You and You Fall Down, on a similar topic, has paved the way for medical pop-cultural studies.