Writer’s profile – Dr JP Steyn
Working as a medical practitioner in South Africa one can be exposed to the widest of circumstances imaginable. This helped me develop a system of healing that could integrate well-judged medical knowledge with the numinous interpretations of disease that patients often rely on when faced with their individual illnesses.
During my student years I trained and worked in a regular large academic hospital in a city. Here I came into contact with the best in medical technology, along with the vast variety of serious diseases we typically handle in such hospitals. However during holidays I worked on missionary stations and in small country hospitals. Already as an unqualified medical student I had to deal firsthand with suffering and poverty and the effect that disease has on the daily lives of rural people. I learned how ordinary people coped from moment to moment with the unpredictability of the unknown and the painful uncertainty of being ill, something often overlooked within the sheltered scientific environment of the academic hospital.
Directly after medical school my husband and I left the city to work in the furthest, most remote place we could find which still was within South African jurisdiction, a small town in present-day Namibia right next to the border with Angola. Although we found the local Ovambo people to be the most wonderful people on the African continent, we again experienced a contradictory world. The South African government had set up a modern hospital hundreds of miles from the nearest city and here we could use our freshly acquired medical expertise to our hearts’ delight. However, there was a reason for such a modern hospital. Our area was seen as a military zone, and the war with the Namibian freedom fighters, who were positioned in Angola, brought us face to face daily with the cruelty of war causalities and the irrational security measures of authorities in a war zone. Again I learned that healing and even pragmatic medicine can never be separate from the world people live in and from the weird and wonderful processes people use to deal with death and the unknown.
Ultimately, for the sake of our newly born children we moved back to South Africa. Desperate to avoid the trappings of an urban lifestyle, especially while raising young children, we found a position in the incredibly beautiful northern part of the country on the slopes of the Wolkberg (mountain of clouds). From here my husband could lecture at a university located in a so-called ethnic homeland and I was allowed to run a private practice for the local people, on condition that I also was prepared to also see the campus students as patients. Once again I experienced the world of wonder and reason side by side; a mixture of intuitive living and pragmatic science in a contrasting but magical way. On one hand I saw highly educated academic patients with their strong belief in the rational empirical side of medicine. On the other hand there were the patients from traditional villages in the homeland, pastoral farmers still living according to an ancestral belief system with a shamanistic sense of nature. I slowly but surely became aware that there are experiences of illness that ordinary medicine simply cannot address within its present field of knowledge. I observed, acknowledged and analysed, working hard to maintain a strict scientific mindset but also to allow for the inexplicable experiences that I encountered all the time.
However, due to the chaotic political situation in South Africa at that time we were forced to move because it became illegal to live and work as a private white person in a ‘black’ homeland. We moved back to the city where my husband and I furthered our training in a psychiatric academic hospital. I was put in charge of three large isolation wards with long-term psychotic patients who had been sent there after committing a crime. These isolation wards were on the on the outskirts of the city and formed part of a large and secured complex where the last hundred or so leprosy patients without family resided. Here the balance between reason and wonder was taxed to the point of perplexity. The psychiatric reasoning and medication schedules had to handle the sometimes harsh reality of weighing the state’s responsibility against a patient’s possible freedom. In the background, however, I was continually aware of the extraordinary symbolic content that featured in the symptoms, delusions, hallucinations and dreams of these diverse patients; content that sometimes made more sense than the rules of my pragmatic science. I also had to deal with the suffering and loneliness of patients who were fine in medical terms but not allowed back in their own society because of an ignorant, stubborn fear of both leprosy and madness. Analytical psychology and the work of CG Jung started to make sense to me, while pure medical psychiatry as taught in the hospital setting felt incomplete and one-sided. Fortunately I was in the right environment to have the privilege of enrolling for analysis and training with one of the best professors in the field of psychodynamics, and eventually chose this direction instead of formal medical psychiatry.
After our training, my husband and I decided to move as far south as possible because our children had reached an age where they needed a secure environment for their formal schooling. My husband started to teach at a university near Cape Town and, as I needed time as a housewife and mother, I settled for a part-time medical practice in a typical urban environment. If I had hoped that this environment would put an end to a sense of division between wonder and reason, I was deeply mistaken. In a setting where people had enough to eat, lived safe lives and never stopped aspiring to subjective fulfillment, I realized again that health and illness encompassed more than the diagnosis of flu, arthritis and heart attacks. There were always situations where antibiotics, cortisone and blood pressure medication fell short, where the gynaecologist, cardiologist or high tech hospital down the road made no difference to individual suffering.
In fact, I noticed that a unique form of stress underlies many of the symptoms of patients in such an affluent environment. This encouraged me to increase my knowledge and training in psychology and particularly in stress management. Psychoanalysis, bio-feedback, medical hypnosis, meditation techniques and body work based on Eastern philosophies of health became valuable tools. However, I was careful to allow for constant feedback between pragmatic medical procedure and the more subtle biodynamic methods, creating a therapeutic milieu which could cope with the diversity and breadth of symptoms in prevalent diseases, but never ignore the limits set by sound medical research.
It was a natural progression to establish a practice that mainly focused on psychosomatic medicine, especially the elusive syndromes that revolve around chronic fatigue, allergies and autoimmune diseases. This also included workshops, together with my husband, who is a professor in industrial psychology, which dealt with stress management in the corporate world. At last I managed to create a working environment where it was possible to integrate wonder and reason to the point where I could use empirical medical science against a background of integrative biodynamic methodology.
