Notwithstanding four years of medical school and an eight-year residency, a psychiatrist really learns his trade from his patients. After five years of practicing in San Francisco, including stints in the emergency room and the city jail, Paul Linde thought he had seen it all. When his pediatrician wife decided she wanted to practice medicine in Africa for a while, he went along for the ride, not expecting that the experience would transform his life. Of Spirits and Madness is Linde's account of his year spent practicing psychiatry at Zimbabwe's Harare Central Hospital. With compassion, good humor, and growing insight he describes his patients and their demons and difficulties. We meet Winston Chivero, who injures himself by sticking needles and nails into his leg in order to protect his community from a bewitchment; Sister Pagomo, a Shona nurse suffering from kufungisisa, or "thinking too much"; Esther Mawena, who tries to kill herself after her husband gives her AIDS; Samuel Rugare, a 28-year-old laborer driven mad by too much mbanje, or cannabis; and many others.
Overwhelmed at first by the press of suffering humanity waiting patiently in his clinic to see him, Linde gradually comes to understand how mental illness cuts across cultures. He also sees the devastation it can cause in a country where psychosis is severely stigmatized as a contagious spiritual illness caused by witchcraft. Most of all he is left with many important lessons from his patients who endure poverty and illness with incredible patience and spiritual dignity.