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back into the parlour, the wife was lying on the ottoman. Her stockings were rolled down and her dress up. ‘She’ was a man. He examined her. The trouble was severe piles. Neither he nor the husband nor she referred to the sexual organs which should not have been there. They were ignored. Or, rather, he was forced to accept them, as they had done according to their own reasoning which he would never know.
    He became aware of the possibility of his patients changing. They, as they became more used to him, sometimes made confessions for which there was no medical reference so far as he had learnt. He began to take a different view of the meaning of the term crisis. He began to realize that the way Conrad’s Master Mariners came to terms with their imagination – denying it any expression but projecting it all on to the sea which they then faced as though it were simultaneously their personal justification and their personal enemy – was not suitable for a doctor in his position. He had done just that – using illness and medical dangers as they used the sea. He began to realize that he must face his imagination, even explore it. It must no longer lead always to the ‘unimaginable’, as it had with the Master Mariners contemplating the possible fury of the elements – or, as in his case, to his contemplating only fights within the jaws of death itself. (The clichés are essential to the vision.) He began to realize that imagination had to be lived with on every level: his own imagination first – because otherwise this could distort his observation – and then the imagination of his patients. The older partner died. Sassall had to spend far more time in the surgery, listening. He also had to find another doctor to share his practice with. He decided to split the practice in two so that the other doctor should work with his own surgery in his own area. Then, still overworked, but with more time for the average patient, he began to observe himself and others.

    He began to read – especially Freud. So far as a man can by himself, he analysed many of his own character traits and their roots in the past. It was a painful process – as Freud himself describes when discussing his own self-analysis. For six months or so, as a result of his resurrected memories, Sassall became sexuallyimpotent. It is impossible to say now whether this period of crisis was induced by his decision to examine within himself the basis of what up to now he had projected outwards as ‘the unimaginable’, or whether he entered a period of crisis and therefore decided to look more closely at himself. Either way it bears some resemblance to the period of isolation and crisis which precedes in Siberian and African medicine the professional emergence of the shaman or the inyanga . The Zulus have a name for this process. The inyanga , they say, suffers because the spirits will give him no peace and he becomes ‘a house of dreams’.

    When Sassall emerged, he was still an extremist. He had exchanged an obvious and youthful form of extremism for a more complex and mature one: the life-and-death emergency for the intimation that the patient should be treated as a total personality, that illness is frequently a form of expression rather than a surrender to natural hazards.
    This is dangerous ground, for it is easy to get lost among countless intangibles and to forget or neglect all the precise skills and information which have brought medicine to the point where there is the time and opportunity to pursue such intimations. The quack is either a charlatan or he is a healer who refuses to relate his own few insights to the general body of medical knowledge.
    Sassall enjoyed this danger. Safe thinking was now like settling down ashore. ‘Common-sense has been a dirty word with me for many years now – except perhaps when it is applied to very factual and easily assessed problems. When dealing