Frank Njenga: ‘Over 40 years of healing the mind’

The first time I ran into Dr Frank Njenga was in 2015 at Fairview Hotel, Nairobi. He had just finished a meeting at the swimming pool. I asked him for an interview. “Not now, but let’s keep talking,” he said. Every year for the five years I have run into him or texted him asking for an interview, his response has been the same, “Soon, my friend. When the time is right.”

Two weeks ago, I texted. The time was right.

A few months ago, Dr Njenga opened a 103-bed ultra-modern psychiatric hospital in Nairobi to cater to the growing needs of mental health patients. It is a cherry on his psychiatry practice that has spanned for decades since he graduated from the University of Nairobi, trained at the Maudsley Hospital, a psychiatric hospital in London, obtained Membership of the Royal College of Psychiatrists in 1980 and got a fellowship status soon after.

He has been in private practice as a full-time psychiatrist since 1983.

I interviewed a lady in her 40s who said that when she was young, her mother would frequently travel to Nairobi to see you. Her father would tell them that their mom was suffering from malaria but they later found out it was depression. I thought, how long has Dr Frank Njenga been at this?

(Chuckles) It’s been long. When I was 16 years old, I read about Frantz Fanon and I was struck how clever he was. He understood human beings in a way that I had not seen anybody else do. I spent most of my younger years wanting to be like him, to be clever and have an impact. Later, after my studies and as I went through psychiatry, I realised that what most practitioners in this field do to patients is to take away their dignity. So the motto of this institution, which we’ve run now almost for 25 years is ‘Recovery in Dignity’. So for me, delivering this hospital is a culmination of a journey that was deliberate.

I was born in the year 70-BC. That’s Before Covid. (Laughing) I’m 70.

What are you trying to unlearn at 70?

I have a preoccupation with learning. I have an almost insatiable desire to learn. And it’s not just to learn academic things. I like to learn everything. Recently, I went to the kitchen and asked my wife to teach me how to cook. I have accepted that I am a restless soul and that restlessness is only cured by learning new things.

You deal with a lot of people with mental health issues. How do you condition yourself after, do you lie on a couch and talk to someone?

My training spanning over 40 years emphasises a great deal of self-care. One thing that has remained with me is I come first. Without me looking after myself, I cannot be an effective husband or father or son.

I look after myself physically, I exercise almost every day and most importantly I have a good group of friends and support system.

Recently on social media, there was a ruckus about your method of treatment that some, who claimed to be your former patients, felt that you were too focused on medication and hospitalisation.

The beauty of living in a free country, in a free world, is the fact that every citizen is entitled to an equal opportunity to comment. Sometimes they are correct, sometimes they are wrong.

Not everybody agrees with me, and indeed if everybody agreed with me something would be wrong somewhere. I think it’s refreshing that there are some people, some well-informed, some not so well-informed, who disagree with the methods we use in the treatment of mental disorders.

Also, there are a large number of people who vote on their feet, who keep coming to us, who are constantly being referred to us for care, who are our testimony of the effectiveness of the treatment. We rely heavily on non-medication interventions which in certain situations work better than medication. So I don’t know who spoke about those things, but we embrace all varieties of opinion just like we embrace all medical and scientific interventions.

If you’re to chop your life in decades, which part did you feel like you had the greatest transformation and the greatest insight into who you are as a man?

The cliché requires me to say my 40s. (Chuckles) But that’s not true. I was transformed completely in the second decade of my life. I joined High School (the Delamere School, now Upper Hill School) in 1964, the year after independence, and finished in 1969, and enrolled in the university in 1970. The foundation of my person and personality were formed in those six years, from the age of 14 to 20.

Part of the most ridiculous transformation was that we joined an all-white school, four or five of us. We discovered to our total shock and surprise that we could beat them in Maths, English, Geography, and History. And within a short time, we were at the top of the class. I became the first head boy of an all-white school. From that time, I have not feared any person either on account of their skin colour, age, education, or religion.

How do you escape from work, sickness…

For all the sins I have committed, I play golf. (Chuckles) When the good golfers in the world are called to a party, I will not attend. But when a party is called for those who enjoy golf the most, I will be there.

Do you see yourself as an old man at 70?

My wife will tell you this, I’ve always aspired to the status of being accepted as an old man. Hopefully, a wise old man. I have no fear whatsoever. I saw my grandfather and later my father as some of the wisest human beings they were and I thought that part of that wisdom was the accumulation of knowledge and time. So physically I’m not an old man, but mentally I’m not an old man.

How do you manage to dissociate yourself from your patients and their pain?

That’s a very good question because I have seen myself all my life as a teacher. I have taught formally, I have taught informally. I continue to teach young doctors and I can see that one of the problems of being young is the inability to distinguish your work and your life as a human being. It’s almost a function of age, time, and experience that you can go to work and engage, and empathise, and be completely involved, but depending on your training and experience, it’s also completely possible to disengage.

What have you learnt about the human mind over these 40 years?

Its capacity to adapt, to bounce back. People have major reserves to almost reconstitute themselves back into their original positions. This is understated and often under spoken.

What do you think is your strongest quality as Dr Frank Njenga?

Romantic optimism. I just know in the very deep part of my heart that these things are possible. I think we allow ourselves limits and limitations that we impose for ourselves. When I told people that we could put up this hospital, some years ago, many dismissed me. All the things that I know can be done in my head, I try to actualise.

What’s the last thing that deeply saddened you?

Recently, one of the things that sadden me is the state of our politics. Deeply. Because we deserve better. We as a people of Kenya have so many assets in terms of potential but we behave and we are treated as though we exist and live in a banana republic. When I see the insatiable greed that is around me, and I’m not pontificating, it’s truly saddening.

Do you think greed, this need to grab, acquire, and steal, is a mental affliction, some sort of sickness?

That is the million dollar question. We can easily dismiss greed as a mental affliction, then find an explanation from experts and attempt to treat it like a malady.

But greed is from two angles. One, it’s individual and almost constitutional. Some individuals are almost by disposition gluttonous. Whether that’s because of how their parents brought them up, or whether it’s in their genes, I don’t know. But the one that bothers me is the greed that seems to be cultural.

We have socialised ourselves into systems of acquisition that lack merit. The problem is twofold. One is that we reward gluttons. Secondly, we do not punish them for it. We elect them to Parliament. We make them leaders.

The number of people who go into public spaces to enrich themselves is beyond what you dare believe. And what is very interesting is that I see them here after their time in office, suffering from depression, confessing that they went for leadership to enrich themselves.

What’s your limiting personal trait that you have had to work on overtime?

Oh! That’s a very important one. It’s my intolerance for two things. Foolishness and laziness. I’ve had great difficulties being patient with people who are unable to comprehend simple things. It’s a weakness on my part. Because I think people choose not to be clever, or not to understand. I’m also very impatient with slow and lazy people.

I genuinely want to be patient, but after a certain point, it becomes necessary for me to make a decision that appears unfair or unreasonable.

What do you think is the most underrated human emotion?

The capacity to achieve joy. People don’t appreciate that you can work towards happiness. We underestimate our capacity, individually and as a nation to achieve a higher state of happiness.

On a sliding scale of 1 to 10, where 10 is very happy, how happy are you and how have you seen your happiness transform over the years up to now at 70?

I would rate myself as between 7.5 and 8, I’m constitutionally happy. If I went back to God and God said, ‘Can I give you another life on earth and you can change it in the way you want.’ I’d say no. I had an excellent childhood, an excellent education, a very privileged adult life and I’m growing old gracefully, come on? (Laughs)

I saw a photo of a very pretty girl on a wall at the top of the staircase. Is that your granddaughter?

Let me put it this way. Four women in my life are the source of happiness for me. The first is my mother, she’s 94. There’s my wife. I’ve been with my wife for over 50 years. Then there’s my daughter, she’s also on that wall. Then my granddaughter— my source of great joy. I did a Ted Talk in London about 10 years ago and it was based on my granddaughter.

My thesis around this was as follows, ‘That becoming a grandfather is almost a physical state that transforms the human person from a self-centred inward-looking individual who lives a lot for and about themselves, to one who is compelled, almost biologically to now be outward-looking and to work for the survival of the species.

When you become a grandfather, it becomes more important for you to ensure that your granddaughter grows up in a place where there are rivers and forests. Before that, you know it in your head. After you become a grandfather you know it in your heart.

I like that. I want you to describe for me the first time you met your wife.

(Chuckles) She’ll kill me! (Laughing) It’s ridiculous! I met her at a bus stop, at Gill House. It was in the evening at about 5 o’clock and I was on my way home. I lived with my parents in Nairobi West. She was waiting for a bus. I had entered a bus, No. 13, when I saw her talking to a guy I knew. I jumped off the bus and went and said hello to the guy who had no choice but to introduce us. (Laughs) Later we got onto the same bus and we chatted a little bit. The rest is history.

Does marriage get easier now that you’re 50 years in?

If you don’t write anything else, write this point: yes it gets easier. For me at least. Every decade has been easier than the last.

Is there one patient over your long career that you just can’t forget?

Yes. Two actually. The first one is a young French boy who nearly killed 500 people on a 747 British Airways flight from London to Nairobi. He developed a paranoid illness in Paris. The other one was an American girl who was attacked by a hyena. I remember what she said. She said a hyena’s bite was painful, but what she remembered most was not really the pain but the smell of the hyena. (Chuckles) That a hyena has such a terrible smell that it’s more painful for it to go through the nose. I mean it’s a gem of a story there.

What part of your life needs development and working on?

I think it’s preparation for an eventual exit from the centre stage. I have worked on it for the last 10 years, but I need to find myself a knob that will steadily and gradually allow and enable me to wind down.