Reflections on a life in menopause
In the early 1970s, two medical scientists, meeting for the first time and forging an instant and lifelong friendship, went on a pub crawl through old Geneva, Switzerland, and women's health care through and beyond menopause was about to change. The older was a social scientist who had just completed a five-nation European study on the psychosocial impact of menopause. Pieter van Keep, a Dutchman, a bon vivant with a huge personality, was the Executive Director of the International Health Foundation (IHF). The younger, me, was a South African gynecologist and reproductive endocrinologist on the faculty of the University of Cape Town where I had established the world's first clinic dedicated to menopause research, intrigued by what really happened to women when their ovaries failed or were removed, and when estrogens were replaced.
This truncated memoir is not meant to be a history of NAMS, although it is so integrally tied into my life; nor of the other organizations I was instrumental in starting; certainly not a history of menopause; and definitely not an autobiography. Recognizing that I am in the latter years of my professional career, with the intention in the not too distant future to step away from all matters medical to focus on other interests, I would like to relate a few personal memories of that career. Where did I come from, what influenced me and my life direction, why have I been a clockmaker who tends to become bored when forced into the position of timekeeper—and why spend a life studying menopause?
I had an uncomplicated but very independent childhood, growing up in Johannesburg, South Africa. My father arrived in South Africa as a young man with a traumatic history as he escaped Russia and Lithuania, arriving in Cape Town in 1921 at the age of 16. He was to become one of South Africa's top experts in diamonds, and had a manufacturing jewelry factory. He was an artist and perfectionist—for example, he was commissioned by the De Beers diamond organization to create a major jewelry piece that was their gift to the young Queen Elizabeth and that piece resides in the Crown Jewels. He unfortunately was to die young as a result of iatrogenic complications of unnecessary surgery. From him I learned four things. First was that the best place to store one's treasure was in one's brain. Second was that one should do something properly, or not at all. His joy was the making of a perfect piece of artistic jewelry. Satisfaction came from the act of creation, something I was to observe repeatedly from a young age. Third was to be honest; to safeguard one's integrity—“your word is your bond.” Fourth was that if you had something to say, say it, even at personal cost or risk. Medicine seemed like a specialty and life's career where I could follow his principles, and so from an early age I wanted to be a doctor. My mother was the pragmatic partner in the marriage and the family business. From her I learned the necessity of organization, being fair and supportive to employees, to stimulate growth in the younger generations, and to get up each time I got knocked down. Their full-time occupation with work, and later the health decline of my father, left me much on my own, and I learned the lesson of independence, often hiking the woods and hills near our home; hence my love of nature and the wilderness. My parents were my best role models and teachers.