I attended my last British Medical Association conference as a junior doctors’ representative one sunny Saturday. I had finished long years of postgraduate training and I had applied for a post as consultant psychiatrist in Newcastle-upon-Tyne (I did not get the job). The conference concerned a document called “Hospital Medical Staffing: Achieving a Balance”, a set of Government proposals to change medical career pathways. This included the introduction of a permanent NHS staff grade below the level of consultant. I felt that it was inevitable that the grade would be a dead end, a final career destination for women and for doctors who had qualified overseas, and that it would worsen discrimination within the profession. I was amongst a minority who opposed the proposal.
Delegates were still filtering into the conference chamber as the first speaker took to the podium. I was flicking through my papers, not really listening, when I noticed that the speaker was talking about class-struggle in a way that was out of place in the conservative setting of BMA House. I looked up and was surprised to recognise Sara, a good deal older than when I last saw her, but otherwise unchanged. It was incredible that she had turned up now after more than a decade, bookending the years that formed me as a doctor. It was like something out of a film.
One of the skills that I gained whilst working as a hospital porter was the ability to balance a wheelchair on its back wheels whilst sitting in it. I once did this continuously for 57 minutes. In those days, the Brook Hospital Accident and Emergency Department was very quiet after about two in the morning, and there was not much else to do.
The night staff in Accident and Emergency consisted of a junior doctor and five or six nurses. Four porters were based there, covering the whole hospital. Back then, the A&E at night was nothing like as busy as it is now. Pubs stopped serving at eleven o’clock sharp and the three TV channels stopped broadcasting around the same time. It is possible that A&E was quiet because everyone went to bed early. Britain was a poorer but more equal society back then, GPs still did out-of-hours home visits and the infrastructure of working class life had yet to be dismantled, so there were probably better ways to find support, help or warmth than by going to a hospital.
At 18 years old, I was the youngest porter by far. Many of the others were older than my parents and had been in the armed forces during the Second World War. If one of the younger porters was on nights with me, we would have balancing-wheelchair battles, trying to knock each other over, but on this particular night the other porters were middle-aged and prone to doze off. By two-thirty in the morning, the nurses were on their break, and I was doing balancing-wheelchair circuits of the department. I was passing the only occupied cubicle when the doctor, a woman in her twenties, stuck her head out and shouted for a nurse. Receiving no response, she addressed me: ‘Can you come and help?’ So I did.
The patient was a lad who was about the same age as me, but he looked younger. His arms and face were covered in lacerations. He was shivering and he was smudged with soot and blood. He had awoken in the night to the smell of smoke, and rose to find that the house was on fire. He had smashed a window to lift his younger siblings to safety, then climbed out himself, which is how he came to be covered in cuts. All of his family were accounted for but the dog was missing, presumed dead, which was the main cause of his distress. The doctor was suturing the wounds. She gave me a pair of scissors and indicated when she wanted me to cut the stitches. I asked the lad about himself. He was a student nurse, but he really wanted to be a doctor, so we had something in common. We chatted about the difficulties in securing a medical school place if you had no medical connections and no one else in the family had been to university. The doctor joined in and talked about her experience of her “snobbish” London medical school. Moving on from that rather depressing topic, we discussed Bob Dylan, who seemed to be coming back into form after a long fallow period. The lad seem to gradually cheer up.
At one point, the Sister-in-charge came in. She was taken aback to see me assisting and said that she would get one of the nurses to take over, but the doctor said she would prefer that I carry on. The Sister rolled her eyes and left. Eventually, all of the wounds were sutured and dressed, and the lad went off to be reunited with his family, parting with the hope that we would meet again under better circumstances, perhaps at medical school. We never did.
The doctor introduced herself as Sara and offered to make me a coffee. We retired to the staff room, by now vacated by the nurses. Sara was a small woman with reddish hair tied back with black ribbon. Her white coat was far too large for her, because hospitals made little accommodation to the existence of female doctors. The arms of her white coat were rolled back, a stethoscope stuffed in one pocket and a note pad in the other. Sara was self-assured and assertive in the way that young doctors often are. She asked me a lot of questions about myself. She did not really disclose anything much about herself, but I was flattered that she showed an interest in me. Eventually, a nurse came in and told her there was another patient wating to see her.
This was the start of a brief relationship with Sara. In a film or a novel, it would have involved an awakening with an older woman, but there was nothing sexual about this relationship. There was a form of seduction going on, but it did not involve my body. I was being groomed to become a member of the Workers Revolutionary Party.
Sara looked out for me over the next few nights. She encouraged my interest in her work. She was nice to patients, and she explained what she was doing and why. Doctors were more aloof and much more careless about patient consent back then, but she took care to explain to patients who I was and made sure that they were happy with my presence. On one occasion, I cut myself on some glass in a rubbish bag as I collected it from one of the labs. After the cut healed, I realised there was still some glass under the skin. Sara performed a minor operation to remove it. I still have a small neat scar on the back of my hand.
Back on the day shift, I was based in the porters’ lodge, a smoke-filled environment where there was a permanent card game, an endless supply strong tea and a steady trade in stolen goods. This place belonged to the hospital’s male manual workers, and it caused some discomfort when Sara sought me out there. Medical staff were regarded with considerable suspicion. Sara was always a bit careless with social niceties (the nurses complained she ate more than her fair share of the night shift sandwiches) and she appeared oblivious to the palpable hostility that her presence provoked. The other refuge in the hospital was the laundry, a Jamaican domain where friendly company and high-grade cannabis were available behind huge piles of bed linen. Occasional appearances by junior doctors were tolerated much better there.
Outside of work, Sara and her husband were totally wrapped up in the Workers Revolutionary Party, which was a very peculiar Trotskyist sect. A lot of young people had transient involvement in Trotskyism in the 1970s. Mainly students and recent graduates. Not so much members of the actual industrial proletariat. There was quite a range of different Trotskyist groups to choose from, from tiny and obscure to large and well-known. They all took the view that the Bolshevik revolution had been carrying mankind towards a glorious future until Stalin defeated Trotsky and it all went wrong. This was curiously incompatible with what Marxists call the Materialist Conception of History, which emphasises the historical role of impersonal socio-economic forces rather than the importance of the actions of individuals.
Following the Stalin-Trotsky deadly rivalry model, the various splits and tensions between groups were driven by conflict of egos. Differences in political ideas were trivial by comparison, and were often imperceptible to outsiders. The groups had major differences in style, which was probably a reflection of the dominant personality in each group. Most had an unequivocal leader, who was invariably a man.
All of the Trotskyist groups were consistently unsuccessful in their objectives, but the WRP’s singular achievement was to stand out amongst them as distinctly weird and sinister. I am hazy now about how Sara persuaded me to join, although it certainly started by getting me to talk with her about the contents of the WRP newspaper, Workers Press. In keeping with the general stance of the organisation, any idea I generated myself was wrong, whilst anything I repeated from Worker Press was astute.
Although I was young, I could not make the excuse of naivety. From the beginning, I noticed that some of the positions that the WRP took were odd. At no stage was I sufficiently convinced to want to fully commit myself to the struggle. In the weeks that I spent in the organisation, I felt that I was witnessing something really strange. As has been the case with several of the more interesting episodes in my life, I felt more like an observer than a participant. When the organisation started making uncomfortable demands upon me, I left. Many other young people had similar encounters with these groups. Only a minority came to feel any sense of longer term commitment. Like others who proceeded rapidly from the in-door to the out-door, I was curious. Apart from anything else, I had well-formed opinions and I was no less attached to them as a teenager than I am in my maturity.
Amongst the Trotskyist groups, the International Marxist Group were unusual in being fashionable. John Lennon was involved with them. Tariq Ali was the charismatic and talented editor of their paper Black Dwarf (later Red Mole), which was itself unusual in that it was readable and caught the spirit of the ‘underground’. The International Socialists were rather dour by comparison and went on to become the Socialist Workers Party. Along the way, they spawned the Revolutionary Communist Party, which swung sharply to the right in the 1990s and now operates under a number of different guises as part of the libertarian alt-right. Baroness Claire Fox of Buckley has been a prominent participant in both old and new variants. The Labour Party’s Militant Tendency (a party-within-the-party that privately called itself the Revolutionary Socialist League) managed to briefly gain municipal power, an episode that did little for the general credibility of Trotskyism. They took control of Liverpool City Council in the 1980s and struck a blow against the Thatcher Government by issuing redundancy notices to the Council’s entire workforce. The debacle was part of the justification for New Labour’s sharp swing to the centre-right. Surprisingly, this patchwork of feuding and ineffectual revolutionary groups was thought to create a real risk to the British state in the 1970s, and the security forces put a lot of effort into monitoring and harassing them.
My family background was full of politics, which was common amongst working class families in the 1950s and 60s. Both of my grandfathers were long-serving officers of branches of their trade unions, chair and treasurer respectively. On my mother’s side, the family were Labour Party municipal aristocracy. My grandmother was a life-long activist who sat as a school governor and on hospital boards. Her standing in the Party had benefits, one of which was the tenancy of a council house in Charlton with a substantial garden, attractively positioned at one end of the Village. My great-uncle and my mother’s cousin had been Mayors of Woolwich. The great-uncle had previously been active in the Communist Party, and I inherited his Left Book Club collection. On the paternal side of th family, my grandfather and a number of other family members were active in the Socialist Party of Great Britain, a Marxist-but-not-Leninist group of working class autodidacts. Their main activities were organising debates and speaking at Speakers’ Corner in Hyde Park. I grew up with politics over Sunday lunch and a precocious awareness of the ideas of Marx and Engels.
My parents were not party members, but they felt strongly about politics and almost everything else. When I was small, we lived in two rented rooms with shared kitchen and bathroom facilities. My parents then bought a three-bedroom inter-war semi-detached house in Wricklemarsh Road, Kidbrooke, which is where we lived throughout the 1960s. By 1969, my father’s career as a manager in a paper merchant company was sufficiently successful that we moved into a larger house in Kidbrooke Grove, a broad, leafy street close to Blackheath, where our neighbours were solicitors, journalists and retired colonial administrators. My parents assimilated and were popular in this close-knit upper middle class enclave, but they remained proud socialists, anti-monarchists, anti-racists and militant atheists. To the end of her life, my mother insisted that we were still working-class in the face of obvious evidence that this was no longer true. My childhood was filled with debate amongst adults who were uneducated but well-read. There were books, classical music and strong encouragement to question authority of all types. Under the circumstances, I could not claim that my flirtation with Trotskyism arose from ignorance. However, if I was motivated by rebellion, none of the family seemed remotely bothered.