Sidney introduced himself to me early in my career as a hospital porter. He was a polite and deferential middle-aged man. He told me that he had been working at the Brook Hospital for 15 years, so if there was anything that I needed to know, he would be able to fill me in. Slightly built, balding and wearing glasses held together with Sellotape, he resembled an older Woody Allen. His offer of guidance was well-intended, but his advice turned out to be totally unreliable. Sidney would confidently tell you where something was, or how something should be done, and nine times out of ten it would be incorrect. The consistent wrongness of the information he gave did not deter him from repeatedly offering it. Everyone in the porters’ lodge acquired a nickname, and Sidney was referred to as “Steak-And-Kidney-Silly-As-Arseholes”, which was a bit of a mouthful, but in the context of the lodge was neither unkind nor inaccurate.
Despite a background nervousness, Sidney was unwaveringly cheerful and upbeat. He was friends with the hospital road sweeper, Wally, who pushed a wheeled bin around the hospital roads all day and swept the gutters. The same job was done in the surrounding streets by local authority road sweepers, and Wally’s main topic of conversation was his grievance that local authority road sweepers got a bonus in the autumn because of fallen leaves, but he did not. When I came into the lodge with piles of copies of Workers Press, Sidney and Wally would loudly sing “The Red Flag” at me. It reminded me of Robert Tressell’s novel, The Ragged Trousered Philanthropists, which examines the way that workers uncomplainingly toil solely for the benefit of the rich.
The work of general porters involved lots of heavy lifting, and there was always a tussle over who would take the bottom (heavier) end of any load going up the stairs. Some of the work involved patient contact, which could be uplifting, but was often distressing. One night I had to take a seven year-old girl’s body to the mortuary, the memory of which still troubles me fifty years later. On another occasion, one of the wards was struggling to cope with an angry man in his twenties. He was withdrawing from heroin and awaiting transfer to the local mental hospital, where he expected to be given methadone. The ambulance was taking a long time to arrive and he was winding up. The ward’s strategy to deal with this was to call the porters: Bill, who was 64 and very unfit, backed up by me, The Boy.
As we arrived, the patient, who was sweaty and twitching, threw a chair through a window. After calming him, a burly junior doctor told us that if the patient kicked off again, we were to punch him under the jaw with an upper cut that would, he said, render him unconscious. He said “You go ahead and hit him; don’t worry, I’ll cover for you”. Then he left. Bill immediately said “Don’t hit anyone; if he kicks off again, we’re leaving”, which sounded like a better plan to me. The doctor seemed to have got his ideas about de-escalation from a bar fight in a cowboy film. Bill was a coarse man who leered noisily at scantily-dressed Top of The Pops teenagers on the lodge’s flickering black-and-white television. His idea of a joke was to put his false teeth in someone else’s mug of tea, which then became apparent to them when they drank the tea. I did not like him much. So I was surprised to see that he was thoughtful and gentle with this shivering, agitated addict. We sat with him and chatted quietly for thirty minutes. He thanked us politely as he climbed into the ambulance.
David was a porter who liked a spliff and walked with a pronounced limp. He was into Lou Reed, Leonard Cohen and poetry. He had a certain aggressive edge, but we talked about music and we often worked together. One evening, he had an argument with Bill over the washing up. Bill went immediately for a low blow: “You’re just a cripple, a green card man”. Green cards were held by those who were registered disabled. David came straight back: “The only one here that doesn’t have a green card is him,” (pointing at me) “I may have a bad leg, but you’re mental.” Bill slunk off, muttering. David appeared to know something that Bill thought he had concealed.
Bill retired on my 19th birthday, which was his 65th. He said he was looking forward to spending more time with his wife. Whilst explaining to me about the strength of his enduring love for his wife, he said that every morning, before he left for work, he took her a cup of tea with a shot of whisky in it. He did not really make clear whether she knew about the whisky.
The summer of 1975 was long and hot. The grass on Blackheath turned pale yellow. The weather led to behavioural changes in London that became permanent. Grown men started wearing shorts. Shorts on British males had been disappearing since the 1950s. Even the Boy Scouts had gone into long trousers. Mid-70s shorts were not practical baggy khaki garments. Instead, they followed the same design as those worn by Glen Hoddle and Kevin Keegan, young soccer stars of the day. They tended to be too small and too tight, which was not flattering, even on professional athletes. The acceptance of them being worn by bright pink fleshy men in aisles of supermarkets and the saloon bars of pubs marked a real shift in the boundaries of public decency.
Another big change was the arrival of the backyard BBQ. This was the period when Indian and Chinese food had only recently broken out of Soho and was becoming popular in the suburbs. Amid a new adventurousness over food, charcoal became available on British high streets for the first time. By the end of the summer, a constant heavy aroma of fire-accelerants and burning meat hung like a smog over London, as it does at the first sign of good weather today.
Kung fu was a big thing that summer. It had been popularised by a TV series starring David Carradine and by the films of Bruce Lee, who had died aged 32 in 1973. In the hot weather, people wearing headbands did Tai Chi moves on patches of parched grass. There is a narrative that the mid-1970s were grim, owing to frequent strikes, an oil crisis, a three-day week, and rampant inflation (25% in 1975). It is said that the popular music of the time was bloated, boring and remote from the audience, the worst kind of prog rock. What I remember is sunshine, low unemployment and a lot of great music: Toots Hibbert, Bob Marley, Steely Dan, Little Feat and Dr Feelgood. Stabbings and shootings in London were rare and mainly connected to organised crime.
It would be wrong to give the impression that the porters’ lodge was a rough or difficult workplace, especially compared to the harsh working conditions of today. Whilst there was little sign of the nobility of labour as depicted in Soviet social realist art, I never saw any of the bitter interpersonal conflict and raw vindictiveness that I later experienced between senior doctors. The porters were consistently kind to patients and, for the most part, civil to each other in a sweary sort of way. Towards the end of my time at the Brook, I was assigned to transport patients to and from the operating theatres. Porters shared a small over-heated windowless room in the theatre suite with a small group of operating department assistants (in those days, unqualified). Tensions bred easily, and on one occasion I squared up to someone who was trying to intimidate me. Luckily, my reactive pugnaciousness surprised him and he backed off. Altercations of this type were uncommon, and nothing like it ever occurred amongst the larger group of porters in the lodge.
The Brook General Hospital had been built as the Brook Fever Hospital. Infectious disease is the scourge of mankind and always has been. The Covid pandemic has exposed a collective amnesia about how frequently there have been waves of mass deaths due to infectious disease throughout history. In the second half of the twentieth century, sanitation, decent housing, vaccination and antibiotics gave high income countries respite and the opportunity to forget. Covid denialists seem oblivious to the large numbers of people who died from infectious disease in the UK as recently as the 1940s. Tuberculosis was particularly feared. As well as causing death and disability, its treatment could be daunting. Prior to effective chemotherapies, people with large tuberculous cavities in their lungs sometimes underwent thoracoplasty. This involved surgical removal of ribs in order to collapse the cavities and allow the lungs to heal. It was potentially lifesaving, but patients were left mutilated. The vans of the mass X-ray screening programme for tuberculosis were a common sight in British streets until the late 1960s.
The Greek physician Hippocrates had a massive influence on the early development of European medicine. One of his legacies was the general belief that infections were caused by miasma, a foul smelling gas arising from the decomposition of organic material. Germ theory developed in the late 19th century, following the earlier success of John Snow in demonstrating that cholera was spread by contaminated water supplies, not by bad smells. Fever hospitals were designed to allow the medical treatment of patients with infectious disease under conditions that contained the spread of disease. Wards were built as two-storey pavilions that were structural separate from each other. Fever hospitals sprawled over large sites in order to minimise cross-infection. Wards were joined by walkways covered by glass roofs supported by ornate cast iron. As infectious diseases came under control after the Second World War, increasing portions of these hospitals were redeployed for other purposes. Departments occupied new buildings constructed in the spaces between Victorian buildings, and the topography of hospital sites became increasingly irrational. The Brook was no exception. The porters’ lodge had originally been the Matron’s house, but its function was changed when the expectation that nurses would not marry was dropped.
Some of the Brook’s covered walkways had had plastic side panels fitted, each with a large sliding door in the middle. The panels kept out the rain, and the doors allowed the electric trucks and wagons into the quadrangle between wards. The wards had rubbish and laundry chutes and we collected the bags at the bottom. There were quite a few of these enclosed quadrangles between the old ward pavilions, more or less identical to each other. On my second day, David and I were doing the dirty round. As we rode into our fourth quadrangle, I had powerful sense of déjà vu, the most vivid been-here-before experience of my life. It was so unsettling that I mentioned it to my mother that evening. When I was two, my father was found to have tuberculosis on a routine visit to a mass X-ray van. He was an inpatient for months. I was forbidden to visit him in order to avoid infection. I knew about the episode, but could remember none of it. I had no idea that the Brook had been the location of his incarceration. The quadrangle where I was overwhelmed by déjà vu was the one where my mother had taken me once a week, so that my father could watch me play from a ward window high above.
In the months that I knew him, Sidney seemed to develop increasing problems in navigating the chaotic layout of the hospital. At first, it just took him a long time to find his way back to the lodge. Before long, if he was sent out alone, someone would eventually have to go out on an electric truck to find him. He seemed unperturbed by this and smilingly accepted teasing about his growing disorientation. One evening, I asked Sidney about his taste in music and he started talking about his home life. He had a small flat in Lewisham where he had lived alone since his marriage broke up. He was bitter towards his ex-wife, because she had not coped when their only daughter was born with severe disabilities. As far as Sidney was concerned, she had turned her back on them both. His week was built around his visits to his daughter in a long-stay hospital. She recognised him, he said, but she had little speech. The rest of the time, he liked to listen to Nat King Cole records and read cowboy fiction. He did not really bother with friends or family. Then suddenly he did not want to talk about it anymore.
Not long after, I had just arrived at the lodge for a night shift when Sidney staggered in. He was in an awful state. He was deathly pale and he was bleeding from a head wound. He stood in an awkward posture and kept wincing in pain. He insisted he was fine and would not tell me what had happened to him. A few moments later, a man rushed into the lodge. Sidney had got off a bus opposite the hospital and crossed the road without looking, stepping out in front of his car. Although he was thrown through the air, he got up and rushed into the hospital without waiting to speak to the driver. The man had followed him, because Sidney obviously needed treatment and there was need to inform the police of the accident.
I got a wheelchair and the pair of us wheeled him around to A&E, where I was working that night. Sidney had broken his shoulder badly and he was admitted to the orthopaedic ward pending surgery. I visited him on the ward after the operation. He continued to insist that he was fine and that it was a lot of fuss about nothing. He thanked me for my help the night before, but he called me Jimmy, which he had started to do lately. A few days later, he was transferred somewhere to convalesce and he never returned to work.