I remember my first night as a doctor, spent in St Andrew’s Hospital near the Bow flyover, watching anxiously for ectopic beats on the cardiac monitors until the nurses chased me kindly out of the coronary care unit. The hospital is gone now, demolished to make way for flats. The memory is stirred by “Against Miserabilism,” a recently published selection of writing by David Widgery. A politically committed East End GP, writer, and activist who died in 1992 in his 40s, his essays cover diverse topics—the politics of 1968, the inception of Rock Against Racism, the fight to save the Hackney Empire, Sylvia Pankhurst championed against more genteel and accommodating suffragism, the plight of patients condemned to lack of care in the community as hospital after hospital were boarded up. It is also a celebration of diversity, embracing feminism and challenging racism and homophobia, infused, as any doctor should recognise, with the linkages between personal and political. Worn by the compromises of the 1970s, Widgery is a trenchant witness to the dawn of Thatcherism:

“This morally squalid equation of freedom with the thickness of your wallet is still more horrible when you consider it can only be achieved by a deliberate campaign to make the poor poorer.”

“Mrs T’s much-loved “scroungers”, who are at present hanging on to their dignity by their fingernails, will be formally and legally kicked over the edge. For their own good, of course…”

“Thatcher reminds us that the gnawing of poverty is a better instrument of discipline than the policeman’s truncheon.”

The new collection is also a spur to re-read Some Lives, Widgery’s classic account of his work and his community, to see if it still belongs in the canon of “essential” reads for anyone working in medicine, like A Country Doctor’s Notebook, The House of God, or How the poor die.

Some Lives, weaves together a history of the East End, of migration and merger, adaptation, pride in work in the docks and other trades. The loss and betrayal of this rich and complex community, to worklessness and purposelessness, provide the moral engine of the book. The human impact of sado-monetarism, “presents in human terms, conveniently out of site to the politicians, in our surgeries every day”; patients often “ill-fed and ill-housed as well as plain ill”. Then as now the health service is the carer of last resort. The impression is of a limitless ocean of need and misery, of physical and psychological distress. Inspiring or depressing. Reading the book as a medical student this seemed like a challenge, something to measure oneself against.  Now it is almost unbearable.

Overshadowing it all is the brutal transformation of the docklands. Instead of reviving the world’s choicest building site as a new and liveable city, unregulated forces of pharaonic development have been unleashed, communities are uprooted leaving nothing on a human scale.

“I’m watching something die and I wish I wasn’t. Perhaps the best I can do is to record the process.”

It is possible to watch Widgery practice in Andrew Bethell’s BBC 40 minutes documentary “Limehouse Doctor”, visiting patients grown old too early; worn by work or smoking or alcohol, their community gone. Painful too, given his ambiguous early death, before the end of filming, whether by accidental overdose or suicide.  

A quarter century gone, there is much that still resonates. The shift from market economy to market society: “a process of decivilisation” as the doctor patient relationship is “reshaped by the commodity-process.” He writes of “a decade when the NHS, a triumphant example of the superiority of collective action and public initiative in an area where the “law of the market” is seen at its worst, was forced into decline and disorganisation.” Reminded of anything?

Nicholas Hopkinson, reader in Respiratory Medicine, Imperial College London.

Competing interests: None declared.