At Xmas, my mother, usually so sad, burst into song

Two Christmases ago my mother made a series of unusual telephone calls to London from her home in Trinidad. "Is your father coming home for the Christmas holidays?" she asked my daughters. They were puzzled. I was more so. In nearly 35 years, I had not previously had a single call of that kind, and we were not on the best of terms. I came to the tentative conclusion that the questions concealed more than they revealed.

I rang her a couple of days before I left for Jamaica to spend Christmas with friends. She recited a sort of official communique. "I have not been ill since I gave birth to your brother 30 years ago and I am feeling very ill now." That was all, but her voice seemed strong and firm. I replied rather lamely: "You sound as though you have a lot of gas in the tank." She sucked her teeth, a "cheups", a West Indian sign of dismissal, and slammed her phone on the cradle.

My mind went back to the Christmases of my childhood. My mother was a schoolteacher and we lived in a tiny village in the south of Trinidad. She had no friends, she was not tactile and she spoke seldom, and then barely a sentence or two. Days would pass and not a word would trip from her lips. She appeared always sad, encircled in gloom, as if weighed down by some tragedy. I imagined that she was slowly dying and kept it a secret from us all. She read voraciously, gave monosyllabic orders to the maid and listened to soap operas and the BBC news on the radio powered by a car battery. (The village was without electricity.) Then suddenly upon some trite misdemeanour she would explode violently on my father or any one of her children.

But at Christmas her personality seemed to change completely. My father would return from the shops with bags of dried fruit - prunes, raisins, sultanas in cutely decorated boxes - and always three bottles of rum. Mum would take down the huge clay jars from the shelves where they sat all year round. They had a thorough rinse with detergent and lemons, while she broke into song. "Careless Hands" was a favourite. "They brought you joy/And there I love you so. And all the sorrows doesn't make the roses grow." Or sometimes a hymn, "Through all the changing scenes of life/In trouble and in joy." She was a brilliant soprano and she phrased the words magically.

She would smile beautifully throughout the days leading up to Christmas, hug and squeeze us to her huge bosom and tell us tales of her childhood. Then one Saturday the family tumbled into a Ford Prefect owned by a neighbour and went off to San Fernando, the industrial capital of the island. We visited Toyland, danced around the hem of mum's flared skirt as she purchased goodies upon goodies to make tiny bodies tingle and jingle with joy. Then came the feast at the Jack Frost cafe - hot dogs, hamburgers and milkshakes. We would pick up Beryl on our way home. Beryl was a deaf mute. I was terrified of her; I imagined her emerging from fire and brimstone to polish our furniture. Her hands gesticulated furiously; signs of the demon, I thought.

Christmas Eve was all religion. The entire family and all the Anglicans in the village warmed the Church of Ascension and sang the hallelujahs loudly. And I waited until Canon Lyons in his clipped English accent intoned "Oh Lamb of God that takest away the sins of the world, have mercy upon us. Oh Lamb of God that takest away the sins of the world, receive our prayer. Oh Lamb of God that takest away the sins of the world, grant us thy peace." I whispered, "happy birthday, Lord " on the stroke of midnight.

And so, on the Christmas after my mother's phone call, I sat on the balcony of a house on a hill in the Jamaican countryside and belted out quite spontaneously the lyrics of "Careless Hands" and of my mother's favourite hymn.

The following day I packed and left for London via New York. At Kennedy airport I phoned my wife to tell her I was on my way home. She asked me to settle myself. "Your mum," she said, "collapsed and died earlier today."

It is only now, with Christmas approaching, that I am struck by her absence.

Darcus Howe is an outspoken writer, broadcaster and social commentator. His TV work includes ‘White Tribe’ in which he put Anglo-Saxon Britain under the spotlight. He also fronted a series called Devil’s Advocate.

This article first appeared in the 18 December 1998 issue of the New Statesman, A time for unadulterated tradition

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The proposed cuts to junior doctors’ pay will make medicine a profession for the privileged

Jeremy Hunt is an intelligent man with a first-class education. This makes his ill-fated proposed contract appear even more callous rather than ill-judged.

The emblem of the British Medical Association (BMA), the trade union for doctors in the UK, symbolises Asclepius, who was believed to be the founder of western medicine. Asclepius was killed by Zeus with a thunderbolt for resurrecting the dead. In the same way, the proposed government-led contracts to be imposed on doctors from August 2016 may well be the thunderbolt that kills British medical recruitment for a generation and that kills any chance of resurrecting an over-burdened National Health Service.

The BMA voted to ballot their junior doctor members for industrial action for the first time in 40 years against these contracts. What this government has achieved is no small feat. They have managed, in the last few weeks, to instil within a normally passive profession a kindled spirit of self-awareness and political mobilisation.

Jeremy Hunt is an intelligent man with a first-class education. This makes his ill-fated proposed contract appear even more callous rather than ill-judged. Attacking the medical profession has come to define his tenure as health secretary, including the misinformed reprisals on hospital consultants which were met not only with ridicule but initiated a breakdown in respect between government and the medical profession that may take years to reconcile. The government did not learn from this mistake and resighted their guns on the medical profession’s junior members.

“Junior doctor” can be a misleading term, as we are a spectrum of qualified doctors training to become hospital consultants or General Practioners. To become a consultant cardiac surgeon or consultant gastroenterologist does not happen overnight after graduating from medical school: such postgraduate training can take anywhere between 10 to 15 years. This spectrum of highly skilled professionals, therefore, forms the backbone of the medical service within the hospital and is at the forefront of delivering patient care from admission to discharge.

Central to the opposition to the current proposed contract outlined in the Review Body on Doctors' and Dentists' Remuneration is the removal of safeguards to prevent trusts physically overworking and financially exploiting these junior doctors. We believe that this is detrimental not only to our human rights in a civilised society but also detrimental to the care we provide to our patients in the short term and long-term.

David Cameron recently stated that “I think the right thing to do is to be paid the rate for the job”. This is an astute observation. While contract proponents are adamant that the new contract is “pay neutral”, it is anything but as they have tactfully redefined “sociable hours” as between 7am and 10pm Mondays to Saturdays resulting in hardest working speciality doctors seeing their already falling inflation-adjusted pay slashed by up to further 30 per cent while facing potentially unprotected longer working hours.

We acknowledge that we did not enter medicine for the pay perks. If we wanted to do that, we would have become bankers or MPs. Medicine is a vocation and we are prepared to sacrifice many aspects of our lives to provide the duty of care to our patients that they deserve. The joy we experience from saving a person’s life or improving the quality of their life and the sadness, frustration, and anger we feel when a patient dies is what drives us on, more than any pay cheque could.

However, overworked and unprotected doctors are, in the short-term, unsafe to patients. This is why the presidents of eleven of the Royal Colleges responsible for medical training and safeguarding standards of practice in patient care have publically stated their opposition to the contracts. It is, therefore, a mystery as to who exactly from the senior medical profession was directly involved the formation of the current proposals, raising serious questions with regard to its legitimacy. More damaging for the government’s defence are the latest revelations by a former Tory minister and doctor involved in the first negotiations between the BMA and government, Dan Poulter, implying that the original proposals with regard to safeguarding against unsafe hours were rejected by Mr Hunt.  

The long-term effects of the contract are equally disheartening. Already, hundreds of doctors have applied to the General Medical Council to work abroad where the market price for a highly trained medical profession is still dictated by reason. With medical school debts as great as £70,000, this new contract makes it difficult for intelligent youngsters from low-income backgrounds to pay back such debts on the modest starting salary (£11-12 per hour) and proposed cuts. Is medicine therefore reserved only for students from privileged backgrounds rather than the brightest? Furthermore, the contracts discourage women from taking time out to start a family. Female doctors form the majority of undergraduate medical students – we should be encouraging talented women to achieve their full potential to improve healthcare, not making them choose unfairly between work and family at such an early and critical stage of their career.

Postgraduate recruitment will therefore become an embarrassing problem, with many trusts already spending millions on hiring locum doctors. Most hospitals are not ready for Hunt’s radical reforms as the infrastructure to supply seven-day working weeks is simply not available. With a long-term recruitment problem, this would also be a toxic asset for potential private investors, should the health secretary venture down that path.

Jeremy Hunt has an opportunity to re-enter negotiations with the BMA to achieve a common goal of improving the efficiency and recruitment to the health service while protecting patient care. Although the decision for industrial action should never be taken lightly, as future leaders of clinical care in the UK, we will do everything in our power to defend against such thunderbolt attacks, by men playing god, the integrity and dignity of our profession and on the quality of care it delivers to our patients.