The fall of 1975 was my Titanic moment.
I remember the day well. After boarding an old cargo ship, I sprinted to the top deck. My classic trunks were feathers in my hands. Huffing and puffing, three levels later, I dropped them at the railing and peered out over the harbour as the ship’s crew hoisted the ramp and fired up the propellers.
It was early morning. The sun was rising over the cranes and fishing boats, all the colours and sounds of Freetown Harbour. The air was already hot and sticky. My mother and father had driven me to the harbour, so there I was leaning over the railings, almost falling over, trying to spot them in the crowd. It might seem like something out of an old film, but the people on that old boat did not know when they would see their loved ones next. We savoured those last moments of contact.
I was eighteen years old, on my way to Cambridge University, and I knew it would be close to a year, perhaps Christmas, before I would return to Freetown. After a few desperate scans, I saw my parents, along with my sister and a handful of relatives, gazing up at me. I started waving frantically, jumping up and down and blowing kisses. The thick ropes that tied us to the dock were tossed up like confetti, and just like that, the ship began lumbering from the harbour.
I wasn’t sure if I would return to Sierra Leone after my education, or travel somewhere else and help to support my homeland from afar. I was a proud African and believed in my country. My father’s profession as a historian deepened my appreciation of my heritage.
He had also set the bar rather high, since Cambridge was my father’s alma mater. He had been part of that African elite. I already knew that I was to be a doctor, so it was time for me to deliver.
I had always been a very good student. I did not play sports and attend cricket matches. Education was everything when I was growing up. I did, however, have my rebellious side. In addition to my pornography enterprise in Kenya, I had sometimes had trouble relating to my teachers. Rules and discipline are often questioned by sharp minds, and while I had some memorable teachers, I thought the majority were narrow-minded idiots.
But now I was free. I was ready to take on the world. The wind was in my hair and I could taste sea salt on my lips. My entire life was ahead of me. The voyage to Liverpool from Freetown took nine long days. This ship was not huge by today’s standards. I shared a cabin with another young man, and we spent a great deal of time reading or playing shuffleboard on the deck.
Once we arrived in harbour, I took the train from Liverpool to Cambridge. The train station at Cambridge was popping with fresh-faced students, a portrait of energy, elation and confusion, asking directions, checking instructions scrawled on paper and running this way and that with clunky trunks in tow. It became clear in those first moments that my next great challenge lay before me. I was used to being at the top of my class. However, these students were also the cream of the crop, wherever they came from. I would not say that I was intimidated, but I was certainly aware that I was no longer a big deal. We were all big fish dropped into an expansive ocean. It was sink or swim, and I had a lot of growing up to do.
We piled into cabs at the station and made our way to the colleges. I was at Selwyn College and had the same room my father had stayed in during his time at Cambridge—b28. (My father had a hand in that.) Selwyn College was all-boys and very civilized. We had someone come in and make our bed in the mornings. At 4 PM, another person gave us afternoon tea. But we also knew how to have fun. The rules stipulated that you could not have visitors in the evening, especially of the female persuasion. Curfew was midnight, but that simply meant you could not use the gate. I became quite adept at scaling walls. At least things had improved since my father’s time. Back then, you could not have a woman in your room unless you hauled your bed into the hallway. The dormitory masters felt that a bed was an essential ingredient for companionship. Not so. Akin to hanging a tie on the doorknob, everyone knew what a bed in the hallway signified.
On my first day at Cambridge, the sun was beginning to set by the time I unpacked and met some of my neighbours in the dormitory. I inhaled sharply when I saw them freshening up for dinner. I knew from my father’s days that all students at Cambridge dressed up for meals, but I hadn’t realized that this meant every man wore a tie snugged neatly on his neck. I did not own a tie at the time. We never wore ties in Sierra Leone. It was too hot there, and ties were not considered part of the national dress.
My first order of business, therefore, was to rush out to the store before dinner to buy some ties. Like many students, I did not have a great deal of money, but I found a second-hand store near campus where I bought a box of fifty ties for £1. I figured that would set me up for years. It was not until I got back to my room that I discovered that they were all tie-your-own bow ties.
It took me a while to fashion a reasonably symmetrical bow tie, so I was late to dinner that night. I certainly made an impression, though. I was the only boy wearing a bow tie, and I have worn one ever since. Not only did the look work for me, it seemed to please others. What did I get after that for every birthday and Christmas? A little box with a bow on top. And what was inside? A brand new bow tie. I never bought myself a bow tie again after Cambridge, but I must have accumulated about a thousand of them. The bow tie became my trademark, so much so that if I wore a regular tie, people looked at me funny. The look became synonymous with Arthur Porter.
Politics quickly became a big part of my campus life. When I was not studying, I devoted myself to the Cambridge African Union. Not many Africans were at Cambridge, perhaps only a few hundred out of a total student population of fifteen thousand. But the community was smart and driven, and generally came from big families. During my father’s time, African students were preparing to become presidents, prime ministers and senior civil servants in their home countries. Although the situation had changed, these boys were certain to return as leaders in their fields. Many in the union were studying the arts and had a mind for politics. Their countries had recently gone through independence, and they had a real sense of change and possibility.
My position as a science student set me apart. And I knew from the very beginning that I wanted to rise up the union ranks. I spent my first year at Cambridge getting to know the right people and making sure they knew me. By my second year, I already had my eye on the union leadership. Campaigning was a political process in its own right. I networked and got key individuals on my side. I distributed pamphlets with a photo of myself and a small blurb, particularly to the Africans who did not know me well. I even held sherry parties and invited influential members of the union. Ballots were handed out to every member at Cambridge, and sure enough, I was elected president. It was a very nice honour, and it looked good on my curriculum vitae. The union became my social circle, and we often met in pubs, restaurants or other places on campus to discuss politics.
The Cambridge African Union was my first experience of taking on a serious position of leadership. I became popular very quickly and won over my brethren. And even then, I was not afraid to make unpopular decisions. It was not long into my term as president that I found myself at the centre of a controversy.
We were constantly tackling the issue of race relations, and many Africans at Cambridge did not want white South Africans or white Rhodesians in the union. I felt skin colour should not matter; what mattered was what was in the heart. It was like those early days in Kenya all over again. I was once again standing on the fence, half white and half black, trying to guide things to a consensus. Some members tried to oust me as president. Like any good university, Cambridge had a robust student newspaper, and the mini-controversy was soon splashed across its pages. It even made it into the Cambridge Evening News. I won that battle. I was able to win over enough black African support to my side. White Africans, for the most part, were no longer seen as particularly influential. Their connections were dying as more countries nationalized and achieved independence.
My argument, however, had been one of philosophy and fairness. If Africa was to move forward, it needed to accept all people who wanted to be a part of it. By excluding white members, I felt, we would only be contributing to the hatred and racism that had stained our history.
Plenty of members believed I was being Pollyannaish. What did I know about racism and hatred? In fairness, I probably did not fully understand. While the racial divide had been there while I was growing up, particularly in Kenya, I had never fallen victim to violence or aggressive discrimination. Nevertheless, I held on to my belief that, while we were outside of Africa, we should be thinking about building bridges rather than bringing the fight to distant shores. I wanted our members to be a beacon of what things should be like, as opposed to how things were—or had been.
During my second year at Cambridge, I also met the woman who would become my wife. Pamela Mattock was British, hailing from northern England and studying to be a radiation technologist. The similarities with my mother and father’s situation were uncanny—they too had met at Cambridge, where my mother was studying to enter healthcare.
The circumstances under which we met, however, were different. I was usually busy with my studies, but my friends and I had developed a very clear and direct strategy for meeting new women at lunchtime. We would wait for two or more women to sit down on their own, and then we would swoop in. We chivalrously inquired if anybody was dining with them before dropping our trays, knowing full well those seats were not taken. One day, Pamela was one of those young ladies.
She was sitting with two friends, eating a muffin, and I found her attractive and interesting enough to ask her on a date. I would be romanticizing if I said it was love at first sight. We did not see each other every day after that, pining and doting, sending each other love letters, flowers and chocolates. Deep down, though, I think that I always knew she was the right person. It was her patience and consistency that made her stand out.
Pamela understood immediately that I was ambitious and driven. During my nine years at Cambridge, from 1975 to 1984, I earned a bachelor of arts in anatomy, a master’s in natural sciences and a medical degree. It was no easy task. I studied mornings, evenings, nights and weekends. I learned to study in my sleep. So for our relationship to work, it would have to be a slow burn. Most women I had met asked me to make a choice right then and there. Pamela was patient.
During the summers, when school was out, I worked in London as a bricklayer and drove a little truck on construction sites. I was paid under the table and received a fair amount of money for my labours. It was hard work, though, running from 6 AM to 8 PM, and I was exposed to the elements. I could always tell the difference between summer and winter by the temperature of the rain. It was no worse, however, than marching to school in the rain back in Sierra Leone. I enjoyed my summers in London. Many other foreign students were in the capital during these months. We were paid at the end of each week, so I had money in my pocket, and we spent our evenings in the pub.
I was so busy that Pamela and I lost touch completely for a couple of years. However, I never forgot about her. We met again at a dinner party about two months before my finals, and picked up right where we’d left off. I wrote my exams, qualified and became a medical intern at the university. Now I felt it was time to settle down, and we started dating more seriously after that. It was not long before we were living together, and about a year later I asked Pamela to marry me. We had a relatively small service in her hometown in Yorkshire. My immediate family from Sierra Leone made the trip. I believe it must have been the first, and perhaps the only, multicultural wedding in that little Methodist church in Bradley. Many of the villagers who were not formally invited guests still came out to see the wedding and all the “colourful” folk from Africa. In the three decades that followed, Pamela would stay by my side no matter where we roamed.
It is a cliché to say that behind every great man is an even greater woman. Sometimes, though, clichés exist for a reason. Pamela could not have pursued a full-time career amid my ambitions. I would never have accomplished what I did without her commitment and patience. She ran our home, took care of our four daughters and created an environment where I was free to strive, pursue and succeed. At times, the one-dimensionality of our respective roles became abundantly clear. When parent-teacher interviews came around, I always made a point of attending, or at least tried to do so, given the importance I placed on education. One year, I told my wife I would meet her at the school once I had finished work. It occurred to me only later, as I prepared to leave, that I did not have the foggiest idea where I was going. I knew the name of the school, but I had never dropped my daughters off or picked them up. I had never attended one of their sporting events or extracurricular activities. I loved my daughters dearly. Nevertheless, dedication to one’s career comes at a price. I did find the school that night, after consulting a map and fielding a few panicked phone calls to Pamela. The point is, her supporting role kept us going. In truth, I do not think support is the best term. It was an equivalent role, because without it, I would not have been able to function properly.
My Best Man, Kevin Gangar, was a close colleague at Cambridge and hailed from Trinidad and Tobago. He married an English girl as well. Kevin was very interested in travelling, particularly back to his home in the Caribbean, and I believe they tried living there for a while. However, it was always difficult to go “back home” after you married someone locally. It was easier to become part of the English reality, with the comforts of two cars, a great school system and a predictable standard of living.
Pamela had not travelled much before she met me. Some couples believe they can handle overseas living but the reality proves different. Expectations change. Fortunately, Pamela took our international lifestyle in stride. The leap from England did not take long. Shortly after I finished my residency in Cambridge, I was looking to travel somewhere new for my specialist training. I applied to a number of places in the U.K. and Canada. Before I heard from anyone else, I got an acceptance letter from the Cross Cancer Institute at the University of Alberta in Edmonton. I received other offers, but people in Alberta were doing research in areas that I was interested in.
I could not have been more eager to begin, though we got off to a bit of a rough start.
We stepped off the plane in Edmonton into the most horrible weather you can imagine. I had spent much of my childhood in the subtropical climate of Sierra Leone and Kenya. Granted, England’s weather can be cool, rainy and rather miserable; a Canadian winter, however, can be downright nasty. It was only September, and yet the snow was above my knees. I saw cars with power cords plugged into block heaters to prevent engines from freezing. Car tires were distorted into squares. Pamela and I had one child in tow—our oldest daughter, Gemma—and we slogged our way to our small two-bedroom apartment. We had about $10,000 to our names. For the next four years, I would be making the modest salary of a resident.
Money was tight back then, but we never thought about it in that way. Our needs were simple. We did not have much of a social life. In those early years, I spent long days and nights at the hospital. When I was not there, my head was stuck in medical textbooks. I got used to the harsh weather partly because I was so rarely outside. One thing I did like about Edmonton, however, was those sunny days and frontier skies. It was far brighter and more wide open than London. It could be quite lovely as long as you did not open a window or a door.
I was about one year into my training when opportunity dropped out of those skies. Every second day I would spend the entire night at the hospital on call. Some nights I slept, other times I never sat down. It was one of the slow nights, around 2 AM, and I was dozing over a textbook when the phone jolted me to attention. On the other end was an officer from the Royal Canadian Mounted Police with a rather unusual request. Like a shooting star, a Russian communication satellite had plunged into a forest near Grande Prairie. The RCMP needed someone to perform a survey to ensure there were not high levels of radiation in the surrounding area.
I was training to become a full radiation oncologist, so I immediately sprang into action. It sounded awfully exciting, though as it turned out, cleaning up after fallen satellites was not the most glamorous job in the world. I had to drive the six hours up to Grande Prairie right then and there. When I arrived, around daybreak, authorities had the area all wired off. There were no fires or suspicious-looking men walking around in space suits or black suits and sunglasses. I never even saw the satellite. People might be surprised to know that satellites fall to earth all the time. It just does not tend to happen in your backyard.
I performed my survey and found the radioactivity to be slightly above normal, but below the range where it would be dangerous. The survey was really more of a precaution on the part of Canadian authorities. The significance, however, was that the incident placed me on their radar. Anyone could have been on call that night at the hospital and picked up the phone. What the experience did was to allow me to showcase my knowledge and my willingness to work. From that day on, I’m sure the RCMP and other government agencies had my number on speed dial. I never got paid for any of these consultations, but I considered them an investment.
My persistence and enthusiasm paid off when I was asked to make a trip to Russia soon after the fall of the Soviet Union. In the late 1980s and early 1990s, Western powers were worried about the considerable stockpile of nuclear warheads lurking behind the Iron Curtain. And once the curtain was lifted, countries such as Ukraine, Latvia and Kazakhstan were suddenly faced with what to do with their arsenals. It was risky and expensive storing atomic bombs and radioactive material. National pride did not allow these countries to just give their arsenals away, so the creation of medical isotopes seemed like the perfect decommissioning stream.
The concept was quite novel. In the past, most disarmament programs had involved simple decommissioning, not redeploying. My role in Russia was to advise those in charge on the steps needed to convert the material in these bombs into medical tools that, theoretically, could have a big impact on the delivery of care. It was a real demonstration of “atoms for peace.”
In layman’s terms, I explained to the Russians the process of mixing nuclear isotopes with different salts, which caused the isotopes to degrade in a kind of distillation process. I guided delegates down the periodic table, adding neutrons here and taking away protons there, and described the building blocks for creating radioactive material for cancer patients. It was not the most efficient way of generating medical isotopes, but the process was appealing due to the political climate at the time. Later, I would provide similar consultations to the U.S. Department of Energy. I did not get paid for these labours. I enjoyed the work; I never did anything that was not fun. But more to the point, these consultations gave me some political connections and ultimately led to future appointments.
People have often wondered how I accomplished so much in my career in such a short time. The answer is indispensability. In those early years, whether it was at the hospital or in my work with government agencies, I made myself aggressively available. It was far easier for people to have me around than not. No matter that I was missing a child’s birthday or my wedding anniversary, or had a bad cold; I was always ready to work. I arrived early and left late. I did my job so well that I was often doing the work of two, three or four people.
To succeed in this world, you need to have smarts and a little bit of luck. You also need to be indispensable. Your presence needs to become priceless. Being constantly present and visible is where the politics comes into play. When I was not seeing patients, studying or dealing with satellites and warheads, my focus was on getting to know the decision makers around me and making sure they understood how indispensable I was. That was probably why, after finishing my training as a radiation oncologist, I was offered a full-time job at the University of Alberta.
From the outset I tried to develop very good connections in the radiotherapy world. My research helped put me on the map. I was best known for my work concerning prostate cancer, in particular the use of brachytherapy, whereby I inserted radioactive material directly into the organ. It was the first time the technique had been done in this fashion. Rather than spend eight weeks in radiotherapy, patients endured just three days with needles surgically implanted in the prostate. Armed with my growing body of research, I threw myself into the national and international seminar circuit. As it turns out, I was just getting warmed up. Over the course of my medical career, I would receive credit for three hundred scholarly works in peer-reviewed journals. I also sat on the editorial board of thirteen scientific publications.
Throughout my life, I have also tried to steer clear of what I call “useless moments.” Whenever I did something, I asked myself about its purpose. Time was the greatest commodity, and I was always looking to grow. I never joined the chess club at Cambridge, for example. While chess is a wonderful game, I did not see its value in terms of building my career. Leading the Cambridge African Union, however, had practical merits and implications for my future. I engaged only in activities that would take me forward, not backwards or sideways. Successful people, in my view, consciously build their futures.
The next step for me came in 1988, even sooner than I had expected. I had only spent one year in Edmonton on staff as a senior specialist, but I made that year count. Now the University of Western Ontario was offering me the position of chief radiation oncologist for the London Regional Cancer Program.
At just twenty-nine years old, I was probably the youngest medical chief Western had ever hired, and probably the youngest department chief at any hospital in Canada. To this day, I do not know of anyone else who has achieved this milestone so quickly. It goes without saying that I was the youngest person in my department. I was even younger than some of the residents still training to be full specialists. And yet there I was, bright-eyed and bushy-tailed, coming into a large department with just one year of full-time experience under my belt. I could only imagine how the appointment had gone over with my staff. I would expect there were whispers in corners, a few furrowed eyebrows and a high degree of skepticism. I did not blame people. But I doubt they underestimated me once I arrived. My general philosophies of management are fairly straightforward. To use a military analogy, I fight on the front lines, not at the back.
I was consistently in the fray, getting my hands dirty, ready to do battle. I went out of my way to get as much input from my staff as possible. A good leader must listen and be accessible. However, staff knew that once a decision was final, the book was closed. A very clear strategy was in place if you wanted to be part of the team. I tried to build a mutual respect and camaraderie that was not based on my title or the name on my desk. I respected people if they continued to earn it. For my part, I did not demand respect because of my rank or position; I earned it.
Although I had already achieved a great deal in my field, I must admit I was restless. My family and I lived in a very pleasant house on the outskirts of London. Pamela gave birth to our second daughter, Fiona, and the four of us enjoyed a quiet and traditional Canadian life. Deep down, however, I was not satisfied. I knew the moment I took the job that it was simply a springboard to greater heights. What I really wanted was to lead a much larger department, perhaps in Toronto or somewhere in the U.S. So I continued making speeches, participating in seminars and networking on the international circuit. I shook lots of hands. And within three years of my arrival at Western, I received two job offers in the U.S.
The first was in New Orleans, where I was offered chief of oncology in the Ochsner Health System. I seriously considered it, as the hospital had the reputation of being the Mayo Clinic of the South. I also had a soft spot for the food and culture of New Orleans. Management flew me down there to meet the players. They wined and dined me for a few days. I might have taken the job if it were not for David Duke, the Republican in the Louisiana House of Representatives for that area of the city. We were driving through New Orleans, not far from the hospital, when I saw Duke’s face plastered on political posters. It must have been election time.
In addition to being a politician, Duke was known for his strong affiliation with the Ku Klux Klan. In mid-1974 he had founded the Louisiana-based Knights of the Ku Klux Klan and appointed himself “Grand Wizard.” The organization slowly evolved during this time, as members shed their hoods and white robes and slipped on suits and ties, endeavouring to become more professional and part of mainstream society. Duke left the Klan in 1980 and formed the National Association for the Advancement of White People. He had won his seat in the Louisiana House Representatives in the 1989 election and would hold the post until 1992. So when I arrived in New Orleans in 1991, a year remained in his term.
Seeing those posters made me a bit uneasy. When I asked my tour guide, who also happened to be a senior manager in the hospital network, about Duke, he said the oddest thing. “Not to worry, Arthur,” he smiled, slapping my leg reassuringly. “It doesn’t mean much. We were all in the KKK when we were young.”
We laughed it off and carried on with the tour. But to me, an African of mixed race, his words meant something. I wasn’t yet a Republican myself, but I knew that my relationships with local politicians would be crucial to my success wherever I roamed. So the job prospect in New Orleans did not get off to the best start.
The Detroit Medical Center had come calling at around the same time. My family and I were more than familiar with the Motor City from our cross-border shopping trips. It had one of the largest radiation departments in the U.S., and it was the only place with a superconducting cyclotron. That would mean little to the average person, but for a radiation oncologist, it was the ultimate toy. The National Superconducting Cyclotron Laboratory, located at Michigan State University, was just bringing this new piece of equipment online in the early 1990s. It tickled my fancy, so to speak, because I knew that this research tool could take me to the next level. Nobody else had one, so anything we did on it would be considered novel in some way. Like so many other professions, medicine, and indeed oncology, fall victim to fads and trends.
The job on offer was that of radiation-oncologist-in-chief, as well as chairman and professor of the Detroit Medical Center and Wayne State University. I toured the facilities, met all the players and was very impressed and reassured. Back in London, Pamela and I sat down at the kitchen table to make a final decision on our next step. She asked me questions about what I would be doing and how the family would fit in. We spoke about where we would live and whether any good schools were in the area for the girls. And then she asked me: How much does it pay? I had no idea. While money tended to accompany success, it was never the driving force behind my decisions. I assumed, in my ascension to bigger roles, that higher compensation would follow. Nevertheless, it was an important question that had simply never come up in the job interviews.
I got up from the table and called the president of the hospital and dean at the School of Medicine that very night.
I told him how interested I was in the appointment. My wife and family were excited about the prospect, too. But how much did the job pay?
“I have no idea,” Dean Sokol said.
My position at the Detroit Medical Center, you see, was my first experience with commercial medicine. In Canada, where healthcare is bound to the public sector, it was always very clear what I would bring home. My new boss-to-be told me that, as chairman, I would form a company, hire my staff and bill the patients. I was chief in every sense of the word. If no money was left over after salaries, equipment and overhead, then I would not get paid. Of course, establishing the largest oncology department in the state of Michigan would require some start-up cash. The dean suggested that I take out a mortgage on my house.
When I returned to the kitchen table and told Pamela there was no formal salary, and we would need to mortgage the house just to get started, she nearly slid off her chair. It was not the most traditional financial plan. I was only thirty-two years old, with two kids. If I accepted the post, I would become one of the youngest people ever to reach full professor status in Canada or the U.S.
It was no ordinary move. But the risks never stopped me. Although I was wary of what lay before me, I was always ready to take on the world.
The Detroit Medical Center was a wild leviathan compared to where I had come from. More importantly, it would be my first foray into business. I have never been a sports fan, but a certain analogy seemed particularly apt. The London Tigers were a professional AA baseball team that played in Canada from 1989 until 1993. They were the farm team to the Detroit Tigers. In many respects, after rising quickly on the Canadian scene, I too was being called up.
It was time for the big leagues.