As Alicia Garza, one of the founders of Black Lives Matter, declared in 2016, being a political ally is often “wrought with guilt and shame and grief.” Instead, she proposed, “co-conspiracy is about what we do in action, not just in language.”

But what kind of action? There have always been Americans who could imagine a world of racial equality and justice, and who worked in cross-racial alliances to make it happen, not just — as we do today — at a street protest, or by issuing heartfelt statements of support, or compiling an appropriate reading list — but by taking definitive, and sometimes violent, action. This history provides us with a sense of how anti-racists are made, not born, and what it can mean to commit to being part of this struggle. It also illustrates the dangers of committing to violence or “armed propaganda,” and how actions that seem correct in one moment might seem less effective, even foolhardy, years later.

Dr. Alan Berkman made such bold choices, and faced the consequences, when he decided to support political comrades in most radical sections of the New Left. Raised in a small white working-class town in upstate New York in the 1950s and early 1960s, Berkman was in medical school and on his way to a brilliant career when the injustices and inequalities of American life overwhelmed him. Turing down a future as a privileged medical research scientist after his internship year, he first took action by becoming a community doctor in some of the poorest neighborhoods in New York City.

The violence he saw by treating the bodies of his patients, friends, and neighbors intensified his commitment to radical politics. He saw first-hand how structural racism took its toll on communities of color, either through diabetes, heart disease, and cancer, or from the beatings and shootings by police. Raised by working-class parents who believed in taking action, Berkman was transformed from a concerned liberal, willing to march in anti-war demonstrations, to much riskier actions. He testified in police brutality cases. He snuck in under the FBI’s guns at the siege at Wounded Knee to bring in medical supplies and provide care to American Indian Movement stalwarts. Most important perhaps was what he concealed: he became one of the go-to doctors that served the political underground.

Berkman’s radicalization, and his decision to collaborate in violent resistance, was partly due to his clarity that he was treating symptoms of social inequality, but that the disease itself — racism — was thriving. In health science schools, the underlying causes of mortality are often taught with this metaphor: when you are standing by a stream and are constantly pulling out dead bodies, focus upstream to understand why the bodies are falling into the water in the first place. Berkman began to understand that all his medical skills, his abilities to titrate an appropriate drug, or perform that right procedure, would not save the communities he was serving. He had to look upstream to understand, and to stop, the mutilated and sick bodies that came to be treated every day.

The radical underground in the United States would not have survived as long as it did without such people. Berkman joined an increasingly like-minded group of comrades above ground who committed themselves to principled, violent resistance against the twin problems of American imperialism and racism. He was part of groups that financed the anti-colonial struggles in southern Africa because they understood the links between apartheid regimes and American racism.

Such people saw themselves as part of a long history of American anti-racism. By the late 1970s and early 1980s, Berkman was in the leadership of the John Brown Anti-Klan Committee, an organization that sought to educate white people about the presence of the Klan and white supremacy in multiple American institutions, but especially among guards working in the prisons. But he also used his skills and privilege as a doctor to advocate for lower level workers in the health clinics that employed him, and was fired at least once for his actions.

Then he was put in a situation that both called on his medical skills and changed his life.

By the early 1980s, Berkman became more and more willing to support what was called “armed propaganda”: actions that met state violence with other forms of violence such as bombs and armed robbery to support their cause. Like many of us today, Berkman watched police attack peaceful protesters and Black and brown bodies in the streets, in the prisons, and in hospitals. The attacks overwhelmed and infuriated his egalitarian morality.

In 1981, members of the political group Berkman belonged to, called the May 19th Communist Organization (named after the birthdates of Ho Chi Minh and Malcolm X and full of white people supporting militant people of color) took a fatal step. Unbeknownst to the doctor, women in the organization’s leadership, who had already participated in breaking revolutionary Assata Shakur from her New Jersey prison and spiriting her to Cuba, agreed to drive the getaway cars in an armed robbery (what they called an expropriation) by self-styled revolutionaries in the Black Liberation Army (BLA).

On October 20, the BLA initiated an “expropriation” of a Brink’s armored truck in Nanuet, New York, just outside of New York City, to raise money for their cause in October 1981. What had been successful on other occasions failed: several shoot-outs occurred. Two local policemen and a Brink’s guard were killed, four members of the group were caught, and another participant was gunned down the next day in a police chase.

But there was another casualty. During the mayhem, one of the women getaway drivers pulled out her gun and shot herself in the leg by mistake, shattering bone and muscle. She was losing blood rapidly but going to an emergency room was out of the question: by law, hospitals must report all gunshot wounds. The police were looking for her and she had skipped out while on furlough from a prison sentence. One of the conspirators called Berkman. Although he was not involved in the Brink’s action beforehand, he felt he had to act, and by doing this, and then helping her escape, became a co-conspirator.

The federal government was not willing to treat what would otherwise have been a misdemeanor (treating but not reporting a gunshot would) as a minor offense, and prepared to charge Berkman as an accessory after the fact to murder because he refused to cooperate. They could not prove that he had aided her escape, but suspected it. He thus became only the second doctor in American history after Samuel Mudd, who treated John Wilkes Booth after the Lincoln assassination, to be charged for treating a patient.

With this hanging over his head, Berkman was imprisoned, and served eight months in a New York City jail for refusing to testify to the Grand Jury convened to make the case against the Brink’s suspects. Once released, he knew he was about to be indicted again. If convicted, he would go to prison for decades, and so he made another choice: leaving behind his wife and young children, Berkman disappeared into the political underground in 1983. Although he had never committed an act of violence himself, the bench warrant issued instructed law enforcement to assume that he was “armed and dangerous.”

Berkman and others in his group, now hiding from authorities under false names and fully committed to the movement, tried to make the price of imperialism and racism high. Using various revolutionary names, they organized bombings, preceded by a telephone call that permitted people to evacuate, of American political sites that included an FBI office and a U.S. Senate antechamber.

After a year and half, Berkman and his comrades were caught one-by-one and tried in differing cases. Berkman was given ten years for his link to explosives found in Pennsylvania; others in his group, including Laura Whitehorn, Susan Rosenberg, Marilyn Buck, Linda Evans and Timothy Blunk, received sentences that were two to five times that long because they were directly linked to the theft of explosives used in the bombings. Their last joint indictment, which Berkman and his comrades labeled the Resistance Conspiracy Case, charged that they had tried “to influence, change and protest policies and practices of the United States government concerning various international and domestic matters through the use of violent and illegal means.”

During the years he served his time in some of our harshest federal prisons, often in solitary, Berkman was diagnosed with, and nearly died from, cancer and the inadequate prison health care available to him. His comrades even agreed to settle their Resistance Conspiracy Case to keep him from dying from the stress of a possible trial. When he wasn’t too sick, Berkman continued the work that had brought him to the movement in the first place. Providing jailhouse medical care to his primarily Black and Latino prison mates, he earned their respect and a nickname: “Brother Doc.”

Berkman also used his prison time to rethink what he had done. He began to see the limitations of both small group political work and violent resistance. He knew he had acted on principles, and never harmed anyone, although he clearly could have. As he approached his release date, his lawyer persuaded New York State to renew his medical license if he promised to care for the poor.

Berkman returned to what had brought him to politics in the first place. He knew his political actions, prison time, and cancer had to count for something. For the next decade, he became an expert on the care of those with HIV/AIDS in New York’s Black and Puerto Rican communities, then became involved in the global fight against AIDS through Columbia University’s School of Public Health School.

Horrified by the way the international AIDS community was not making the new life saving drugs available to the global poor, Berkman was spurred to peaceful action. He formed an organization called Health GAP, the Global Access Project in 1999. Using direct confrontations with political leaders, brilliant lobbying, and demonstrations, and eventually work with the Clinton and then Bush administrations, the group was able to get U.S. policy changed to allow generic forms of the new drugs into other countries at reasonable costs. The actions probably saved millions of lives.

Berkman spent the last years of his life training another generation of global public health practitioners as he worked in Uganda, South Africa, the Dominican Republic, Brazil, and other countries. Finally, his seventh round of cancer caught up with him and he died in June 2009.

Not many of us will ever have Berkman’s particular blend of personal conviction, willingness to take risks, loving and principled support, and ability to suspend fears in order to make commitments. Most of us will not turn to violence as a way to make social change, and many on the left saw the actions at Brink’s and the bombings as demented and, more importantly, not politically useful. Berkman’s commitment, however, to equality and solidarity never wavered, as his tactics for making change did.

Berkman’s choices ask us to think about how our own commitments are, or are not, grounded in principled support to end structural racism. Many of us understand, but to do not support, the turn toward violent trashing of federal buildings or the setting of fires, especially when it is not clear if this is being done by frustrated anarchists or agent provocateurs.

What does it mean to be a white “co-conspirator,” if we are serious about the long effort to dismantle structural racism and to fight state violence? As we now confront the structures of power that Berkman and his comrades tried to overcome, we are asked anew whether we are willing to act, and in what ways. It is time for a new co-conspiracy that is attuned to the very specifics of our political now as we continue the work Berkman, and others like him, did to try and change the American story. Even if we think some of what he did was wrong-headed, his commitment to justice is a lesson we need to consider.

Susan M. Reverby is the McLean Professor Emerita in the History of Ideas and professor emerita of women’s and gender studies at Wellesley College, and the author of Co-conspirator for Justice: The Revolutionary Life of Dr. Alan Berkman.