Unnatural Causes

by Dr Richard Shepherd

  In addition, although this does seem to me, looking back, like ludicrous overenthusiasm, I thought I could establish exactly what had happened from the wounds themselves and from the blood staining around the room. That was, after all, what Professor Simpson would have done.

  A tell-tale spattering on the wall said that the first and fatal injury was inflicted here. The wound was in the left upper chest and its track was slightly left to right. Classic. This told me that the killer was right-handed, that both he and the victim had been standing and that he had used an overarm downward thrust.

  The victim then collapsed onto the left side of the bed. That was clear from the position of the bloodstains on the sheets. And from the thin lines of blood spattered on the ceiling above – ‘cast-off staining’, which is the result of blood flying from the blade’s tip as the assailant raises the knife to stab again – it was easy to deduce that the killer had stood over his victim while stabbing him three more times.

  The victim had rolled out of bed and crawled for the door. This was evidenced from the trail of blood he had left. The final four stab wounds were almost certainly inflicted here, by the door, where the victim had died in a pool of blood. But the killer might have saved himself the effort: the first thrust was fatal and after it penetrated his heart the victim had only minutes to live. The proximity and uniformity of these four wounds, all at the same angle, each a copy of the last, indicated that the victim was motionless by this point and perhaps already dead. And what about the blood I had seen smeared on the banisters? That had certainly been left by the bloodied departing boyfriend: it was all over for the victim before he had reached the door.

  The killer had already confessed but, nevertheless, I was so proud of my deductions that after the post-mortem I insisted on telling the detective.

  ‘Uh huh,’ he said, without interest.

  ‘Look, you can see here …’ I held out the helpful diagram I had drawn. He did not take it.

  Ever eager, I now offered to write a statement explaining my reconstruction of events.

  He blinked and looked away.

  ‘Nah, don’t bother, Doc. No one will read it, the bloke’s coughed.’

  I was greatly disappointed. It was my first inkling that the police really do not want me to play Sherlock Holmes. Or even Keith Simpson. My hero was an invaluable part of the crime-solving team in the first half of the twentieth century and was involved throughout homicide investigations at every level: throwing theories around with high-ranking officers or counsel, discussing clues with detectives at the scene. I’d like to do that too. Sometimes I am bursting to tell the police exactly what my skills and training suggest happened. But police investigation has changed. The ‘science’ of homicide has now become such a specialized business that the many disciplines involved offer their separate facts and the police co-ordinate everyone’s findings and come to their own conclusions. That can work – as long as the officers are skilled and experienced.

  Next, the decision to charge or not is made by Crown Prosecution Service lawyers. Fine. As long as the lawyers don’t struggle when confronted by complex medical issues.

  I think the system would be most effective if we could all sit down together when a case is difficult and complicated – the police and the CPS with the pathologist, the forensic scientists, the blood-spatter specialist, the toxicologist, the ballistics expert – and discuss our facts together. But we seldom do that any longer.

  10

  Gradually, crime scenes and post-mortems became my working life. I was allocated easy cases to start with. They were all different but they were all straightforward. Routine, in fact. Except that there is really nothing routine about any crime scene, it’s just how we all try to make it seem. A motionless body, sometimes hideously mutilated, lies at the centre of a web of bustling, serious professionals who are all engaging fully with it while somehow remaining detached from its horror.

  And at the edges of this web, at a safe distance, is the grief and shock of the bereaved. Pathologists know that even the most routine cases carry a payload of trauma for someone. At that stage, I was still determined to stay uninvolved in this trauma if I could. I did know, however, that sooner or later there would have to be an interface with the living.

  At home, there were growing children and a busy wife. I was a hands-on father, unusual perhaps then, but I had been brought up by a hands-on father myself and the result was that making time for my children was a bigger priority for me than for many others of my generation.

  However, I did have to learn how to leave the mortuary behind me at home. I had to forget the sights and smells of the place, forget the homicide victim I had just been examining and whip off the mask of clinical detachment just as I walked in through the front door to the quotidian world of daylight and children. Of course, that wasn’t easy. My mask was securely fixed. And so probably I didn’t always remove it successfully. Certainly, my wife did have a problem with that. Jen understood why I had to be detached. But she told me scientific detachment was an approach I adopted far too often. At home. In our marriage. Which was now under strain.

  A few years earlier, Jen, who had loved being a nurse and a health visitor, had shyly told me that she had always secretly wanted to be a doctor. She hadn’t progressed well at school because her father held extremely conservative, indeed colonial, views on the ‘right’ sort of jobs for women and the education they required. She was also mildly dyslexic, which had further affected her early educational attainment.

  I had no doubts about her abilities or her intelligence, and when she told me her ambition I promised to support her through the long years of hard slog ahead. Now, I was very proud of how she had worked her way through the Open University into a place at my alma mater, University College London. She was already on her way to qualifying as a doctor.

  But, of course, this put us under great pressure: of time, of money. I earned a fair salary but nannies were expensive and, although Jen would be earning one day, she wasn’t yet. Quite often my work clashed with her training and then one of us had to give way. Our lives were hectic and complicated and our relationship sagged beneath our loads. A forensic examination of our marriage would reveal clusters of quick discussions, one of us always rushing in as the other rushed out, communication often limited to little more than times, dates, parents’ meetings, school sports days, logistics. Clinical interaction of that sort.

  A beautiful summer’s Sunday morning. The children, still small, streaking into the garden like arrows as soon as I opened the back door. Me, a fresh-faced pathologist, always at the ready to rush to a crime scene and getting a whoosh of adrenalin if the phone rang when I was on call. Jen, almost a doctor, always studying.

  I was just about to make breakfast.

  Outside, the children cried, ‘Oh no!’

  The phone was ringing. At this time of the morning. It could only mean one thing.

  I considered the possibilities. Probably, because it was Sunday, someone had simply died after a Saturday-night fight. Upstairs, I knew Jen must be sighing. I imagined her sitting with her elbows on the desk, her head sinking into her hands.

  I did feel bad. She had been up since the crack of dawn with her books and I had promised to look after the children today. If the phone didn’t ring. But it had, and now Jen was about to take the shrapnel from a drunken brawl.

  A voice told me that the victim was a young Caucasian male. So, there had almost certainly been a pub-brawl last night. Except for one thing. The caller had identified himself as a detective chief inspector. A detective chief inspector who said, as the call ended, that he would be waiting for me at the mortuary with a detective chief superintendent. Top brass. At the weekend. There must be something unusual about this case.

  ‘Which mortuary?’ asked Jen, getting up from her books. ‘Westminster?’

  ‘Swindon.’

  She did a double take.

  ‘Swindon? In Wiltshire?’

  I nodded.r />
  She sighed. ‘See you this evening, then.’

  When I arrived in Swindon, the two senior detectives were waiting, along with a police officer and the coroner’s officer. The mortuary staff handed me a cup of tea and the chief superintendent began.

  ‘Young man. Over the drink-drive limit, took a corner on a country lane badly. His girlfriend was in the front seat and basically … well, have you got her statement, John?’

  The detective inspector nodded and opened a file. He shuffled through some pages of typing.

  ‘So … the lad was working all night on Friday and he’s probably been up all day on Saturday and he’s had a few drinks so now he’s tired and drunk and it’s six o’clock. Good light but the road’s a bit damp. He’s picked up the girl and he’s taking her back to his place for a cosy Saturday night. They’re going round a bend and the van’s coming towards them and she says …’

  His finger found its way down the page.

  ‘ “I shouted, ‘Oh my God, Michael, look out!’ and he immediately jerked the car to the left. Michael’s side of the car hit the driver’s side of the van. At the time of the impact I closed my eyes. When I opened them, both vehicles were at a standstill, although there was still glass flying around inside the car. I looked at Michael and his head was back and his eyes were closed. I thought he was unconscious. I shook him and he sat bolt upright as if I had just woken him up.”

  ‘ “I saw the other driver get out. And then this man appeared. I don’t know where he came from. He was wearing trousers with no shirt and he was really brown, he gave the appearance of being a labourer.” ’

  The chief superintendent said, ‘He was actually working in his garden nearby and heard the crash.’

  His colleague nodded and read on.

  ‘ “This man asked if I was all right. Michael got out through the window and walked to the front of the car. He pulled bits off it and kicked it and seemed to be very angry and upset. I was upset too. I was hysterical. Michael was kicking and throwing a paddy.”

  ‘ “I got out and lit a cigarette and gave one to Michael and then this man with no shirt said, ‘Don’t light your cigarettes, there’s petrol at the back of the car here.’ ”

  ‘ “Michael told him to mind his own business and the man with no shirt said something to Michael, I didn’t hear what, which aggravated him and then a fight started.” ’

  The detective stopped reading and looked at me. They both looked at me as if they expected me to say something.

  ‘What actually happened in this fight?’ I asked.

  ‘Michael tried to hit the man with no shirt and missed. The man hit him back, that’s all.’

  That can’t have been all. Why were they reluctant to tell me more? I asked, ‘Well, what does the girlfriend say?’

  The detective read, ‘ “The man with no shirt clenched his right fist and hit Michael full in the face, either on his nose or his mouth. Another man, with streaked hair, had pulled up in his car by now and he got behind Michael and put his arms right round Michael to hold him and Michael went a funny colour, a purply red, and passed out. The man let him sort of fall to the floor.” ’

  The detective stopped reading again. But I knew there was more.

  ‘Any further description?’ I prompted.

  ‘ “By this time, it was raining heavily. The man with no shirt started shaking Michael quite violently to try and get some response from him. He was saying, ‘Come on, get up!’ but Michael didn’t move and I could see he was really hurt, he looked really poorly. The reddish purple tinge had faded. They couldn’t revive him. An old man in a Sierra stopped and put his jacket on him to keep him warm until the ambulances came. When my ambulance drove away, Michael’s ambulance was still there.” ’

  The chief superintendent took up the story: ‘Never recovered consciousness. Swindon sent him to Oxford for a CT scan, then he came back to Swindon. He died here this morning.’

  He handed me some medical notes from Oxford. I looked at them and nodded.

  ‘So you want to know whether you’ve got a road traffic accident on your hands or a homicide?’

  I saw them flinch at the word homicide. I wondered again why we had the top brass here. Was the deceased famous? Especially well connected?

  The superintendent said, ‘The girlfriend’s making a right fuss, saying the bloke with no shirt killed Michael and now the family’s making a big fuss too.’

  I got up. ‘Well, let’s take a look at him.’

  ‘Right,’ said PC Masters as we walked into the room where the young man’s body lay waiting for us. ‘This is Michael Ross.’

  I did not recognize the name but I half expected to recognize the face. There were cuts and bruises but I could still see that the young man had handsome rock-star looks, with thick dark hair curling around his forehead. However, there was nothing familiar about him.

  ‘How old is he?’

  ‘He’s twenty-four.’

  I began to scribble and, when I looked up, saw that the photographer had arrived and was waiting for me to tell him what pictures I wanted.

  ‘Whole body front. Then we’ll do close-ups of the face and the neck and we’ll have those bruises on his knees, please. Oh, and this fight he got into …’

  ‘The alleged fight,’ said the detective chief superintendent quickly.

  ‘… please photograph the hands so that we can see his knuckles.’

  I scribbled:

  Recent superficial abrasions, mostly vertical over the forehead, bridge of the nose and left side of the chin. Recent punctate area of bruising (8 x 2cm) lying diagonally over the right lower neck.

  I marked Michael’s wounds on my blank body outlines then looked closely at his teeth.

  ‘No sign that he was hit in the mouth,’ I said. The room seemed to rustle a bit but when I looked up everyone was still.

  There were a number of other old bruises and scars on the body, which I noted, as well as details of Michael’s tattoos. His back seemed unmarked. We photographed this and I then turned him over again and began the post-mortem. The officers watched with stony faces. There is usually at least one who turns green and this time, surprisingly, it was the super.

  ‘I’ll have to get used to it all over again; I haven’t been to one of these for years,’ he said apologetically. ‘I’ve just come back from the fraud squad.’

  Ever since the young PC had thrown up in the first forensic post-mortem I carried out alone, I had given a lot of thought to post-mortem revulsion, a condition which can affect anyone whose job requires them to be present.

  I asked myself why I had never, not once, shared their revulsion. Answer: because I was so fascinated by the workings of the human body in general and my findings in particular. I decided that if I could somehow share this fascination with others in the room, I might be able to help them past their horror. My theory was that, if I could involve them in the proceedings through knowledge and understanding, then they would no longer be helpless, shocked onlookers.

  The nervous silence in which I conducted my first post-mortem and the nausea of the PC who witnessed it could not have been sheer coincidence. So I had determined that the next time someone present became really upset, I’d put my plan into action by talking. Politely but lamely muttering, ‘Er … are you all right?’ as the super’s cheeks took on a greenish tinge would not do.

  Adopting what I hoped was a reassuring tone, I said, ‘As some of you will know, I have to check the organs inside the body – not just for injuries from the car crash, not just for damage from the subsequent brawl, but to ascertain that there wasn’t some other, less obvious, contributing factor to this death – like a natural disease. So, I’ll be taking a good look at all his organs.’

  The super nodded. Rather slowly. The room was silent, as though a blanket had been thrown over it.

  ‘Got any music?’ I asked the mortuary staff. ‘Something classical would be nice.’

  They switched on Radio 1. I glanced
at the super. Maybe the sound of inane voices would steady his nerves. I did ask them to turn it down a bit, though.

  Cutting dead skin is like cutting the skin on a chicken joint: easy if you use a sharp knife. The cut is hampered, if at all, not by its strength but by the skin’s natural elasticity, and as a healthy young man Michael Ross’s skin did have that elasticity. As I sliced through the fat which lies beneath – in all of us to some extent, even someone as slim as Michael – I glanced up. The super was not doing too well. Radio 1 wasn’t helping. It was time to start talking again to test my theory that information, any information, is soothing.

  ‘I’m nearly into the chest cavity now. From this stage, without impinging on Michael’s dignity at all, you could try to forget that we are dissecting a human. You’ve cut meat often enough and this is no different in colour or consistency. You’ll soon see that the liver is like any liver you buy in Sainsbury’s. The kidneys too. And this muscle I’m cutting now, well I always think it’s a bit like a good steak.’

  ‘Chips, anyone?’ said the detective inspector jovially.

  No one replied but the superintendent tried to nod again. As if we were making polite conversation. However, he could not pursue this convention by meeting my eye because his own eyes were now fixed on Michael Ross.

  I continued my work. PC Masters was keen to ignore the boss’s discomfort but the coroner’s officer seemed to take a certain amount of pleasure in it.

  ‘It’s all right, he can’t feel a thing,’ he told the super cheerfully. ‘Bloody good anaesthetic, death.’

  I glanced at the super. Hmm. Start talking.

  ‘Of course, I’ll have to look closely at Michael’s brain and his neck. According to the medical notes, that’s where I should expect to find damage caused by the road traffic accident and by the fight. I mean, alleged fight. But I can only be guided by the notes, not bound by them. I still have to examine every organ carefully in case the doctors missed something.’