He said, ‘Mandy?’
And I said, ‘Yes.’
That is fairly convincing evidence from a witness that the baby had lived, and perhaps lived for a good few minutes if the mother had time to give birth in the hotel toilet (evidence of this was soon found) and then get dressed and walk out of the hotel with her crying baby to dispose of it. And that fitted with the pathological evidence from the lungs that the baby had lived after birth.
But could we say for sure that she had killed her baby – and, if so, how?
This was an upsetting case for everyone, not least because of the cool way the mother had given birth, disposed of her daughter – stillborn or not – and then returned to work that day pretending nothing was wrong. Today she might be regarded as a tragic figure. Thirty years ago, many of those involved in the case saw her as an unnatural, calculating baby-killer. She showed no remorse, saying the baby had been born dead – and she showed no sadness either. The police and Crown Prosecution Service remained adamant that the charge should be murder.
I was very confident from all the evidence that the baby had lived. But then, how had she died? I could not find evidence on the child’s body of violence or trauma and no incontrovertible indication of asphyxiation. A very detailed laboratory analysis of the stomach confirmed the baby had taken in water from the lake, but not enough to indicate drowning: it could have got there passively, by non-sinister means.
I gave as cause of death ‘1a: Lack of care’.
The Crown Prosecution Service pressed ahead with its murder charge but they were dismayed by my findings. They wanted me to say that the mother had taken more active steps to end the child’s life.
On the other hand, my report delighted the defence solicitor, who wrote to the CPS:
We would invite you to consider whether the charge of murder should now be withdrawn, bearing in mind the apparent lack of an alleged act on the part of our client which led to the death of the baby … Your pathologist says that death was caused shortly after birth due to an omission on the part of our client. Clearly a charge of murder would not therefore be appropriate … [indeed] we invite you to consider that a charge of manslaughter [i.e. infanticide] would not succeed as you would not be able to show that the death of the baby was the result of a grossly negligent omission … simple lack of care is not enough [to prove this charge]. Our client told the police how she laid the baby down and rocked it but thought that it was dead.
It is true that the Crown Prosecution Service, for a murder case, had to prove a wilful act of omission: that is, the deliberate failure to provide normal care at birth, such as cutting the cord and keeping the baby warm and fed. It is very hard, in the case of a frightened, inexperienced teenage girl, to prove that not doing these things is wilful. In fact, Mandy was not a teenager and she was not inexperienced, as we were to find out, but, for a while at least, the prosecutors were miserable.
‘I am particularly concerned,’ their letter to me began, ‘regarding the vague nature of your report … I am not medically trained but I have a medical dictionary and these are some of the points which have occurred to me …’
She listed six detailed points about the baby’s death.
Medical dictionaries were the scourge of doctors then – as the internet is now. Sometimes I wonder why I bothered with sixteen years of training when all I needed to do was buy a medical dictionary or learn how to Google. But if a dictionary gave that lawyer a way into my work, then let her consult it: I am only too happy to enlarge on my findings and rarely am given a chance to discuss a case.
In response to these written questions from the CPS, I made a further statement, giving detailed answers to each of her points to show that most of her concerns, like meconium, were routinely found in newborns and none of them meant the baby had necessarily been asphyxiated. I stuck to my view that lack of care had caused the child’s death. Although the mother might have actively killed the child, we – I – couldn’t prove it.
The CPS were not at all satisfied. At a case conference with counsel, I was put under great pressure to step closer to the prosecution’s case than the pathology of the child really allowed. I did not give in. Afterwards, I sent further notes answering points they had raised:
It is not possible to define exactly the passage of time necessary to cause suffocation by blocking the airways, however in a newborn baby the minimum time is unlikely to be more than 15–30 seconds. There were no injuries to the mouth or nose to positively confirm that pressure had been applied to those areas, however such injuries are not always present in cases of suffocation. Their absence, while preventing a positive conclusion, is not completely inconsistent with suffocation having occurred.
I have given the survival period of less than fifteen minutes. I think it is unlikely that the period of survival was as short as one or two minutes, only because the changes in the lungs are well-established. I think it unlikely or very unlikely that a single breath would have resulted in the degree of changes I noted in the lungs. It is certainly the common event that a child will cry after birth but, like all things in medicine, it is not absolute and there is individual variation. The act of crying most certainly assists in the expansion of the lungs.
It is not possible from my examination of the baby to make any specific comment concerning the well-being of the mother. There are, however, no features present on the child to suggest that this may have been an unusually difficult or traumatic delivery.
It is very difficult to define lack of care. In my opinion, minimum care of a child immediately after birth is to wrap it in some sort of material to prevent the baby from cooling. Any other form of care may need previous experience rather than professional training. The minimum care of placing a child in a towel will, very markedly, at least reduce the risk of hypothermia. Hypothermia could have caused the death of this child within fifteen minutes. A child has a very large surface area from which to lose heat and this surface area would have been wet as a result of fluids from delivery, once again increasing heat loss. The cooler the environment in which the child lies, the greater the heat loss.
The pathological features of a huge number of possible reasons for the child’s death, including hypothermia, drowning and asphyxiation, may not be present in a child when one would expect them to be in an adult. I cannot exclude or confirm any of them.
The disappointed prosecution still pressed ahead, reluctantly conceding to the lesser charge of infanticide. They also threw in that ancient but rarely brought charge, concealment of a baby.
Mandy was tried at the Old Bailey. Prosecuting counsel was quoted in newspaper reports telling the jury:
When she became pregnant she decided to conceal her pregnancy and the existence of the baby once it was born. She followed the plan through to its logical conclusion by leaving, and allowing or causing, the child to die and disposing of the body by tying it in a black refuse bag. She continued to lie after birth by joining in with the general disapproval expressed when the body was found.
The court was then told that Mandy had initially claimed the pregnancy was a result of a rape but then changed her story. In fact, she had given birth before, on her mother’s lavatory two years previously, when the child had been offered for adoption. A second unwanted pregnancy soon afterwards was terminated.
The jury found her guilty of infanticide. The judge thundered, ‘You and only you had responsibility for that young child and you failed her …’ But he added, ‘It is clear that you were not at that time entirely responsible for what you did.’
She was sentenced to two years on probation and ordered to undergo one year of psychiatric treatment. There was a sense of disappointment in the prosecuting team, as everyone knew her sentence would have been harsher if she had been found guilty of murder. For myself, I had no regrets. It would have been unbearable if she had been tried for murder on the basis of evidence produced under pressure but against my conscience.
14
Soon aft
erwards I found myself learning more about truth – although I was now in a very different situation. The prosecution team and I were entirely in accord over this case, and by the time we were in court we all felt confident that we had uncovered the truth.
It was another Sunday morning call-out. More guilt as Jen had to put aside her work to care for the children, meaning she would have to study through the night to make up for lost time. Jen must have asked herself why the dead seemed so much more important in our house than the living and, looking back, I don’t blame her. The children were older now and a little more independent, but conflicting demands were causing frequent clashes between their parents. However, our division of labour was clear-cut to me: as the breadwinner, my work had to take priority. Only now can I see from Jen’s point of view how frustrating this must have been and how much I must have infuriated her. After all, she wasn’t studying for studying’s sake but so that one day she would be a doctor and a joint contributor to household income. I entirely failed to appreciate that: I was so work-immersed and so focused on how to make our hectic lives functional that I couldn’t, or wouldn’t, understand her dissatisfaction.
I set off that sunny morning towards central London, feeling more excited than guilty. I adored my children and a Sunday spent looking after them would be many things: fun, demanding, tiring, fulfilling. But – and this now seems perverse and scarcely believable to me – those pleasures could not compete with the possible intellectual engagement of an interesting post-mortem. Yes, even though I was already a few years into the job, I still could not contain my excitement at each new case that came my way. The stardust that the pages of Keith Simpson’s book had sprinkled in my young eyes so long ago was still there. Let other hearts sink on nearing Westminster mortuary: mine beat faster as I thought of the situation, the story, the puzzle of the body awaiting me. And this was despite the fact that I knew the chances were, on a Sunday morning, that I’d be dealing yet again with the consequences of another Saturday night pub brawl.
Westminster mortuary is hidden behind the coroner’s court in Horseferry Road in central London, but these are not among that area’s famous buildings. In fact, tourists heading towards the Tate hardly notice the beautiful old red-brick court on the corner and they are completely unaware of the mortuary behind it. Like so many institutions of death, it is discreet enough to oblige those who don’t wish to be reminded of the inevitable.
In fact, the mortuary had then not long been rebuilt and was the most modern in the UK. Its public entrance was glassy, its lighting was bright, its offices spick and span and its areas for grieving relatives elegantly painted in pastel shades. But, despite all that glass and newness, arriving here on a weekend marked a transition. From family life back across the taboo, into a darker world where, albeit it with jolly staff and warm rooms, death is a way of life.
The smell of the mortuary, death’s perfume, in my nostrils, I greeted the small crowd waiting for me: the mortuary staff, a SOCO (scenes of crime officer), a young police constable and two detectives. There was also a police photographer who seemed often to be on call when I was and who was becoming a familiar face.
The kettle on, we went into the tiny staff tea room. It was empty on a Sunday. Detective Inspector Fox spoke first.
‘Now then, the deceased is a young bloke. Saturday night, a lot of booze, a bit of cannabis …’
So, it was a typical Sunday morning job after all. My heart sank. I’d rather be at home with the kids.
‘Had a bit of a run-in with …’
Not the first time I’d heard this one either. A knife, bottle, fist?
‘… his girlfriend, and …’
She’d knifed him then, almost certainly. The detective hesitated.
‘And so she strangled him.’
I stared at him. That was not the ending I’d expected. Female stranglers are extremely rare, almost non-existent. Looking back now, tens of thousands of post-mortems later, I believe there is no other female strangler in my files.
‘Has she confessed?’ I asked.
‘Turned up outside the police station in the middle of the night with blood, scratches, shirt torn, crying her eyes out. We called an ambulance. She said she’d had a fight with the boyfriend and thought she’d hurt him.’
‘How long before?’
‘Apparently only minutes. We rushed over there, no pulse, did everything we could, got him in the ambulance and kept trying but it was no good. When we told her he was dead she was … well, it was terrible.’
He looked upset. He’d obviously been in the Met a long time and I wondered why this case was affecting him so much.
‘I was interviewing her for hours and she never changed her story. Self-defence. And … well … she’s a sweet young thing.’
His colleague agreed. ‘Yeah. Theresa Lazenby, her name is. Nice little face. In tears most of the time.’
The detective inspector nodded. ‘Seems such a good kid, it’s hard to believe she could have … but he was trying to kill her and she had to save her own skin.’
I know how the living send out signals which are designed to appeal to our hearts. I know how easily I personally respond to these signals. The girlfriend’s remorse had clearly rubbed off on the detectives and, although she had confessed to a terrible crime, she had somehow won their sympathy. I felt relieved then that the dead can send out no such subtle appeals to our emotions. They can only tell the unadorned truth.
The mortuary assistant handed me a mug of tea and I threw it back and went to the lockers to put on my scrubs, apron and mortuary wellies. As we made our way from the public area to the busy, functional working area, the clangs and clatters of the trolleys grew loud and the smell increased. I glanced at the men around me. For the SOCO this was routine. And the detectives had seen it all before and were nonchalant, or at least keen to appear nonchalant. However, as we passed the bank of fridges and line of trolleys waiting by them, I could see that the young police officer was nervous. PC Northern had not eaten the biscuit the staff had given him with his tea and now his face was pale and hollow. Just before we went through the footbath into the room where forensic post-mortems take place, he blurted out, ‘It’s my first PM!’
By now my management of onlookers was improving. I could not forget my failure to alleviate the misery of the police officer at that first post-mortem: it seemed to me that he had picked up my tension and this had greatly added to his distress. Since then I had worked hard to appear relaxed. I remembered the Michael Ross post-mortem, where a superintendent had barely been able to control himself in front of very junior staff. After that, I had determined that, when I performed a post-mortem, no one should ever leave the mortuary traumatized.
My only weapon was communication.
‘When we look at a dead body,’ I told PC Northern, ‘we never forget that they were a person once, that there are grieving relatives, that the deceased and their family deserve respect. We’re going to help all of them today by trying to find out exactly what happened. We’re looking for evidence, we want to help the dead man tell us his story. It’s important for all the grieving people that we put aside our own feelings and do a good job for them. So, without uttering a word, the body we’re examining today will be our witness and our teacher.’
PC Northern nodded glumly.
I used the kindest, most reassuring tone I could muster. ‘Don’t worry, I’ll talk you through it. It won’t be nearly as bad as you think if I explain what I’m doing.’
The worldly wise detective sergeant said, ‘You get used to it.’
The detective inspector was determined to be macho: ‘Listen, the people in the fridges here are gone, not at home, lad. So just pull yourself together.’
We stepped into the brightly lit room where the body was lying naked, wrapped in a plastic sheet on a metal table.
‘He’s been ID-ed,’ said the SOCO as I opened the sheet.
‘What’s his name?’
He knew the name
but he passed the question to the young policeman, who was glad to stop staring at the body and shuffle busily through his notes.
‘Er, Anthony Pearson. Aged, er, twenty-two.’
Anthony Pearson had a mop of blond hair and well-defined features. His eyes were shut. The dead usually look peaceful and without facial expression. Was there a hint of anger about him? Not because he had necessarily died angry but because, out of habit or bad luck, his features fell that way.
I thought then that he was mildly obese – but norms have changed so much that today I would simply describe him as stocky. There were large tattoos as well as bruises on both arms and old scars across his wrists that hinted at a troubled life. The much more recent incisions, defined by lines of blood running across his forearms, confirmed it. Defibrillation marks on his chest were evidence of the resuscitation attempts the officer had described.
Most noticeable of all was his neck. Beneath it the hospital sheet was heavily bloodstained. Across it was a thick, ragged line of blood that had dried after trickling from the side of his mouth.
I nodded to the police photographer, paparazzo to the dead. He lifted his large camera and organized the correct siting of the two large flash guns, the sort often seen outside film premieres. Snap–flash!
‘OK, that’s the whole body, Doc.’
‘Close-ups of the neck now, please,’ I said.
I was already taking notes on my pro-forma sheets. The ligature mark is a vital piece of evidence and, of course, it can indicate the type of material used. If the ligature is wire, electric cable, string or thin cord then the mark is clear-cut and deep with sharply defined edges. But this mark was highly irregular. Ragged, even. She must have used something soft. Fabric? Perhaps a scarf?
For the photographer’s next shot, I rapidly placed a ruler across Anthony’s throat so that the photos would confirm the measurements in my report. Snap–flash!
Unnatural Causes Page 12