Unnatural Causes

by Dr Richard Shepherd

  The result of this mythology is that, sadly, many relatives who are asked to agree to a post-mortem of their relative will not do so. Of course, they do not always have a choice: if death has been sudden, whether it is natural or accidental, the coronial system will usually take over, and the coroner will certainly demand a post-mortem if homicide is suspected. Society needs to know, and this greater good overrides the relatives’ wishes. Bearing in mind that a relative could be – and quite often is – the murderer.

  The general horror of post-mortems only became completely clear to me when I read a statement a relative gave following a major disaster. She had learned that a post-mortem had been performed on her son without her knowledge. Since he was a disaster victim she thought the cause of death was already obvious:

  In my view, it was wrong to carry out any unnecessary invasive procedure which disfigured the body and showed lack of respect for it and for my family’s emotional and religious needs. To me, he was still my son, and any unnecessary mutilation of his body was an unforgiveable intrusion.

  I really do understand that it is hard, very hard, to recognize the finality of death. To understand that the son who was thinking and feeling and animated yesterday is not so today. To comprehend that yesterday he would have been in agony when I inserted my knife but today he cannot feel it at all. And perhaps the hardest thing is to see the insertion of that knife not as an intrusion but an act of respect and, yes, maybe of love.

  Here are the words of the QC who was acting for the group of angry, bereaved relatives that included the mother I quoted above:

  The care with which our dead are treated is a mark of how civilized a society we are. Much goes on for understandable reasons behind closed doors. For this reason, there is a special responsibility placed on those entrusted with this work and the authorities who supervise it to ensure that bodies of the dead are treated with the utmost care and respect. That is what bereaved and loved ones are entitled to expect and what society at large demands.

  Who cannot agree with him? Except that he was representing relatives who, among other miseries, were angry that their loved ones had undergone a post-mortem.

  For me, his words pinpoint why post-mortems are so important. When I perform one, I am thoroughly, efficiently and perceptively delivering to the dead not just ‘the utmost care and respect’ which a civilized society expects, but love for my fellow man. I am ascertaining the exact cause of death and in doing so it is very distressing to be regarded as a mysterious, cloaked butcher. I sincerely hope that those to whom I have spoken directly, or who have heard my evidence in court about the death of their relative, appreciate that I did my job with care. And, I believe, love for humanity.

  Very gently, I tried to help Alannah’s sobbing family to understand that her body had not been brutally mutilated at post-mortem but respectfully investigated – for their sake, her sake and society’s sake. The world did not shrug its shoulders and say, ‘Oh well, there goes another fifteen-year-old girl.’ It demanded to know the truth.

  I assured them that her body had been faithfully and beautifully restored after this process – as all bodies are – by my colleagues. Mortuary technicians are rightly proud of their skills. Alannah’s family should have no fears about seeing her. Indeed, they must do so. Seeing a loved one’s body is a way of saying goodbye, recognizing death’s finality and celebrating a life.

  I made arrangements then and there for them to see Alannah. They thanked me quietly as I left. I knew how long and hard the grief road would be as it unfolded in front of them. Maybe I had made a few steps on it easier for them. For our different reasons, none of us there has probably ever forgotten that meeting.

  Of course, I can’t personally feel grief for every one of the tens of thousands of people on whom I’ve carried out post-mortems. Grief is not an emotion I experience as I incise a body. It is something I experience when I see others suffering their own loss, either within the controlled forum of the coroner’s court or, more informally, at the mortuary or office. I’ve come to terms with the need to manage my response now. In the years since that meeting about Alannah I’ve even come to believe these contacts between pathologists and the deceased’s loved ones should be arranged far more often. Information, its very solidity and certainty, can provide not just clarity but support, relief and a sound basis from which relatives might, eventually, move on.

  For myself, I would say I have spent a working lifetime respecting and understanding relatives’ pain – while trying not to internalize it. Analytical readers will by now be associating my reluctance at the start of my career to meet relatives with the death of my own mother so early in life. And at my subsequent willingness to engage with others’ grief they will say, ‘Aha! He couldn’t allow himself to experience the enormity of grief for his own loss! So, he experiences it again and again in manageable proportions through the grief of others. And, at the end of the meeting, he walks away from it!’

  I accept that there is probably something in that theory.

  16

  Although I carry out my work with respect and a sense of loving humanity, I do so with an essential scientific detachment. A few years into my job, I did think I had become rather good at leaving detachment at the door of our house, so I was a bit disappointed at Jen’s hints that I was applying it to family life; that the jovial, loving husband I’d thought myself to be was instead a dour and preoccupied workaholic.

  Moi? Surely not. So I was caught stabbing the Sunday roast with a series of different knives from different angles while I waited for the oven to warm up. So what? I was convinced I could deduce the exact size and shape of a knife from the injuries inflicted by it and there was no lump of meat so like a human lump of meat as a joint of beef. I’d be a fool not to carry out a little experimentation when I was waiting to shove the beef into the oven. Wouldn’t I?

  ‘You mean, Daddy, that you pretended our lunch was a human person?’ asked Anna, putting down her knife and fork. ‘A human person being killed?’

  ‘Don’t be silly, it obviously isn’t a human person,’ I said, tucking into my beef briskly.

  ‘My meat’s full of stab marks,’ added Chris. ‘Look!’

  I had expected greater loyalty from the other male in the family. I glowered at him over the joint. But it was too late. By now everyone had put down their cutlery.

  Our lives were absurdly busy. I tried to get back from work most evenings in time to take over childcare from the nanny and cook the dinner. Jen was now working junior doctor hours. Forget synchronizing diaries, it was a matter of cobbling each week together.

  Then, when we were out one day, our house burned down. Not entirely, but enough to mean we had to move out. The fire was either started by an electrical fault, by an aggrieved offender against whom I’d given evidence (as the police suspected), or it was my fault. We never did find out which, but Jen tended to favour the last of these possibilities.

  We stayed with friends, we rented accommodation, we fussed over builders, we agonized over whether to sell the house as a burnt-out shell and buy another, or restore it and return. I tried not to regard the house, with its intact structure and black, smoky, largely missing interior, as symbolic of my marriage, but even I could see that the difficulties and pressures of living in a series of temporary homes were not making that marriage any smoother.

  What a relief when the holidays arrived. Kids and dogs were all piled into the car and we progressed slowly north up the motorway. Off to the Isle of Man, where my generous in-laws were ready with food, love, parties, towels for the beach, teatime for the children, whisky-and-sodas for the evening. Austin and Maggie were becoming charming caricatures of themselves, he the solid colonial, she with groaning wardrobes of glamorous dresses, the pair of them with more friends than you could fit in the house, perhaps fit on the island.

  Jen and I called a truce during those holidays and tension between us evaporated as Jen’s good parents worked hard to ease all our burden
s. I was only caught once in the kitchen sticking Maggie’s knives into the beef and Maggie was intrigued rather than angry. Then, happy and refreshed, with brown, giggling children in the back seat, buckets of seashells wedged between flip-flops and dogs thumping tails full of sand, we returned to London looking very different from the tight-jawed individuals who had left.

  It took about two days for us to revert. And even before we became those busy parents and doctors again, the tensions returned. We didn’t have rows: we had seething and we had silences. I was probably trying to make up for a seething or a silence, the cause of which I forget, when I bought Jen a new dress and flourished tickets for the opera. Tosca. I was really keen to see it, I knew it would be my sort of evening because a colleague had described Tosca as ‘a wonderfully forensic opera’.

  Such an evening out was very extravagant by our standards and we certainly looked forward to it. The only possible fly in the ointment being that I was on call and hadn’t been able to swap this shift with someone else. Sure enough, the babysitter had already arrived and we were in the bedroom getting ready when the phone rang. Jen watched me answer.

  ‘Pam here.’ Tough, no-nonsense, organizer of disorganized pathologists Pam. That could mean only one thing. Jen saw my face and her eyes narrowed.

  ‘Right,’ Pam said, her habitual way of starting a conversation. ‘You’ve had a call-out. Shocking case. Whole family shot dead in their beds, probably last night but not found until this afternoon. The father survived. Just. Badly wounded, now in hospital.’

  That sounded like the kind of case I should go to right away. And my face must have said so. Jen saw it and turned her back on me. The lovely new dress was still on its hanger. Instead of lifting it off, she sadly opened the cupboard and put it away.

  ‘Where?’ I asked Pam.

  ‘I’ll tell you where, but you’re not going tonight.’

  I inhaled sharply. I always went immediately.

  ‘You got Jen that dress and you bought those tickets and there’s no way you’re cancelling that.’

  Pam always knew everything.

  ‘But –’

  ‘Go running off to some homicide now and she’ll never speak to you again! It can wait.’

  This was enough to give any forensic pathologist palpitations. The point about rushing to a crime scene is that, quite apart from police urgency and the relatives’ need to know, we’re at our best when the body’s early processes such as cooling and rigor can offer us the most accurate indicators of time of death.

  I said, ‘Pam, I think I’ll have to go because –’

  ‘I’ve already said you’re not going tonight. And if you’re worried about time of death, stop. The police already know. The father left a suicide note and the neighbours heard some bangs and said it was about 1 a.m. Anyway, it happened last night and the police have been working on it this afternoon. With three bodies to process and all the other stuff, they won’t need you until tomorrow.’

  ‘But –’

  ‘The dead aren’t going anywhere and the husband’s in hospital so there’s no rush.’

  There was always a rush!

  ‘Just get there at eight tomorrow morning, it’s all arranged.’

  ‘But –’

  ‘Dick. You’re not arguing with me, are you?’

  Nope. No one argued with Pam.

  So we went to the opera and Jen wore the dress and it was a lovely evening except that somehow the family shot in their beds went to the opera with us. I was trying not to think about them but I did. Which body would I start with? How bad were the father’s wounds? Had he killed them all and intended to kill himself. But bottled it at the last minute? Or just misjudged the shot? Or had there been a mad, masked intruder who had made him kill the family and write a suicide note – in which case, why had the father been spared?

  I didn’t go to the call but it had been obvious to Jen that I was more than willing to, and that Pam had stopped me. Jen was monosyllabic while we were out. We returned home and waited until the babysitter had left. And then we had the row. Well, Jen rowed. In the face of her anger I was very, very quiet, like a small mammal crouching in the hedge until the bird of prey flies over. I had somehow managed to ruin our wonderful evening out.

  ‘I can’t stand it,’ Jen said, ‘when you go quiet and moody on me. I’m upset! Why don’t you reach out to me? Comfort me?’

  Erm. Because …

  ‘Is that why you work with corpses, Dick …?’

  Now just a minute.

  ‘Because they won’t notice when you act completely detached around them?’

  Touché!

  Although Jen blamed the early death of my mother for my ability to withdraw as soon as the going got tough, I suspected it was more likely because of my father’s volcanic tempers. I had depended on him totally and mostly he created a secure, loving world. Which was rocked from time to time by his outbursts. The long-term result is that I barely ever allow myself to loosen the lid of my own volcano.

  Of course, I do feel angry or sad or disappointed sometimes. But, instead of displaying it, I retreat into silence. I seldom argue and never shout. Well, I did once, perhaps around this time or a little earlier. Many years later my daughter said at her wedding that she could remember me losing my temper on only one occasion in her entire life (new suit, children, bath, water-pistol). I felt no shame. In fact, I’m quite pleased I managed to lose my temper at all.

  Our romantic opera evening wasn’t the success I’d hoped for, so I thought I might as well scuttle over to the homicide scene right away. But one look at Jen’s face told me this could be grounds for divorce, so I contained myself. However, I was up at 6.30 the next morning, Saturday, getting ready to leave for the murdered family’s house. Jen did not wake up. Or seemed not to, anyway.

  I arrived at 8 a.m. as instructed by Pam. This was going to be a long, long day. There were still plenty of police around but surprisingly few reporters. Probably they had been and gone. There isn’t a homicide – especially a multiple homicide – that is so ghastly it goes unreported. In my experience the worse the better, as far as journalists are concerned. Even today Jack the Ripper’s ugly murders continue to make headlines. Only the details of some sexual murders seem to evade the press – although that is probably more to do with information being withheld than a sense of decency towards the bereaved.

  When I entered the house of the murdered family, it retained that silence of death I now knew so well, although police officers were still busy and people were chatting. What I found inside was a ghastly parody of the family homes up and down the land that were waking up to a normal Saturday morning.

  It was in very good order. There was none of the chaos which can characterize murder scenes: no empty bottles of beer and vodka, no filthy carpets, no decaying kitchens, no blood-filled bathrooms. This was a family which cooked and ate well and took care of themselves and each other.

  The teenage daughter’s bedroom was clean and pretty, with homework completed and put away by her school bag. Her clothes were neatly folded. She lay in the bed in her shiny pyjamas. A single bullet had passed straight through her head.

  In the next room, her older brother lay on his back, shot through the centre of his forehead, from about six inches. Apparently as he slept. There were no signs of a struggle or any other disturbance.

  Their mother, a pretty, dark-haired woman, lay on the right-hand side of the marital bed. Hands together as if in prayer beneath her right cheek. Peaceful. The bullet had smashed through her left forehead and a trickle of dried blood ran down her face.

  ‘No doubt about it, the father did it,’ said the SOCO.

  ‘How bad are his injuries?’ I asked.

  The officer had been there much of the night and looked grey-faced and dishevelled.

  ‘Well, apparently he’s not going to die.’

  I wondered if the father had wanted to die or if merely injuring himself really had been his intention. He’d been very cer
tain about the previous three shots. Had he also shot himself in the head? If so, it would have been hard to be sure of avoiding death. Strange.

  I discussed with the photographer what pictures he had taken and then told him what more I needed. I took one final look at the mother and both the children before agreeing with the coroner’s officer that these three tragic bodies could be removed to the mortuary.

  Once they had gone, and because there were no more fingerprints to be taken, I could wander around the scene and look at it in more detail. At that time, no one had heard of DNA evidence, and forensic science certainly was not as advanced as it is today. The result was behaviour at the scene of a crime that would nowadays be regarded as worse than casual. So, while we were always quite careful not to touch anything other than the body, if a fingerprint taken turned out to belong to a pathologist, then the only result was that we had to buy the SOCO a bottle of whisky.

  The post-mortems of the family were straightforward: here, after all, were three healthy people, all of whom had been shot once through the head. Yet it was a most haunting case. That house, with its silent, ordered rooms and incongruous bodies, certainly stayed with me. Its darkness followed me home and I could not quite eliminate it as I closed the door behind me. It was late afternoon and the children were running riotously through the house. The sight of them, laughing and pink-faced, so alive, made me absurdly happy.