Unnatural Causes

by Dr Richard Shepherd

  Identification was, and is, the first priority for the pathologists in any mass disaster – there were many worried relatives, desperate for reliable information. The number of a call centre had been given out through the media for friends and relatives to phone, but it had no queuing system so callers found it to be constantly engaged. One can only wonder at the anger and frustration that caused. But the lesson was learned and call centres were organized and designed differently after that. There were thirty-five deaths but over the ensuing day the call centre took 8,000 calls, and there were many more to hospitals and even mortuaries.

  If injuries were slight the police gave information over the phone. Bad news was delivered personally by officers. It would have been all too easy, without proper care, to tell a woman her husband was dead when he wasn’t, or vice versa. For instance, there were four people on the train with exactly the same name. Incredibly, two of them were in one carriage – but only one of them was dead.

  Fingerprints and dental records were at that time the only really dependable means of identification: it was no good relying on the loose personal effects like handbags or wallets that arrived with the bodies as these almost invariably turned out to belong to someone other than the individual in that body bag. In addition, the police and fire service were so keen to remove all human tissue that a body bag containing three body parts very often contained the body parts of three different people and not one, as the rescuers must have assumed. There were about sixty separate body parts – heads, legs, jaws, internal organs – and they all had to be matched up. The coroner’s staff and the police entered the details onto a database and from this, gradually, complete human beings began to emerge in cyberspace … the male, aged about forty-four, six feet tall, slightly overweight, balding, birthmark on right shoulder, travelling in the train’s front carriage, eventually turned into a person with a name. We were pleased to reach the point of positive identification. But, of course, at that same point hope ended for friends and family.

  We continued working until the small hours of the next morning to get the first view finished. Then we went home to rest in order to avoid fatigue errors before returning early to begin the post-mortems. The bodies of a few people who had died in hospital after the crash were now arriving. These added to our workload but, since these individuals had all been identified by relatives while in hospital, the process was much easier.

  Most of the dead at the very front of the train had been killed by severe injuries, not just from the initial impact but by forcible ejection from their seats and hard contact with the unforgiving inside of the carriages. Some died of traumatic asphyxia because the tables they were sitting at were forced back into their abdomens, or because other objects fell onto them. There were many lessons learned from Iain West’s overall report of our findings, including the need to anchor seats to the floor and to redesign hard surfaces to lessen their resilience in a collision. There were some calls for seat belts, but this was impractical and has never been implemented on trains. Overall, British Rail, which then controlled the signalling equipment, learned that there were many improvements to be made both to routine safety systems and to crisis systems. If any phoenix rose from the Clapham ashes, it was these improvements.

  And for me, there was a personal phoenix too.

  The mortuary after the disaster was a busy, focused place and I got on with my job. As I looked at each victim I remembered that they had set off for work one morning and never arrived. Instead they had been crushed and severed, their families bereaved. The ramifications of that would continue for years, if not generations. I thought all this but I could not allow myself to feel it. To feel anything. I knew that the intensity of my emotions was so strong that I could not have worked and so the door on them had to be kept slammed tightly shut.

  At one point, I looked up to notice how very white the face was of the police officer who had been at my side for some hours.

  I said, ‘Do you need a break? You don’t look very well.’

  He said, ‘Doc, I think I’m going to be all right. Because there’s one thing keeping me going.’

  I waited for him to tell me that a pint at the pub or the embrace of his girlfriend would be his reward.

  He said, ‘My flying lesson.’

  I must have misheard. I thought he’d mentioned something about flying …

  ‘Yes, Doc, soon as I finish my shift, I’ve got a flying lesson.’

  I stared at him.

  ‘You fly a plane?’ I asked, incredulous. ‘That’s something I’ve always wanted to try!’ I did not add, ‘… but have never been able to afford.’

  Well, hasn’t everyone wanted to fly? But the idea of finding the money then fitting flying into my everyday life, slotted somewhere between home, giving lectures, departmental meetings, post-mortems and court appearances … well, it seemed barely worth considering.

  The officer said, ‘I’ll tell you, the fresh air up there beats the smell of the mortuary any day.’

  I looked around me at the collection of crushed limbs we were now investigating. Did I need anyone to tell me that the clouds are a better place to be?

  The policeman said, ‘The Met has a flying club, that’s how I do it. If you’re interested, I reckon you could join, seeing how closely you work with us.’

  A few weeks later I found myself at Biggin Hill. Precisely, at the threshold of runway 2–1. More precisely, inside a two-seater Cessna 152 beside a police officer who was also a qualified flying instructor.

  We’d sat with cups of coffee while he briefed me on this, my first lesson, and then, heart beating wildly, fingers shaking with excitement, a buzz in my stomach that felt like raw terror, I opened the throttle and runway 2–1 unspooled before me.

  ‘Pull back gently when we reach fifty knots,’ said my instructor. ‘Gently!’

  I did so and the nose of the plane lifted. There was a heart-halting moment as the rumble of the wheels on the tarmac faded then stopped and suddenly all I could hear was the whoosh of the wind and the noise of the engine. Yes! We were airborne.

  We climbed. Up, up. The deep blue horizon shifted further down. I looked at our speed. Seventy-five knots. We passed a cloud. Just flew past it, the way the bus passed me in the mornings when I was about to miss it. I was flying through thin air. In a tiny metal box. And I wasn’t falling down.

  I realized I had been holding my breath. I exhaled. I inhaled. I dared to look below me. The houses of Greater London were behind us and I could see all the way to the south coast, all the way to Brighton. My eyes rested on the sheer stunning beauty of the countryside laid before me like a feast, like a woman in her finery, like a work of art, a picnic of clouds. I felt elated. I was really flying. I was leaving behind the sad and the drab. Mortuaries full of the still bodies of humans devoid of human spirit, the small failures, the niggling worries, the disappointments, the silences at home, the recent spate of that annoying compromise ‘Cause of death: Unascertained’; the idiotic vanities and the frustrating rivalries. All the joyless trivia which can paint life grey had simply disappeared to be replaced by this surge of wild happiness.

  I concentrated on the controls of a small plane suspended somewhere over Kent and knew that if flying could make me feel this way, I must never give it up. Ever.

  19

  I gave up flying after five hours of lessons. The fire in our house created such an array of complications and pressures that wild surges of unbounded joy were driven right off the agenda. Spending my very limited spare time alone with an instructor in the air when I should have been spending it with my family began to look downright selfish. So, it was back to PM40s by day and chores by night: cooking, writing up post-mortem reports, phoning builders. Back down to earth.

  Not that life was boring. I loved the variety of my work – in one week I might have a suicide by shotgun, a carbon-monoxide poisoning, a drowning, a knife murder, a drug overdose, a variety of sudden natural causes. Each had its own fascination, as l
ong as one detached oneself from the emotional payload death carried for the living who surrounded it. Drug overdoses were still rare, particularly if the user had died with a needle in the arm: that was certainly something to show interested colleagues (today, of course, these cases are simply routine). There was a strong possibility that the deceased, if an intravenous drug user, was HIV positive and so drugs deaths triggered elaborate safety precautions. AIDS was still sufficiently new and unexplained to be terrifying and, in those days of ignorance about its transmission, fear stalked hospital corridors.

  Iain West had become the UK’s, and perhaps the world’s, foremost expert in death by bullet or bomb: his career had peaked alongside IRA activity and his work regularly made headlines. I did appreciate the breadth of the cases I dealt with but colleagues hinted that I, too, should find an area in which to develop special expertise. What, though?

  Drugs deaths were a growing trend, so was death by glue-sniffing, but these generally demanded more of toxicologists than forensic pathologists.

  Babies? No, thanks. I felt that few pathologists could enjoy working on such morally complex and emotionally draining cases, although in fact this specialization was to explode, in significance and complexity, over the coming years.

  My intellectual curiosity drew me towards knives, a method of homicide as old as mankind and one I predicted would last on this planet as long as man does. Or woman. One of the interesting aspects of homicide by knife is that it is very often a woman’s weapon of choice. The knife in every kitchen drawer in the land is a murder waiting to happen. And it is easy to use. No training or specialist knowledge is required. Not even much force, really. All that is needed is the ability to get close to the victim. But it was not the domestic or street nature of knife murders that interested me so much as the fact that, increasingly, from the incisions themselves, I often felt I could attempt to reconstruct the events surrounding the homicide. And, although I was coming to terms with the fact that, post-Simpson, the police didn’t seem to regard reconstructions as proper evidence and lawyers less and less often had the time or inclination to hear them, I could not entirely abandon the reason I had become a forensic pathologist: to help solve death’s puzzle.

  I don’t think I actively made a decision to be a knife specialist. It just seemed to find me. And my interest was sealed after a call-out on a sunny Sunday autumn morning when I had woken early to see the clear sky and wish, sadly, I could fly a little aeroplane through it. Our burned house was healed and sold, we had passed through the chaos of moving, the new house was in something like order … but I knew that taking time out from work and family to continue my flying lessons was still simply out of the question.

  The leaves were turning colour as I headed off through the crisp, cold morning towards a village where an elderly man had been found in his kitchen with his throat slashed. As I neared the address I met a line of police cars parked at the roadside. A harassed young constable was trying to persuade a knot of gossiping neighbours to move back.

  The old man had lived in one of those big early council houses, detached and built to last from solid black and red brick. The neighbours fell silent as I approached. They listened as I identified myself to the constable, then as he lifted the crime-scene tape and I walked through, they all started to talk at once. In the corner of my eye, I glimpsed someone in a police car. A woman, head in hands.

  ‘I’m the coroner’s officer; thanks for coming so quickly,’ said a big, red-faced man at the door who I guessed at once was, like many coroner’s officers at that time, a former policeman. SOCOs were busy with their evidence bags, and there were a couple of senior detectives. A police photographer arrived.

  ‘That’s the daughter,’ muttered the coroner’s officer, gesturing to the police car in which the woman sat. ‘Phoned and couldn’t get a reply, rushed straight over …’

  In the kitchen near the back door, feet stretching to the entrance of the living room, lay the body of an elderly man.

  ‘Mr Joseph Garland. Eighty-two years old,’ the coroner’s officer murmured in my ear.

  Mr Garland lay on his right side. His clothes were bloodstained. Beneath him the kitchen floor was bloodstained. The mat was bloodstained. The cupboards and walls were bloodstained.

  He wore pyjamas with a tweed jacket thrown over the top. His hands were bloody. His feet were bare. By the open back door stood a pair of bloody wellington boots.

  I could hear the two detectives talking behind me.

  ‘So, they bang on the door or maybe he just sees them outside in his garden. He throws on the jacket, gets into his boots, goes out there and … they knife him but he manages to get back into the house, probably reaching for the phone …’

  I looked back at Mr Garland. The bloodstaining was unusually distributed. His jacket and pyjamas were heavily stained on the front. Confusingly, the blood extended down to the upper calf. There was no blood below this except on the soles of his feet. The wellington boots, however, were bloodstained on the outside and in a narrow rim on the inside at the top.

  It was obvious that he had been wearing the wellies at or after the time he received the injuries. Then he had taken them off when he came into the house. They stood neatly in what was almost certainly their accustomed place by the door. Their owner probably had a long-practised, ingrained habit of stepping out of them as he entered.

  ‘I bet he once had a wife who nagged him about bringing mud onto the kitchen floor,’ I said to no one in particular.

  I stared out into the back garden, which was being combed now by a number of police officers. I saw a trail of blood leading to the greenhouse. Outside it, Mr Garland’s pots were stacked. Inside, through dirty windows, the summer’s tomato plants were visible. They were brown, dying off as autumn closed in.

  Beyond the greenhouse was a garage and parking area. A deep pool of blood was visible in the parking area: clearly the wound had been inflicted here. A red car stood nearby at an odd angle, the driver’s door not properly shut, as if someone had leapt out in a hurry.

  ‘It’s the daughter’s,’ explained the coroner’s officer.

  The photographer had finished his initial work now and I went back to the body. I rolled Mr Garland over and a huge incised wound on the side of his neck, just above the jacket, gaped at me. A knife had cut through the muscles and the right jugular vein and partially severed the carotid artery. There were a number of other horizontal wounds across the throat, but none so deep as the wound that had most certainly killed him.

  I felt his arms and legs. Rigor mortis had set in but was not fully established in the legs. I took his temperature.

  Another policeman was listening intently to his radio.

  ‘Suspicious van … two men, early twenties, approached a pensioner this morning. Asked if he had any gardening work. The van was a white Ford, registration probably included letters T and K …’

  ‘Get someone out there looking for it,’ said a senior voice, who then introduced himself to me as a detective superintendent.

  I had been crouching by the body and stood up now.

  ‘Could you ask his daughter if he was left-handed?’

  The super looked at me for a moment and then disappeared to the police car. Through the open door I heard Mr Garland’s tearful daughter confirm that he was indeed left-handed. She knew what this question meant, even perhaps before the detective, because she began to wail.

  ‘I don’t think this is a murder investigation,’ I said when the detective came back.

  The officers, busy around the scene, inside and out, all seemed to freeze.

  ‘This wound is self-inflicted. I’m afraid Mr Garland killed himself.’

  The super shook his head.

  ‘That was our first thought. But we’ve searched high and low for a knife and there just isn’t one.’

  ‘There must be.’

  The detective began to look annoyed: ‘You can’t kill yourself and then dispose of the weapon. There’s n
o weapon here. This is a homicide.’

  ‘Maybe he dropped the knife into the bushes.’

  The super gestured to his team of officers, even now busy in the flower beds.

  ‘This is their second sweep of the garden. It’s not that big and there’s no knife.’

  I was sure the knife was there. I was sure the old man had killed himself. I paused and considered. How sure was I?

  The detective was glaring at me. ‘You don’t know anything until you do the post-mortem, Doc.’

  People always think that by opening the bodies of the dead I will find their secrets locked inside, like someone who cracks safes. But in this case, I already knew a great deal from careful study of the body’s external appearance.

  There was no point in arguing, as I would have to do a post-mortem anyway. I turned back to the coroner’s officer. ‘Can you arrange to take him to a mortuary now?’

  He nodded and called over two uniformed police officers.

  ‘Right, let’s get him bagged up and over to the Royal Surrey.’

  I turned back to the super. I was confident.

  ‘Of course, I’ll do the post-mortem, but I’m sure this is a suicide.’

  ‘What makes you so sure?’ he asked me, and not pleasantly. It was a tone I knew already but I’d rarely encountered it at the scene of a crime, where there is generally quiet, good-natured teamwork. No, that sneer belonged in court, employed by a senior defence barrister setting out to humiliate a pathologist whose evidence inconveniences his client.

  I responded in my most clinical voice.

  ‘First, the site of the injury. Mr Garland has cut himself several times, and the site he’s chosen is absolutely typical of self-inflicted incisions. They’re nearly always on the neck or the wrists. He cut the right side of the neck, which would be most unlikely if he was right-handed. But you’ve just confirmed that he was left-handed. And look at all those smaller injuries. They’re parallel.’