Unnatural Causes

by Dr Richard Shepherd

  I still worry whether it is in fact my son who we buried. I think the root of this concern is that I was never allowed to see him … there is an additional concern that the bodies may have got mixed up … [Later] I looked at photos of his body. They were far less horrific than I had expected … I could not help feeling ill at ease with how things had been arranged … My concerns about whether I was ever given his body have meant that I have, in the past, sought an exhumation order.

  I had no idea why the relatives of the Marchioness victims had been denied access to their loved ones: this seemed a cruel and unnecessary decision. It was to be a few more years before further information emerged to offer us – the relatives and those of us who had worked on the case – a possible reason why bodies were not seen and coffins not opened.

  23

  Early autumn, 1992. Jen was now a doctor. She had graduated the previous year and we had gone to her results night disco at the medical school bar, where I, at least, had felt rather geriatric. And then decided to enjoy the dancing. I was ridiculously proud of Jen but probably didn’t show it. And maybe she was grateful to me for the support – the children, the house, the bills – but she didn’t show that either. How hard it was to cross whatever chasm lay between us. It was much easier to ignore it, especially now that she was a junior doctor, working all hours, and I was so busy at Guy’s.

  Today, for once, I was working from home. Children at school, nanny off, Jen at the hospital. The daytime streets were quiet, much quieter than the office. The room was comfortably warm: a dog flopped on each of my feet. And the desk was littered with pictures of a homicide in which I was completely engrossed.

  On top of the post-mortem pictures and a book of photographs of the victim’s clothes were the scene-of-crime photos. I could not forget that rather grey July day. The urban wilderness of a large, south London park. A path heavy with tree shade, lightened by the trunks of silver birches. The POLICE DO NOT CROSS tape wound from tree to tree.

  I saw something white in the grass, among the trees, which, from a distance, you could mistake for a discarded handkerchief. As I neared the handkerchief, a detective on either side of me, it grew larger and became more dissonant with its surroundings until, by the time I arrived, the contrast screamed between this green place and the human body which lay, blanched, mostly naked, below shimmering birch leaves. A young woman. Curled defensively. Stabbed many times. Her lower body naked. Sexually assaulted.

  I waited for the police photographers to finish their work before I took her temperature and a few early swabs for semen. I felt her for rigor mortis and found that only her jaw had set. Then I examined the scene, looking at places where the ground had been disturbed, the detectives pointing out the bloodstains on the grass, noting crushed leaves and broken branches where there were signs of a struggle. This all took many hours. The body was at last removed to the mortuary, where, watched by the same grave detectives, I performed the post-mortem. In the comfort of my study now, I remembered that long, long night. How it was dawn before every one of the forty-nine stab wounds had been measured and documented, each track traced through the internal organs it had penetrated.

  I looked up. The clock ticked in the quiet house. I reached for the post-mortem report and reread the conclusion. No natural cause had contributed to the victim’s death. She had died of multiple deep stab wounds inflicted by a knife or knives about 9cm long, about 1.5cm wide at the hilt. She had struggled and had been stabbed right through her left hand as she tried to defend herself. Once she was dead her assailant had not stopped stabbing her. And once she was dead he sexually assaulted her.

  There was immense public horror at Rachel Nickell’s brutal murder. She was a beautiful, twenty-three-year-old mother who had taken her toddler to Wimbledon Common for a walk. The nation’s shock put pressure on the police to solve this crime, and solve it soon. So immense was this pressure that the Met stepped outside its usual box. Officers talked to forensic psychologists about profiling the killer. And they talked to me about reconstructing the case.

  I had all but given up hope of playing my part in a police investigation – ever since my first careful recreation of a crime, that bedroom knife murder, was spurned by the case detective. And now, for once, the police had come to me and asked for a reconstruction. Specifically, they wanted me to piece together the likely sequence of events that day, based on the evidence present at the scene and at my post-mortem findings.

  I had recently been inspired by a convention of American forensic pathologists I had attended. For a while now I’d felt that, as a profession, forensic pathology wasn’t developing much: we all rushed around on our cases and discussed them in the pub, but that isn’t the same as development, of ourselves or of our profession. I went to American conventions for a different perspective and recently I’d found just that when I had learned that American pathologists were now encouraged to be a bit more Simpson-ish by participating in the investigation.

  So I read through my own very thick post-mortem report on Rachel Nickell. The wound details went on for pages. Three wounds, on the chest and back, which I had numbered 17, 41 and 42, stood out from the rest. They were the only superficial wounds in a victim who had been stabbed deeply over and over again. Could these have been the first?

  There is a moment at the very beginning of the chain of events which leads to a homicide such as this when the perpetrator has to get close enough to his victim to gain control. We know that establishing control is a particularly important part of most sexual homicides. In such cases, we often find wounds that are not deep enough to injure but scary enough to make a victim comply with an assailant’s demands: these are ‘prodding wounds’. Were 17, 41 and 42 ‘prodding wounds’? There was just one on the deceased’s back – number 17 – while the others were high at the front of her chest. I looked at them again. I wondered if she was first prodded in the back. And then, did she turn to face her assailant?

  In the scene-of-crime pictures, the most significant bloodstains were easy to discern. They were not under trees but in a place where the summer grass was left long and full of seeds, like a meadow. This was about five metres from the place the body was discovered in the late afternoon by a shocked mother with a toddler, dog and pushchair.

  There was a second, smaller area of staining, much closer to the body’s final position: it was adjacent to the forked birch tree under which the dead woman was found. And, of course, there were bloodstains beneath the body. It was safe to assume that the initial assault had taken place at the bloodiest site, that the victim had been moved to the spot under the tree, and then pulled a metre into that final position nearby.

  Looking at the endless list of wounds, it was hard to decide which came first, but the gaping neck wounds must have happened fairly early on as they would have produced the most blood. That would also explain why the victim apparently did not scream. Her neck had been attacked with force and the pain would have been extreme. If that didn’t stop her screaming, then the resulting damage to the muscles around her larynx would have done so.

  The pictures of Rachel Nickell’s clothes told me another part of the story. Her T-shirt was wet with blood, of course. But her jeans, around and below the knee, were muddy at the front. And blood-spattered at the back. I was absolutely sure this could only be because she was kneeling early on in the assault, while the initial injuries to her neck were inflicted.

  Of course, with such injuries she could not have remained kneeling. She must have fallen. It seemed likely she had fallen forward and that her assailant had now stabbed her back – eighteen times in all.

  Whichever way she fell, but especially if she fell forwards, her neck would have bled profusely onto the ground. Is that why the killer moved her to the second area under the tree? Or did he do this because by now she had died? Or because he feared he could be seen too easily here on the grass?

  The pictures showed less blood under the tree but the distribution was wider. That is probably
an indication she was lying here supine. I checked the pictures of her body at post-mortem. Yes, leaf mould on her back. This must, indeed, have been where he stabbed her front. If she was not dead when he moved her, she must have died very soon after. Even so, he continued to stab her body. In particular, he stabbed the heart and liver post-mortem. They were penetrated, but the dead do not bleed.

  Next, I noticed that the leaf mould on her back was also visible on her buttocks. So here, under the tree, he must have ripped off her jeans. And during or after this, her body was pulled over to be sexually assaulted in its final, compliant position.

  Did he continue to stab her afterwards? Or did he run off at once?

  ‘In my opinion, the minimum length of time needed to inflict all the injuries would be three minutes,’ said my post-mortem report.

  I knew that because, as usual, I had re-enacted the moves here at home. If the murder had taken only three minutes, it certainly must have been fast and furious. And it gave every appearance of a frenzied attack. Even the coroner himself used this expression and the newspapers had certainly not been able to resist it.

  I had also spent hours analysing the knife wounds – some of which showed evidence of the weapon’s square hilt on the skin because the blade had been plunged in up to its maximum depth. And for the first time I had a body part scanned. Magnetic resonance imaging showed the exact track of the knife wounds in the liver. All this information meant that, although the police had already presented me with a variety of possible knives, each time I had confidently told them that, no, the wounds proved this could not have been the murder weapon.

  When I finished listing the sequence of last events in the life of Rachel Nickell, a young woman whose name is widely known for the saddest of reasons, I felt bone tired. World-weary. I looked at the clock. Almost time to pick up the children and walk the dogs.

  I switched off the computer and listened to the faint groan it gives when extinguished. The dogs knew that sound and woke up simultaneously, yawning and stretching. They watched as I locked the photographs of the crime in my filing cabinet where no one, least of all a child, would stumble across them.

  Creating a reconstruction that really might help the police to find that young woman’s killer did bring me great satisfaction. I would very shortly be forty and this level of work represented the sort of contribution I had always believed it was possible for forensic pathologists to make to homicide investigations.

  The dogs were wagging their tails, waiting to go. I did not move. I did not want to come back to the here and now from this engrossing work. Because there was something I had to do. Before dogs and children.

  Reluctantly I picked up the phone and dialled one and then another in the list of numbers I had made from the Yellow Pages.

  ‘Hello, am I talking to the undertaker?’

  ‘Yes, sir, what can I do for you?’

  My father was dying in a hospice in Devon. He had advanced cancer and was receiving terminal care. A couple of days ago I had said my sad farewells there, as court cases and other commitments dragged me back to London. My sister Helen had arrived to see him and then brother Robert. I was making this call now, knowing that probably none of us would feel able to when the right time came.

  The voice at the other end sounded confused.

  ‘Sorry … I must have misheard. Did you say your father isn’t actually dead yet?’

  ‘I’m afraid to say he soon will be, and I thought I’d organize things now.’

  ‘I see.’ Was that shock or disapproval? I felt embarrassed.

  ‘I’m actually a forensic pathologist so I … I work with death all the time and I’m aware of the … the practicalities.’

  ‘Ah.’ My plea of mitigation had been accepted.

  The formalities were therefore sorted out and, when the call came to say my father was dead, I was released from mundane details and could allow myself to grieve. Not to cry. Of course. But to feel the immense loss of my good-hearted and much-loved father. He had somehow shuffled through a long retirement in Devon with Joyce awkwardly by his side. My life had not in any way revolved around him, but he was a constant presence. I phoned every Sunday, he wrote every fortnight. Always there. Except now he wasn’t. Something vast and unknowable seemed to gape at me. The immensity of death, which I always managed to evade in the course of my work, startled me by engulfing me now.

  A day or so later I went to Devon and picked up the relevant forms from the hospice to take them to the registrar of births and deaths as instructed. The envelope said: Confidential. Do Not Open.

  Naturally I ignored this. My life is spent dealing with confidential details of the dead and these were my own father’s. As I waited at the registrar’s I opened the envelope and studied the contents without a qualm.

  A cold hand snatched the envelope from mine.

  ‘Just what do you think you’re doing?’

  ‘Well, I was reading the –’

  ‘If you can read, you will have seen that these notes are confidential. You had absolutely no right to open them.’

  My knuckles rapped, we proceeded to a small, shabby room for the formalities. Except that I had already seen on the paperwork that the doctor had given ‘Carcinoma of prostate’ as the cause of death. In the doctor’s scribbled writing, it looked like ‘Carcenoma of prostate’.

  I watched as the registrar, still stony-faced, laboriously wrote the death certificate.

  I said, ‘Excuse me … carcinoma is actually spelled with an i not an e …’

  She looked daggers at me.

  ‘I … I’m a forensic pathologist. That’s why I was interested to read my father’s notes and … well, I write the word carcinoma all the time and I can assure you it is spelled with an i.’

  The woman glared.

  ‘The doctor has spelled it with an e. It is my job to write the cause of death exactly as it is given. Therefore, I shall write carcenoma because that is how the doctor has chosen to write it.’

  So my father’s death certificate, which I had to send out many times, each time with a shudder of deep irritation, gave him a new and entirely unknown cause of death, called carcenoma. It would have annoyed him as much as it annoyed me. Although he would have enjoyed his unique place in government statistics.

  Two days before my mid-life birthday, the Shepherds gathered in Devon for a much bigger event. Our father’s funeral. Here was Helen, who lived in the north of England with her family. Here was Robert, who lived in France with his wife. Despite the geography, we all remained close.

  The night before the funeral, we had a family dinner with all the children but, I am sorry to say, without Joyce. I hope this wasn’t unkind of us. I did remain in touch with her for the rest of her life and took responsibility to see that she was housed and cared for. But that night, we didn’t want to censor any story about our father that predated her; we wanted to be free to exchange anecdotes about that wonderful man and his own special character. Not all of them were to his credit but all of them he would have endorsed and enjoyed. We laughed a lot and drank his health and it was truly an appreciation of his life.

  To die greatly admired by your children is no mean feat. He had been the eldest child in a large family and when there was not enough money for education, and perhaps not enough love, to go round, he set out to create both those things for himself and his own family.

  Immersed in a sense of loss, but also of harmony and support among Shepherds, we drove back to London, the kids in the back, me at the wheel, Jen at my side grabbing the opportunity for some sleep because junior doctors need all the shut-eye they can get. Another family, another generation.

  In fact, I felt some reluctance to leave Devon and go back to work. Guy’s was a busy, stimulating, friendly place and I loved my job. But, unfortunately, I’d run into turbulent waters lately. First, I was roundly attacked by my colleagues for complying with the police request for a reconstruction of Rachel Nickell’s murder.

  ‘You’
re stepping right outside your area of expertise,’ they said.

  I pointed out that, actually, I had relied entirely on my expertise for the reconstruction. ‘And this is the way forensic pathology’s definitely moving in America,’ I added.

  They were unimpressed by the way forensic pathology was moving in America. They shook their heads. They said, ‘When they arrest someone, and the prosecution uses your reconstruction, defence counsel will slaughter you in the witness box.’

  By now I’d experienced enough public humiliation as an expert witness to know this was probably true.

  My other worry was the Marchioness.

  That tragedy had occurred three years earlier, but somehow the wreck of the pleasure boat kept resurfacing. Of course, the grief of those who had lost someone in the disaster could never end – and right now their grief was turning to anger.

  We professionals might have thought it was over for us: some parts of the rescue and its aftermath had not gone smoothly but the focus of attention since the collision had been on its causes. There were many safety systems that should have been in place on the Thames that night and weren’t, and it was generally believed that the disaster happened because neither vessel saw the other in time – because neither kept a proper look-out. However, whatever the reason, the enormous Bowbelle had clearly ploughed into the little Marchioness, and criminal proceedings had followed against the Bowbelle’s master.

  Victims’ relatives were furious that the master had been drinking heavily the afternoon before the disaster as he waited for the tide to change so that the dredger could head downriver. But experts (who didn’t believe that the old RAF rule of eight hours from bottle to throttle had a marine application) said the master had substantially slept off this alcohol intake in a nap before setting off that night. So the charge against him was his failure to keep a proper look-out.