The trailers were filling fast. Eventually it was concluded that there were 2,753 victims, and in total something like 70,000 body parts or fragments were found. Many of the bodies had been pulverized, either by the initial explosion or when the buildings came down. It would have been a lot easier to have put everything into one mass grave but, of course, the families of the dead could not bear the idea that their loved ones might be buried with the hijackers.
Soon, all the rubble from the World Trade Center was being shifted to an old landfill site on Staten Island in the Hudson Bay Estuary, strangely called Fresh Kills. It was sifted, every bit of it, not once but twice by a skilled team led by police and the FBI, which included anthropologists and doctors. And then the long journey through the DNA of almost 3,000 people began. Each tiny fragment of human tissue, each personal effect had to be identified.
This programme in fact continued for many years: identifications were still being made in 2013. Finally, in 2015, 1,637 victims had been identified, accounting for just 60 per cent of those believed to have died: the others had become dust, as all bodies must. Now there are plans to turn Fresh Kills into one of the world’s largest urban parks.
An anthropologist friend who worked sifting through the debris was, like many others involved in the disaster, traumatized by it. After months of sieving for bits of human tissue and bone she developed a horror of flying. When she returned to the UK, before boarding her flight she wrote her name on every part of her body, every single limb, in case the plane crashed and she was dismembered. In fact, it was many years before she worked again.
Towards the end of my brief trip, I was driven to a nondescript building in Manhattan that was one of the British Consulate offices in New York. A Foreign Office team from the UK was waiting for me. At that time, we knew there were many British dead but not how many.
‘So,’ demanded one of the officials, ‘how are we going to get our British bodies home?’
I wondered how they imagined the repatriation of the bodies to be. Then one of them, a politician, talked about a row of coffins being driven in slow convoy from the airport to London, each draped in the British flag.
I shook my head. I had been up for almost two days and I was shocked and tired. From the coalface, this line of flag-decked hearses sounded like a politically motivated stunt to maximize the drama and photo opportunity for the government. I felt something dangerous rising inside me, something really terrifying, something that, if I had let it, could have turned into fury. And I am never angry, let alone furious. But now something escaped.
‘Coffins? Did you say coffins? Most of these people have been pulverized, don’t you understand that? Instead of coffins you’ll probably be sending them back in matchboxes!’
They glared back at me. There was little further dialogue. I was thanked and dismissed.
My report praised the Americans’ handling of the disaster, saying that we could use their paperwork instead of creating our own. As a result, although the final death toll for Britain was, in fact, sixty-seven, just one coroner’s court in the UK, run by an experienced and empathic coroner, dealt with every British fatality. Just one American police officer flew over to give evidence. And there was just one verdict. It was unlawful killing.
Four years later, London too came under Islamist attack. On 7 July 2005, fifty-two people were killed and more than 700 injured when four terrorist bombs exploded, three of them on the London Underground and one on a bus. Literally a few days earlier, with the involvement now of many agencies, the mass-disaster plan that the coroner Alison Thompson and I had started thinking about back in the 1990s had been signed off.
I was not in London at the time but when the appeal went up for help I flew straight back and set to work in the excellent, tented temporary mortuary facility that had been constructed in less than forty-eight hours on the playing field at the Honourable Artillery Company in the City. All the bodies were taken here and the facility, indeed our whole plan, proved fully functional. I carried out my work with immense sorrow. Perhaps, deep down, in some irrational place, I might have hoped that, by making a plan, we would be saved from ever putting it into action. What wishful thinking.
The coroners in charge of that crisis may have had one regret. Relatives of Marchioness victims had bitterly criticized the need for the full post-mortems we had carried out, saying they were unnecessary since the cause of death after such a disaster was clear. Consequently, after the 2005 bombings we were told not to carry out full post-mortems. Our job was identification only. If we opened bodies, it was purely to look for the gall bladder and appendix because if they had been removed this might assist identification.
Afterwards, extraordinarily, the ambulance service was criticized for being too slow in recovering the wounded. Crews do not go where they may be harmed and, because there was a risk that further bombs had been planted, they had been told to wait before entering the bomb sites. Accusations followed that this delay had actually been responsible for a number of deaths. There was a suggestion that lawyers for some victims’ families would seek compensation from the emergency services. Because full post-mortems had not been carried out, we pathologists struggled to answer the questions asked by both families and the coroner to resolve these claims.
I did learn from this. Years later, I was the pathologist in charge when taxi driver Derrick Bird went on a killing spree in Cumbria. It was highly reminiscent of Michael Ryan’s massacre in Hungerford more than twenty years earlier. Some people pressed me not to perform full post-mortems on the grounds that it was obvious what the cause of death was. Mindful of 7/7, I did not give in to their entreaties. Every patient first had an MRI scan to reveal the position of every bullet, and each body was given a full post-mortem. There was not one criticism of the emergency services’ response.
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My second brush with the work of Osama Bin Laden was in Bali a year after 9/11. Two bombs planted by Islamic extremists connected to Bin Laden exploded in crowded tourist areas of this lovely Indonesian island and more than 200 were killed, most of them Western holidaymakers and most of them under thirty.
Once again, at a few hours’ notice I found myself on a plane. I was sitting next to some rather bulky men. I thought possibly they were from special forces. In fact, we didn’t speak the whole way, although I guessed that we were all flying east for the same reason. I assumed they thought I was a tourist or a reporter. However, when there was no one to meet me at Denpasar Airport, they noticed this and turned to me by the luggage carousel for the first time.
‘Want a lift, Doc?’
‘How did you know who I am?’
‘We guessed you must be the pathologist just by looking at you.’
‘How?’
‘Well, for a start you didn’t laugh at the movie.’
That’s pathologists for you. Miserable, death-obsessed, dour-faced butchers. But I was grateful for the lift. And the first person I saw at the hotel was coroner Alison Thompson, who happened to have been staying in Hong Kong and had flown directly here, knowing, again, that the British bodies would fall under her jurisdiction when they arrived at Heathrow. We greeted each other warmly and, although it was early morning in Bali, decided to set off for the hospital where the bodies were being stored.
Before leaving London, I had been told that I was simply viewing the operation from the British point of view. But when I walked into the mortuary the other pathologists (mostly Australians but also Dutch and Germans) recognized me from international meetings we’d all attended and immediately handed me a gown, an apron, some rubber gloves and a knife. And said, ‘Get on with it, Dick.’
The British embassy staff had done an amazing job of locating the British bodies. Not only that, they had found the fuel to keep the generator going of one of the few chilled containers in the whole place – if not the whole country. In fact, as with all disasters, we pathologists just worked a conveyor-belt system of post-mortems, taking whichever body came next,
whatever the nationality.
The problem was lack of facilities for the dead in a world of intense heat. I will never forget the sight or the smell of the bodies laid out in the shade, covered with bags of ice cubes from the supermarket. How I longed to find a lorry full of ice which we could tip all over them. They were changing fast, and not for the better. Many were already fragmented and identification was the usual jigsaw challenge, only made more complex by the untrained recovery teams who just threw everything they found in one area into one bag. It was a great relief to come across an isolated hand wearing a wedding ring which was engraved on the inside with the name of its bearer. It was a small, tragic item and it gave us one small piece of the tragic puzzle.
Most of the victims who had been attracted to that sybaritic island were young and beautiful. They had been enjoying themselves in the bar or nightclub where the two bombs exploded, one after the other. The bombs were planted by an extremist group believed to be funded by al-Qaeda.
Eventually it was confirmed that there were twenty-eight British fatalities and that overall more than 200 people were injured and 202 were killed. It was a hard, exhausting and traumatic time. I have subsequently visited the memorials to this atrocity both in London and in Perth, Western Australia, but no memorial is necessary to remind me of the decaying bodies, the ice, the smell, the single dripping tap in the mortuary that was our water supply and the overarching sense of the futility of terrorism. I am not sure it has ever really left me.
Back home, my working life was feeling insecure. The world of forensic pathology was changing and we were now threatened by new uncertainties of a sort the great Simpson never had to face. The university medical schools had always paid us to lecture in our subject but they decided – almost all of them, one by one – that now they would not continue funding or teaching forensic pathology. The main reason they gave was lack of forensic research and lack of publication in prestigious scientific journals. However, we were too busy with post-mortems and coroners and courts to meet these new benchmarks of a Good University. The age of intellectual evaluation through research assessment exercise had arrived. And we forensic pathologists were found wanting.
Gradually, medical schools with great traditions of forensic pathology closed down departments and it wasn’t long after Iain West’s death that his kingdom at Guy’s disappeared. St George’s hung on a bit longer, but my new department’s warrant for execution had been signed.
We had essentially been privatized. From now on, instead of providing forensic services for free, our salaries paid by the universities at which we taught, we would directly bill the police, coroners or defence solicitors for payment.
I knew that, without a salary, it would be hard to continue with some necessary but unpaid work. I am talking about public work, like my ongoing contribution to teaching the authorities safe restraint methods. And my participation in disaster planning. Everyone else at the group was salaried by the police or some other organization: I no longer had the weight of a university behind me.
Not only was the regular income gone, so were lectures and so were students, except at just a few specialist centres outside London. I had only ever lectured to packed halls and knew how interesting medical students found forensic work. I also felt that at least the rudiments of forensic medicine should be an important part of their training. Every doctor, no matter what their discipline, should be able to identify the signs of suspicious circumstances so that they would know when to call an expert or the police. But there was too much ‘real’ medicine competing for too little space in the training schedules and forensic pathology now became accessible only on specialist postgraduate courses at few universities.
I set up a group called Forensic Pathology Services, widely known as FPS, through which pathologists in London and the south-east of the UK would operate in our brave new privatized world. And suddenly, while I was buried deep in its planning and organization, I realized that I might not want to be a part of it.
With a heavy heart, I had dropped Anna off that autumn at university: she had finally decided to study medicine. So they were gone now, both of our children, to the north of England. Of course, they still needed us, but not in the same way. Our house seemed large and empty and quiet. Was that why we were spending more and more time on the Isle of Man? That home was nearer the children than London. Was it because, as my lectureship duties at St George’s were being wound down, there was little to keep us here? Was it because we loved our cottage on the island and wanted to support Jen’s now-widowed mother – not that Maggie had let widowhood stand in the way of her social life – and in fact were now ourselves becoming part of her whirl?
Or … was my work in London beginning to weary me? Weary me so much that even flying on Friday afternoons could not restore me? Every court appearance seemed to turn into a bruising scrap and sometimes I felt I lacked the resilience to cope with it. There was no longer a bounce in my step when the police called me to another crime, another body. I had given up hope that they would ever phone me for my opinion on a case. And, looking into the future, I could see that pathologists eventually could be tendering for contracts, competing for bodies, even undercutting each other on price. Forensic pathology was a service, but no longer the intellectually rigorous world I had entered, with its scope for debate, study and social change.
Jen had become disillusioned with her work, too. Despite her amazing feat in becoming a doctor so late in life, once she was practising as a GP she found she did not really want to be one. She had always been keen for us to move to the Isle of Man and believed that here she could practise her own specialization, dermatology, and live in the place she wanted to be.
What else pushed us there? Our knowledge of our own senescence? A longing for the lifestyle Maggie and Austin had enjoyed? A hope that, if we spent more time isolated together on an island, somehow the loving communication which was missing would suddenly reappear?
Perhaps I – and perhaps Jen too – was having that thing people call a mid-life crisis, which no pathologist has ever been able to locate within the human body, not even under a microscope. But when I was asked to write the twelfth edition of Simpson’s Forensic Medicine (the third edition of which you may remember had lured me into this profession), the invitation felt like a huge honour. And an excuse. So I was midwife to, but did not remain with, the new Forensic Pathology Services. Instead, Jen and I left London for good. We gave up the tidy hedges and neatly mown lawns of Surrey for a windswept and beautiful cottage on an island somewhere off Liverpool. I was generally believed, by my colleagues and contemporaries, to have completely lost my marbles.
I was very happy and busy renovating the cottage. We went walking for miles over wild and windy moorland under big, big skies that were sometimes so clear we could see across the water to where the Mountains of Mourne sweep down to the sea. We sat by the fire while gales whistled outside. Or we just stared across the fields to the ocean as it conjured up dramatic storms from its depths. I did not carry out a single post-mortem.
And, here we had a social life. We had always been too busy for this before but now we had friends. It mattered little that we were much younger than most of them. We simply slotted into the society that had been ready-made for us by Maggie. So what if she was ageing a little now? She was still at every party, a woman with haute couture dresses bulging from every wardrobe in almost every bedroom in the house. Something delicious bubbling on the stove, a gin and tonic always at the ready and she was never without an admiring circle of friends. It felt good to be among them, good to be part of a community. The children visited often.
For me there may have been no more post-mortems, but there was lots of interesting work. I was writing my textbook on forensic pathology. I flew myself to the mainland to sit on committees for the British Association in Forensic Medicine, who were still sorting out Home Office contracts and many other details of the new privatized landscape. I was asked to give opinions on complex cases
. I was busy on several ministerial working groups, devising and promoting more humane methods of restraint.
Of course, I kept an eye on all interesting developments in my field. I learned that the police had reopened the inquiry into Rachel Nickell’s murder: they now, finally, began to accept that someone other than Colin Stagg might have killed her. It took another six years for developments in DNA testing to nail Robert Napper for her death, the man who had murdered Samantha Bisset so violently and who was already detained in Broadmoor for life. I recalled carrying out the second post-mortem on Samantha Bisset’s mutilated body and I remembered saying to the detective how much I was reminded of Rachel Nickell’s murder. I wished now that I hadn’t simply made a passing remark but said something more forceful, more questioning, more insistent.
There was also a major development in the case of Sally Clark, the mother convicted of killing her two baby sons. She seemed to be planning a second appeal. She had been in jail for over two years now, but this appeal would be based on new evidence. New pathological evidence.
The results of tests performed on blood and tissue samples taken from her second child had been discovered. The pathologist had not revealed this evidence before. In the view of some experts, but certainly not all, it showed that the second child might have died naturally of a bacterial (staphylococcal) infection.
The Court of Appeal’s job was to assess whether, if the jury had been in possession of this information at the time of the trial, it might reasonably have affected their decision to convict. The three judges decided that it might, and that therefore the conviction was unsafe.
In 2003 Sally Clark, by that time a broken alcoholic, was released from jail. She died four years later.
Sir Roy Meadow, the man who produced the extraordinary statistic that there was a 1 in 73 million chance of two children from the same family dying naturally, was publicly discredited. A number of the other mothers he had given evidence against and who were serving sentences now launched successful appeals. His maths was challenged by statisticians and he was struck off by the General Medical Council. He later, much later, won his appeal against being struck off, but by then he was over seventy. One piece of bad, off-the-cuff, maths in court under intense cross-examination was a sad ending to a previously highly distinguished career.
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