by Cina, Joshua A. Perper, Stephen J. ; Cina, Joshua A. Perper, Stephen J.
I think it’s perhaps the fact that he put his hands up and said ‘I need treatment’ and went into hospital, and then the sick-doctor routine takes over.” Shipman paid his fine and worked 2 years as a clinical medical officer before resuming general practice in 1977 at the Donneybrook Medical Centre in the North of England.
By that time, he was the father of four. In the Donneybrook group, Shipman earned a reputation as a hardworking and dedicated doctor who enjoyed the trust of patients and colleagues alike. He remained on staff there for 15 years before going into solo practice in 1992. Despite his solid reputation with the group by 1985 a disturbing trend emerged among his clientele. Allen Massey, the local undertaker, noticed that Dr. Shipman’s patients seemed to be dying at an unusually high rate and in a very uniform pattern – most were fully clothed and sitting up or reclining on a chair. There was no evidence that the person had been severely ill at the time of death and Dr. Shipman was present at many of the deaths. The undertaker approached Shipman directly about his concerns, but was apparently reassured that there was nothing to worry about and that the practice’s books, always available for inspection, backed up his story.
Suspicions resurfaced in 1998 when a medical colleague, Dr. Susan Booth, complained to the local Coroner who in turn contacted the police. A covert investigation followed, but Shipman was cleared since his patients’ records detailed diagnoses and treatments consistent with the causes of death listed by him on the death certificates.
Later, a more thorough investigation revealed that Shipman had altered and forged the medical records of his patients to corroborate their alleged causes of death.
The majority of Shipman’s killings were carried out in a rather monotonous fashion. The doctor’s routine was to make a house call to patients on a weekday afternoon and inject them with morphine or heroin. The patient was then found dead either in the doctor’s presence or within 30 minutes of his departure. The mechanism of death was described as syncope or collapse and the cause of death certified by Shipman was a heart condition, a stroke or old age. The families were advised by Shipman that the manner of death was natural, no autopsy was necessary, and prompt cremation of the body was recommended. Shipman’s killing spree was brought to an end largely because he altered his discrete methods.
While most of his murders did not involve monetary manipulations, for some reason he decided he would not only kill one of his patients but would act as her sole beneficiary as well. Kathleen Grundy, a well-known former mayor of Hyde and a highly active and wealthy 81 year-old widow, was found dead in her home on June 24, 1998 following a brief visit by Shipman. Shipman told her daughter that Grundy had died of natural causes and that an autopsy was not required.
Shipman recommended cremation and had already signed the cremation authorization 28
3 The Alpha Killers: Three Prolific Murderous Doctors
but the daughter firmly objected and Kathleen was buried in a funeral attended by hundreds of people. Unbeknownst to Dr. Shipman, the daughter was an attorney.
She had always handled her mother’s affairs, so she was quite shocked when informed of the existence of a second will leaving her mother’s estate, valued at 386,000-pound sterling, to Dr. Shipman. Upon examination of the recently
“signed” will, the daughter became convinced the document was a cheap forgery, as it was badly worded, badly typed, and totally out of character for her mother who was a very tidy and meticulous person. Furthermore, her mother’s signature appeared to be forged. Believing that Shipman had murdered her mother and forged the will to benefit from her death, she reported her strong suspicions to the local police. Upon examination of the evidence, Detective Superintendent Bernard Postles arrived at the same conclusion and an investigation was promptly initiated.
In August 1998, Kathleen Grundy’s body was exhumed and an autopsy revealed that she had died of a morphine overdose, most likely administered within 3 hours of her death, precisely within the timeframe of Shipman’s visit to her.
Shipman’s home was raided yielding medical records, narcotics, an odd collection of jewelry, and an old typewriter which proved to be the instrument upon which Grundy’s forged will had been created. Shipman denied the forgery claiming that the deceased had borrowed the typewriter from him on a number of occasions.
On September 7, 1998, Shipman was charged with Mrs. Grundy’s murder; a highly confident Shipman denied all charges. Over the course of his interrogation, Detective Chief Inspector Mike Williams was quoted to say, “He was an arrogant type of individual to deal with. And I don’t say that lightly. I’ve listened to the interviews, and he certainly wanted to control and dominate the interview and the officers, at times belittling them. He was treating this as some sort of game, a competition, pitting his, what he considered to be his superior intellect, to those of the officers who were interviewing him.” After intense questioning of the doctor, the police became concerned that Shipman might have murdered additional patients besides Grundy. His medical records were carefully reviewed and any fatalities involving his patients following a home visit by Shipman were carefully examined. The investigation revealed that it is probable that hundreds of patients, mostly elderly women, were murdered by Shipman through the administration of morphine or heroin which in England can be prescribed by doctors. His oldest victim was 93 years old, his youngest 41. Based on the investigation, there were 218 verified victims, 171 women and 47 men. However, the Crown prosecutors decided to charge Shipman with murder in only 15 cases in which exhumation and autopsy provided iron-clad evidence for conviction.
Shipman’s trial started in Preston Crown Court on October 5, 1999. The prosecution asserted that Shipman had killed the 15 patients because he enjoyed exercising control over life and death and dismissed any claims that he had been acting compassionately (“mercy killing”) as none of his victims were suffering a terminal illness or were in great pain.
Kathleen Grundy’s daughter was the first witness for the prosecution and her testimony was very straightforward and convincing. Attempts by Shipman’s defense to undermine her credibility were unsuccessful. A government pathologist Dr. Harold Frederick Shipman: The Champion Serial Killer
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described in detail the postmortem findings and the toxicological studies substantiating that morphine toxicity was the cause of death in most cases. Fingerprint analyst confirmed that Kathleen Grundy never handled the forged will and a handwriting expert dismissed the alleged signature on the will as being a crude forgery. A police computer analyst then testified how Shipman had altered his computer records within hours of the death of a patient to create symptoms or fabricate office visits or consultations that had never taken place. Like many other people, Shipman apparently had not been aware that erased electronic records can be retrieved and that changes made to computer files can be identified and dated as well. The relatives of the murdered victims testified that Shipman often demonstrated a lack of compassion when informing them of the death and he frequently disregarded the wishes of family members. He also displayed marked reluctance to attempt to revive moribund patients. In several instances, Shipman would pretend to call the emergency services in the presence of relatives, then cancel the dispatch when the patient was discovered to be dead. Police examination of the telephone records from these homes showed that no actual calls were made. Finally, evidence of implicit drug violations and abuse was introduced. Large stashes of heroin ampoules were found at his home. Falsified prescriptions for patients who did not require morphine and never received it were confiscated. Records documenting visits to the homes of recently deceased patients to collect unused drug supplies for “disposal”
were uncovered; not surprisingly, there were no indications that the drugs were destroyed.
Following a meticulous summation by the judge, and a caution to the jury that no one had actually witnessed Shipman kill any of his patients, the jury unanimously found Shipman guilty on all charges: 15 counts of murder and one
of forgery.
Dame Janet Smith, the Superior Court Judge, sentenced Shipman to 15 life-term sentences and an additional 4-year sentence for forgery, which she commuted to a
“whole life” sentence effectively removing any possibility of parole. On January 13, 2004, Shipman was discovered at 6:00 AM hanging in his prison cell, having used bed sheets tied to the window bars of his cell to form a ligature. Dr. Shipman had reportedly told his probation officer he was considering suicide so his widow could receive his generous government pension and inheritance. Indeed, following Shipman’s death his widow received a pension and a lump sum from the Department of Health as well as 24,000-pound sterling in inheritance from Shipman. The doctor and his family vehemently proclaimed his innocence to the end.
Dr. Shipman’s motivation for his many murders (except for the last one) is unknown, although the assumption of John Pollard, the South Manchester Coroner who knew Shipman well, seems very close to target: “The only valid possible explanation for it is that he simply enjoyed viewing the process of dying and enjoyed the feeling of control over life and death, literally over life and death.”
A clinical audit conducted by Professor Richard Baker of the University of Leicester at the request of England’s Chief Medical Officer examined the number and pattern of patient deaths over Harold Shipman’s 24 years of practice (1974–1988) and compared them with those of other practitioners. The comparison of the number of death certificates issued by Shipman vs. other general practitioners in the 30
3 The Alpha Killers: Three Prolific Murderous Doctors
same locality with a similar patient mix indicated that he issued nine times as many death certificates than the average doctor. He also determined that death was due to
“old age” eight times more frequently than his colleagues. Clearly, having Shipman as your doctor was a bigger risk factor for sudden death than smoking. Dr.
Shipman’s saving grace may have been his willingness to perform house calls. He was present at the deaths of 20% of his patients compared with a norm of 0.8%.
The audit goes on to estimate that he may have been responsible for the deaths of at least 236 patients over a 24-year period. It was further speculated that Shipman might have been “addicted to killing.” Harold Shipman is the uncontested Master Criminal of medical serial murders. He serves as living proof that evil doctors are not a thing of the past or limited to fiction. Though not as horrific as disembowel-ment, injections of morphine, (or insulin, digitalis or potassium) may be equally lethal. If we were to search for a single minimally redeeming feature of Shipman’s crimes, it was that the victims were all enthralled with him as a doctor and they sank painlessly into coma and death. There is also no evidence to suggest that he billed the next-of-kin for the house call.
Shipman’s motivation was not sexual/sadistic fantasy but rather, first and foremost, the feeling of power that he could choose with impunity when another person would die. It seems likely that his serial murders were either a symbolic punishment of his mother, who callously left him bereft at a very vulnerable time, or revenge against a world that permitted elderly women to live while younger women were allowed to die. Shipman was an exceptional serial killer as he was able to totally compartmentalize his murderous behavior while simultaneously living a normal life as a respected physician, husband, and a father of four children. Furthermore, he apparently committed suicide to enable his wife to receive a government pension from the Health Department which she would have lost otherwise. The record shows that this man was committed to providing money to his wife and narcotics to his patients.
Three prolific serial killers, Jack the Ripper, Dr. Thomas Neill Cream, and Dr. Harold Shipman had at least one thing in common—medical knowledge.
The Ripper’s crimes indicate an uncommon knowledge of anatomy. His weapon of choice may well have been a medical instrument. We will never know if he was a physician – or if he was assisted by one. Dr. Cream was obsessed with drugs and poisons from early on in his career. He put this knowledge to morbid use in his killings. Dr. Shipman used a drug that was and is readily available to presently practicing physicians. His mastery of the medical arts provided him with something that every serial killer needs—easy access to unwitting victims. Whereas the Ripper was likely a sexual sadist who gained gratification from the suffering of his victims, Shipman killed to rectify a psychological wrong that had been done to him.
Shipman and Cream both enjoyed the omnipotence of choosing life or death for their victims, but the former hated women whereas the latter was a family man.
Although these three killers shared some characteristics, there were more differences than similarities. It is highly unlikely that they would be able to form a partnership to run the Clinic from Hell.
Chapter 4
America’s Contribution to Medical Mayhem
I think capital punishment works great. Every killer you
kill never kills again.
– Bill Maher
The history of Americans (and colonists) that have been convicted of serial murder is about 350 years old, a mere trifle when compared with that of some other nations.
The Vain Prodigal Life and Tragical Penitent Death of Thomas Hellier, a book published in London in 1680, reported the crimes of Hellier, a bonded servant in the Virginia colony, who was hanged for the murder of “his master, mistress, and a maid.” He was apparently the first American “domestic killer.” Until the late 1800s, murders by American physicians were practically unknown, either because the perpetrators were too good at concealing their crimes, the index of suspicion was too low, or the expectation to die under medical treatment too high. However, the 1900s and early 2000s showed a significant increase in their number. American serial killer physicians are very similar to medical deviants throughout the world and share similar motivations. Not to seem un-American, but our serial murderers aren’t bigger, stronger, smarter or faster than killers from anywhere else. This is not to say our physicians have been slouches when it comes to homicide—far from it.
Consider the following examples.
Dr. Holmes’s House of Terror
The first, well-known American killer was Herman Webster Mudgett, not a very frightening name (how many murderers are named Herman?). He graduated from the University of Michigan’s School of Medicine in 1884. While in training, he had the nasty but profitable habit of stealing corpses, mutilating them to mimic trauma caused by accidental death, and collecting insurance money on the bodies. After graduating, he traveled across the Midwest running frauds, real estate scams, and marrying an unknown number of women for their money.
In 1886, he took the name “Henry Howard Holmes” and used his medical training to get a job in a Chicago drug store owned by a Mrs. E. S. Holden. He turned the J.A. Perper and S.J. Cina, When Doctors Kill: Who, Why, and How, 31
DOI 10.1007/978-1-4419-1369-2_4, © Springer Science+Business Media, LLC 2010
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4 America’s Contribution to Medical Mayhem
store into a success by being a deft preparer of medications and charming the lady customers with his enticing and humorous conversation all the while meticulously documenting the store’s finances. Mrs. Holden seemed thrilled with the success of her business until she mysteriously vanished in 1887. Shortly thereafter, Holmes announced that Mrs. Holden had sold her store to him before leaving for the West. In truth, Holmes had murdered Mrs. Holden and had skeletonized her body.
Two years later Holmes used the income from her store, the proceeds of her life insurance policy, and the sale of her skeleton to a medical school to build himself a true castle rather than just a mansion. A crew of 800 workers under Holmes’ direct supervision labored from 1888 to 1890 to build a very impressive three-story building complex with turrets, battlements, and 105 rooms.
The building also featured hidden gas jets in the guest rooms, an elevator shaft with no elevator, stairs to nowhere, peepholes, secret alarm bells activated by opening apart
ment doors, hidden passages, soundproof asbestos-lined vaults, kilns, quicklime pits, trap doors, chemical labs, a glass-bending furnace, and a nine-room basement illegally hooked up to the city’s gas mains. Holmes had repeatedly changed builders during the initial construction of the Castle to ensure that only he fully understood the design of the dungeon he had created. In addition, according to law at that time, by firing workers every 2 weeks he didn’t have to pay them.
When this Horror Castle was completed, Holmes started his killings in earnest.
Over a period of 3 years, Holmes selected his victims from among his employees, lovers, and at least 50 paying hotel guests. Most were women but he killed a few men and children as well. Some were locked in soundproof bedrooms fitted with gas lines that permitted him to asphyxiate them at any time. Others were locked in a huge bank vault near his office; he sat and listened as they screamed, panicked and eventually suffocated. The victims’ bodies went by a secret chute to the basement where many were meticulously stripped of flesh, crafted into skeleton models, and then sold to medical schools. He dissected some of the bodies, performed chemical experiments on a few, and saved pieces of several corpses in his vaults (he did not have the benefit of a freezer like Jeffrey Dahmer).
He disposed of most of the evidence in his lime pits or his basement crematory.
Ironically, Wade Warner, the very designer of the furnace, was reduced to ashes within it.
Holmes also had a thriving clinical practice. He picked one of the most remote rooms in the Castle to perform hundreds of illegal abortions. Many of his patients died because of his procedures and their corpses were also processed and the skeletons sold. Despite the lucrative income earned from abortion, torture and murder, the maintenance of a castle was expensive and Holmes’ financial problems grew in spite of his booming business. Following the Chicago World Fair of 1893, with creditors closing in, Holmes left Chicago and apparently murdered people as he traveled around the United States and Canada. He tried to marry Minnie Williams, a wealthy Texas heiress, but her sister objected and Holmes ended up killing both of them. Holmes’ murderous career came to a close after he talked a witless man by the name of Benjamin Pitezel into faking his death in order to collect on an The Starvation “Doctor”