Review: Vivien Horler

Unnatural Causes – the life and many deaths of Britain’s top forensic pathologist, by Dr Richard Shepherd (Penguin Books)

unnatural causes

Four people were in the vehicle accident which claimed the life of Princess Diana in Paris in 1997, and three of them died.

Paradoxically, according to top British forensic pathologist Dr Richard Shepherd, the princess was the least seriously injured of the four.

The driver, Henri Paul, and the princess’s lover, Dodi al Fayed, were killed instantly. The Al Fayed’s bodyguard, Trevor Rees-Jones, the only person in the car who was wearing a seatbelt, was seriously injured. But Princess Diana was conscious and speaking when the ambulance arrived, and as a result the paramedics concentrated on Rees-Jones.

But what no one knew was that the princess has sustained a tiny tear in a vein deep in one of her lungs, which slowly began to bleed.

Once in the ambulance, she lost consciousness and then suffered cardiac arrest. In hospital she went straight into surgery, where surgeons discovered the problem and attempted to repair it. But it was too late.

Seven years later, with rumours still swirling about as to what had caused the accident, a British police inquiry was opened to establish whether there were grounds for treating the deaths as anything other than a traffic accident.

Shepherd, who has 23 000 autopsies to his credit, was asked to act as forensic pathologist to the inquiry. Because the bodies had long been buried, his role was to review the evidence colleagues had collected in 1997.

In this gripping account of the mechanics of what happened after the Mercedes hit a pillar in the Alma Tunnel, Shepherd sets the scene. Driver Paul was in the front left driving seat, with Rees-Jones next to him. Dodi was behind the driver, with the princess behind Rees-Jones.

Paul’s fatal injuries were caused by his hitting the steering wheel followed less than a second later by being hit from behind by the burly Dodi, whose body was still travelling at nearly 100kmh.

Diana also hurtled forward, but her momentum was stopped by the strapped-in Rees-Jones, who cushioned her impact. As a result she suffered just a few broken bones and, of course, the chest injury.

Shepherd describes the tear in the vein as “so rare that in my entire career I don’t believe I’ve seen another”. And he concludes that, had she been wearing her seatbelt, “she would probably have appeared in public two days later with a black eye, perhaps a bit breathless from the fractured ribs and with a broken arm in a sling”.

This is just one of the many cases, high profile and more routine, that Shepherd has been involved in over his long career. Others include being the British representative in New York after 9-11, in which disaster around 60 Britons died; the bomb attacks on three London tube trains and a bus in 2005; and the case of serial killer Dr Harold Shipman, the popular Manchester GP who was found guilty of the murder of 15 of his patients, mainly elderly women.

One of them, Kathleen Grundy, had gone to school with Shepherd’s aunt. In this case Shepherd was hired by the defence team. After Shipman was found guilty and incarcerated, a public inquiry concluded he had “certainly” killed 215 people, and that there were hundreds more whose cause of death was uncertain.

Shepherd became an expert on knife killings and describes a number of these cases. He also had to give evidence after several child and baby deaths, in cases where it was extremely difficult to establish whether a baby had died of Sudden Infant Death Syndrome or had been actually been murdered.

One of these cases came back to bite him. He and a paediatric pathologist concluded a baby had died of SIDS, only for another pathologist to review the records and the poor quality images that accompanied them, and find what he considered to be clear indications of murder.

This, on top of the years of stress caused by the routine uncovering of people’s inhumanity to one another, precipitated a crisis in both Shepherd’s career and

his life, and he was diagnosed with post-traumatic stress disorder.

Part of his “cure” was writing this brilliant and fascinating book. In an interview he was asked whether his work had desensitised him, and he replied: “I think you have to ensure that you don’t become desensitised. A case may have the label ‘routine’ applied to it, but no case is routine for that family.”

Things might have gone better for Shepherd personally had he allowed himself to become desensitised, but this memoir reveals a man of great honesty and compassion. I heartily recommend this book.