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Interview

The forensic pathologist who got PTSD:


‘Cutting up 23,000 dead bodies is not
normal’
Richard Lea
Richard Shepherd’s career saw him work on some of the most
high-profile cases of the past 30 years, such as Harold Shipman
and Stephen Lawrence. But it came at a terrible personal cost, he
says

Wed 26 Sep 2018 08.00 BST

W
hen Richard Shepherd was diagnosed with post-
traumatic stress disorder in 2016, the mental health
nurse told him he was really worried. “Most people say
they’re going to commit suicide,” the nurse said, “but
you actually know what to do.”

Shepherd’s career as one of the UK’s most distinguished forensic


pathologists saw him involved in disasters from the Hungerford
shootings to the Bali bombings, and in high-profile cases from Harold
Shipman to Stephen Lawrence. His daily life was made up of blood-
spattered corpses and formalin-soaked dissections, anguished relatives
and scornful barristers. But it wasn’t a particular incident that left him
immobilised by dread, struggling with sleep and plagued by panic
attacks. Instead, it was the gradual accumulation of stress from 30 years
confronting violence and the grave, the steady buildup of emotional
damage from putting 23,000 dead bodies under the knife.

“You don’t notice it,” Shepherd says, “because you think you’re good
enough to do it without giving in. But, actually, it’s like little fish –
nibble, nibble nibble – such tiny pieces go that you don’t notice the
individual bites. And yet, when you look back, you realise it is having
an effect.”

When you arrive on the scene of a violent crime, he continues, you have
to switch off from the fact that something terrible has happened that
will utterly change the lives of the people involved and those around
them. “The ripples on the pond are huge,” he says. “But I have to shut
that off and look at where are the stab wounds, where are the splashes
of blood – purely scientific, medical things. When you come out of it,
you can say, ‘God, that’s just awful,’ and you do. But at that moment
emotions have just got to go.”

Armed police outside Michael Ryan’s house in


Hungerford in 1987. Photograph: Daily Mail/Rex
/Shutterstock

Shepherd charts the rising cost of this battle for detachment in a


memoir, Unnatural Causes, that puts the reader at his elbow as he
wields the scalpel. Beneath the unresisting skin, he reveals an intricate
and beautiful mechanism – the gall bladder the green of jungle foliage,
the brain the silver-grey of darting fish, the liver the sharp red-brown of
a freshly ploughed field – in which the expert can read the marks of
innocence or guilt. From the eerie quiet of Hungerford High Street after
the murder of 16 people to the trail of blood leading up to the bedroom
of an anonymous terraced house, Shepherd conjures up the uncanny
traces of sudden death, the grisly remnants he tried to put out of mind
for decades.
This strategy of repression has deep roots. Shepherd’s mother
succumbed to the heart condition that had dogged her for years in
1962, when he was only nine. As well as doing all the shopping and
cooking, Shepherd says his father unlocked stores of kindness and
affection that were often untapped in men of his generation. But when
a friend brought a copy of Simpson’s Forensic Medicine into school,
Shepherd found himself fascinated by the gallery of stranglings,
knifings, shootings and electrocutions the textbook contained. Between
those tatty red covers, the worst that could happen – the terrible thing
that had, in fact, already happened – was laid out, anatomised and
dissected. The tragedy that had changed Shepherd’s own life could be
viewed through the dispassionate eyes of the great Simpson, could be
analysed, understood and, perhaps, contained. There he found an
enduring passion and an approach that would guide him through his
career.

It was a stance that served him well early on, Shepherd says, “because I
could detach from the things other people found harder – going to
medical school, doing the anatomy dissections. It actually gave me a
benefit.”

Facing challenges such as these, the moments that can determine the
future course of your life, is like riding in the Grand National, he
continues, and approaching Becher’s Brook. “It’s big and it’s awful and
you’re hammering towards it and you know you can’t stop. When you
go over it, you look back and go: ‘That wasn’t too bad.’” After qualifying
as a doctor in 1977 and conducting his first postmortem three years
later, it was all too easy to think the psychological load that made these
obstacles so daunting had been left behind. “All the emotions involved
in postmortems are gone because I’ve done the first one.” He shakes his
head. “Wrong.”

In 1989, 51 people died when the Marchioness


struck a dredger on the Thames. Photograph:
Graham Turner/Guardian

While he prided himself on his ability to switch between mortuary and


home, from objective investigator to loving husband and father, his
marriage was beginning to show signs of strain, eventually collapsing in
2007. Although his wife would ask him to “show some emotion”, he
says, “I hadn’t realised that it was so tightly screwed down. I was
blocking the emotion that was bad, but I was also blocking the emotion
that was good.”

Cocooned in the embrace of his professional detachment, Shepherd


advanced from one case to another, first under the wing of the
flamboyant Iain West in Guy’s hospital at London Bridge and then in his
own department at St George’s Tooting. Alongside the large-scale
horror of disasters such as the Clapham rail crash in 1988 and the
sinking of the Marchioness the following year, a series of deaths in
custody saw Shepherd pushing for police officers to receive proper
training in methods of restraint, while a string of home-grown
experiments with the Sunday roast made him something of a specialist
in the more intimate tragedy of knife crime.

When a body is laid out on the mortuary slab, Shepherd says, it is often
difficult to tell whether an individual death will have a wider impact.
Take the example of Stephen Lawrence: “I hate to say this but,
pathologically, it was simple. As with many stab wounds, if it had been
a millimetre one way or the other, he could so easily just have ended up
in hospital for a couple of days. But he didn’t. What made it
complicated was the police investigation – or the lack of it.”

The cases that turn out to be important are the ones where relatives
refuse to take no for an answer, the ones that “show the glitches in
society”. “Society is made up of tectonic plates,” Shepherd says. “Every
now and then they have to move to keep society functioning, to take
the pressures out of it.”

One of the shifts he has witnessed


first-hand is the decline of respect
for authority figures. Just as cases
such as Stephen Lawrence have
reduced our confidence in the
police, our trust in doctors has
been eroded by the revelation that
a GP such as Harold Shipman
could kill more than 200 of his
patients. It’s quite right that
medical professionals should be
challenged, Shepherd says, but
“when you’re omnipotent and you
think you’re omnipotent and
everyone else thinks you’re
omnipotent, life is a hell of a lot
easier”.
Harold Shipman, the GP who killed more than 200
of his patients. Photograph: PA As doctors have gradually lost
their veneer of perfection,
appearances in court have become more of a trial, even for experienced
forensic pathologists. “We do all this incredible work, put together
these reports,” Shepherd says. “Then we stand up in court and some
barrister has a go at you and says: ‘You’re talking rubbish.’” When you
have given your heart and soul to a case and someone goes on the
attack, “that can be very painful”.

It is hard enough to imagine this robust, energetic figure wilting under a


barrister’s cross-examination, let alone being pursued to the brink of
suicide by images of decaying corpses. Two years on from his diagnosis
of PTSD, after both counselling and medication, Shepherd’s enthusiasm
for the mysteries of the human body has returned, his love of the
discipline he has made his life restored.

“I’ve been very lucky,” he says, “but there is this sting in the tail, it’s not
been absolutely plain sailing. I am human, after all – cutting up 23,000
dead bodies is not a normal thing to do. How can you do this? You have
to have a fundamental belief that, in the end, you are doing some good.”

As a qualified, professional man who thought he was able to cope with


anything that life could throw at him, Shepherd says it was important to
declare he had reached a point of crisis, that “this did happen and it was
bloody awful but, with treatment, I’m out the other side”. For anyone
with similar concerns, his advice is to “get help, get treatment and you
will go back to a normal life”. He remarried in 2008 and, after retiring
from the Home Office’s list of forensic pathologists in 2017, he
continues to take on cases referred by teams for the defence.

His experience of PTSD was important, he says, but it is not the defining
issue of his life. And that upbeat assessment owes nothing to the habits
of avoidance and repression that stretch back almost 60 years. “Having
gone through that, it has cracked open the carapace. It’s out and I’ve
learned, I hope,” he raps his knuckles on the wooden tabletop, “how to
deal with it.”

Unnatural Causes, by Dr Richard Shepherd, is published by Michael


Joseph.

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Topics
Forensic science
Autobiography and memoir
Biography books
Crime
features

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