14

Soon afterwards I found myself learning more about truth – although I was now in a very different situation. The prosecution team and I were entirely in accord over this case, and by the time we were in court we all felt confident that we had uncovered the truth.

It was another Sunday morning call-out. More guilt as Jen had to put aside her work to care for the children, meaning she would have to study through the night to make up for lost time. Jen must have asked herself why the dead seemed so much more important in our house than the living and, looking back, I don’t blame her. The children were older now and a little more independent, but conflicting demands were causing frequent clashes between their parents. However, our division of labour was clear-cut to me: as the breadwinner, my work had to take priority. Only now can I see from Jen’s point of view how frustrating this must have been and how much I must have infuriated her. After all, she wasn’t studying for studying’s sake but so that one day she would be a doctor and a joint contributor to household income. I entirely failed to appreciate that: I was so work-immersed and so focused on how to make our hectic lives functional that I couldn’t, or wouldn’t, understand her dissatisfaction.

I set off that sunny morning towards central London, feeling more excited than guilty. I adored my children and a Sunday spent looking after them would be many things: fun, demanding, tiring, fulfilling. But – and this now seems perverse and scarcely believable to me – those pleasures could not compete with the possible intellectual engagement of an interesting post-mortem. Yes, even though I was already a few years into the job, I still could not contain my excitement at each new case that came my way. The stardust that the pages of Keith Simpson’s book had sprinkled in my young eyes so long ago was still there. Let other hearts sink on nearing Westminster mortuary: mine beat faster as I thought of the situation, the story, the puzzle of the body awaiting me. And this was despite the fact that I knew the chances were, on a Sunday morning, that I’d be dealing yet again with the consequences of another Saturday night pub brawl.

Westminster mortuary is hidden behind the coroner’s court in Horseferry Road in central London, but these are not among that area’s famous buildings. In fact, tourists heading towards the Tate hardly notice the beautiful old red-brick court on the corner and they are completely unaware of the mortuary behind it. Like so many institutions of death, it is discreet enough to oblige those who don’t wish to be reminded of the inevitable.

In fact, the mortuary had then not long been rebuilt and was the most modern in the UK. Its public entrance was glassy, its lighting was bright, its offices spick and span and its areas for grieving relatives elegantly painted in pastel shades. But, despite all that glass and newness, arriving here on a weekend marked a transition. From family life back across the taboo, into a darker world where, albeit it with jolly staff and warm rooms, death is a way of life.

The smell of the mortuary, death’s perfume, in my nostrils, I greeted the small crowd waiting for me: the mortuary staff, a SOCO (scenes of crime officer), a young police constable and two detectives. There was also a police photographer who seemed often to be on call when I was and who was becoming a familiar face.

The kettle on, we went into the tiny staff tea room. It was empty on a Sunday. Detective Inspector Fox spoke first.

‘Now then, the deceased is a young bloke. Saturday night, a lot of booze, a bit of cannabis …’

So, it was a typical Sunday morning job after all. My heart sank. I’d rather be at home with the kids.

‘Had a bit of a run-in with …’

Not the first time I’d heard this one either. A knife, bottle, fist?

‘… his girlfriend, and …’

She’d knifed him then, almost certainly. The detective hesitated.

‘And so she strangled him.’

I stared at him. That was not the ending I’d expected. Female stranglers are extremely rare, almost non-existent. Looking back now, tens of thousands of post-mortems later, I believe there is no other female strangler in my files.

‘Has she confessed?’ I asked.

‘Turned up outside the police station in the middle of the night with blood, scratches, shirt torn, crying her eyes out. We called an ambulance. She said she’d had a fight with the boyfriend and thought she’d hurt him.’

‘How long before?’

‘Apparently only minutes. We rushed over there, no pulse, did everything we could, got him in the ambulance and kept trying but it was no good. When we told her he was dead she was … well, it was terrible.’

He looked upset. He’d obviously been in the Met a long time and I wondered why this case was affecting him so much.

‘I was interviewing her for hours and she never changed her story. Self-defence. And … well … she’s a sweet young thing.’

His colleague agreed. ‘Yeah. Theresa Lazenby, her name is. Nice little face. In tears most of the time.’

The detective inspector nodded. ‘Seems such a good kid, it’s hard to believe she could have … but he was trying to kill her and she had to save her own skin.’

I know how the living send out signals which are designed to appeal to our hearts. I know how easily I personally respond to these signals. The girlfriend’s remorse had clearly rubbed off on the detectives and, although she had confessed to a terrible crime, she had somehow won their sympathy. I felt relieved then that the dead can send out no such subtle appeals to our emotions. They can only tell the unadorned truth.

The mortuary assistant handed me a mug of tea and I threw it back and went to the lockers to put on my scrubs, apron and mortuary wellies. As we made our way from the public area to the busy, functional working area, the clangs and clatters of the trolleys grew loud and the smell increased. I glanced at the men around me. For the SOCO this was routine. And the detectives had seen it all before and were nonchalant, or at least keen to appear nonchalant. However, as we passed the bank of fridges and line of trolleys waiting by them, I could see that the young police officer was nervous. PC Northern had not eaten the biscuit the staff had given him with his tea and now his face was pale and hollow. Just before we went through the footbath into the room where forensic post-mortems take place, he blurted out, ‘It’s my first PM!’

By now my management of onlookers was improving. I could not forget my failure to alleviate the misery of the police officer at that first post-mortem: it seemed to me that he had picked up my tension and this had greatly added to his distress. Since then I had worked hard to appear relaxed. I remembered the Michael Ross post-mortem, where a superintendent had barely been able to control himself in front of very junior staff. After that, I had determined that, when I performed a post-mortem, no one should ever leave the mortuary traumatized.

My only weapon was communication.

‘When we look at a dead body,’ I told PC Northern, ‘we never forget that they were a person once, that there are grieving relatives, that the deceased and their family deserve respect. We’re going to help all of them today by trying to find out exactly what happened. We’re looking for evidence, we want to help the dead man tell us his story. It’s important for all the grieving people that we put aside our own feelings and do a good job for them. So, without uttering a word, the body we’re examining today will be our witness and our teacher.’

PC Northern nodded glumly.

I used the kindest, most reassuring tone I could muster. ‘Don’t worry, I’ll talk you through it. It won’t be nearly as bad as you think if I explain what I’m doing.’

The worldly wise detective sergeant said, ‘You get used to it.’

The detective inspector was determined to be macho: ‘Listen, the people in the fridges here are gone, not at home, lad. So just pull yourself together.’

We stepped into the brightly lit room where the body was lying naked, wrapped in a plastic sheet on a metal table.

‘He’s been ID-ed,’ said the SOCO as I opened the sheet.

‘What’s his name?’

He knew the name but he passed the question to the young policeman, who was glad to stop staring at the body and shuffle busily through his notes.

‘Er, Anthony Pearson. Aged, er, twenty-two.’

Anthony Pearson had a mop of blond hair and well-defined features. His eyes were shut. The dead usually look peaceful and without facial expression. Was there a hint of anger about him? Not because he had necessarily died angry but because, out of habit or bad luck, his features fell that way.

I thought then that he was mildly obese – but norms have changed so much that today I would simply describe him as stocky. There were large tattoos as well as bruises on both arms and old scars across his wrists that hinted at a troubled life. The much more recent incisions, defined by lines of blood running across his forearms, confirmed it. Defibrillation marks on his chest were evidence of the resuscitation attempts the officer had described.

Most noticeable of all was his neck. Beneath it the hospital sheet was heavily bloodstained. Across it was a thick, ragged line of blood that had dried after trickling from the side of his mouth.

I nodded to the police photographer, paparazzo to the dead. He lifted his large camera and organized the correct siting of the two large flash guns, the sort often seen outside film premieres. Snap–flash!

‘OK, that’s the whole body, Doc.’

‘Close-ups of the neck now, please,’ I said.

I was already taking notes on my pro-forma sheets. The ligature mark is a vital piece of evidence and, of course, it can indicate the type of material used. If the ligature is wire, electric cable, string or thin cord then the mark is clear-cut and deep with sharply defined edges. But this mark was highly irregular. Ragged, even. She must have used something soft. Fabric? Perhaps a scarf?

For the photographer’s next shot, I rapidly placed a ruler across Anthony’s throat so that the photos would confirm the measurements in my report. Snap–flash!

I made a note:

Contused and abraded irregular ligature mark across the front of the neck extending from the right angle of the jaw to 2cm lateral to the left angle of the jaw. Level with Adam’s apple. Deepest bruising either side of Adam’s apple …

I checked very carefully all around the neck wound for other relevant marks. I’d seen cases of strangulation where the line of the ligature was surrounded by scratches or bruises, indicating either that the victim was trying to pull the ligature off or, where the ligature mark overlay groups of bruises, that the assailant had attempted manual strangulation before grabbing the ligature. But there was nothing like that here.

‘She said she used his tie,’ the detective sergeant told me.

The inspector shook his head. He had said it before and he said it again: ‘She’s only a little slip of a thing.’

‘Tiny little girl,’ agreed the detective sergeant. ‘I suppose if your life’s in danger you somehow find the strength.’

I documented in detail the scarring of the wrists, the scratch marks on the back of the left arm and the defibrillation marks, measuring them and defining their location.

‘We’ll have the tattoos and the wrists, please,’ I told the photographer.

He took close-ups of the graphically illustrated tattoos: the cartoon character Top Cat and, on the right upper arm: LOVE. Below it, in larger letters, was HATE.

Since a relative had already identified Anthony, we didn’t need the tattoos for that purpose but routinely photographed them anyway. In those days before DNA evidence was used, many a body was identified by tattoos, particularly if early decomposition defied other means.

Although the ligature mark was so significant, I now checked for other indications to confirm Anthony had been asphyxiated. The first tell-tale sign was the redness of the skin on his face, caused by the obstruction of the thin and easily compressed veins in the neck. The arteries serving the brain are much wider and more resilient to pressure and so the blood can still enter the head through them – but, because the veins are obstructed during asphyxiation, it cannot return to the heart. However, the main indicator – whether asphyxiation is the result of choking, suffocation, strangling, or some other cause – is found in and around the eyes. Many, or even most, people develop multiple tiny pinpoints of blood on the conjunctivae, the inner lining of the eyelids, when asphyxiated. These are called petechial haemorrhages: similar pinpoint haemorrhages can also develop, rarely, when someone coughs or sneezes violently. They are less common in suffocation but almost everyone dying of strangulation will show them. As did Anthony. I held his eyes wide open with forceps so that the photographer could see them. Snap–flash!

I measured Anthony’s height (5’11”) and then turned him over so that his back could be photographed. There was a gasp from PC Northern. I felt ashamed for a moment that I’d forgotten him and my intention to steer him through this, but then, I hadn’t made a single cut yet. When I looked up, I saw he was staring at Anthony in horror.

‘Oh my God, she beat him black and blue!’

I shook my head.

‘No, no, that colouration is just one of the normal processes of death.’

He stared at me uncertainly.

‘It’s called hypostasis. Some people call it lividity. I know it looks like bruising and it can be really alarming the first time you see it. But it’s absolutely normal.’

I explained in some detail the science of hypostasis, how it is gravity’s pull over the red blood cells after death which creates such shocking purple areas. I also pointed out how forensically valuable it can be. Since the laws of gravity dictate that the staining always shows at the lowest point, it reveals the position the body has lain in after death. But, if the body has been moved to a different position, then an overlapping pattern, like a shadow, will tell the story. Hypostasis can be misleading though. Somebody dying face down, nose pressed into a blanket, will have a livid face with blanching around the nose and mouth: normal hypostasis. It is too easy to assume from this that suffocation has taken place, and I have known many a pathologist fall into this trap.

Now that Anthony lay on his front, I could minutely examine his neck below the hairline. There was no sign of any ligature mark here. Nothing. I called the photographer over to record this and then turned Anthony over again. Here was the mark, right across his throat, and only his throat.

Since I hadn’t made a cut yet, PC Northern might have been hoping that by some miracle I wouldn’t need to. He had been sufficiently interested in hypostasis to relax, or almost. Then I picked up my trusty PM40, large and heavy. Through my earliest years of performing post-mortems on sudden natural deaths, there had only been its little cousin, the scalpel. As I moved into forensics, the PM40, a knife specifically designed for post-mortems, with bigger, removable blades, had begun to dominate and by now it had long been every pathologist’s best friend.

Its handle slipped easily into my palm, its weight felt reassuringly familiar. Suddenly all chat ceased and the tension in the room was almost palpable. I heard PC Northern take a deep breath as if he expected it to be his last for some time. But for me, picking up the PM40 felt good, as though I were a conductor picking up his baton. The orchestra is about to play.

I made my usual first cut, straight down the middle of the chest.

I said, ‘We can all see that Anthony was strangled, and we have a statement to that effect, but I have to check that there wasn’t some other cause of death. A natural cause, perhaps. A heart problem, for example, or maybe he had a condition that might have made him especially vulnerable. I’ll have to examine all his organs to establish that. But first, of course, I’ll have to examine the injuries inside the neck, beneath the ligature mark.’

No response from PC Northern.

I carried on working, talking all the time.

‘The internal damage caused by strangling may not be very dramatic. Anthony was just twenty-two. At his age, the cartilage in the larynx and around the thyroid is still pliable. In older people, it becomes increasingly calcified and more brittle so it’s more likely to be broken during strangulation.’

PC Northern inclined his head in something like a nod. Or was he trying not to retch?

‘Strangling has interested pathologists for generations because nobody fully understands the mechanism that causes death,’ I continued. ‘It was once assumed that victims were asphyxiated. Even today most lay people probably think that constricting the neck simply cuts off the air supply. But we know that asphyxiation alone can’t always be the cause because some victims die very quickly from pressure on the neck. In fact, a few die almost instantly, giving no signs of classic asphyxia. And even those who do show those signs have generally died too quickly for lack of oxygen to be the sole cause.’

To my delight, PC Northern’s interest in this exceeded, for a few moments, his revulsion at it.

‘So how do they die?’ he asked weakly.

‘Well, we know that compression of the jugular vein – here in the neck – will increase venous pressure in the head to an unbearable extent – that’s what turns some victims blue. Pressure on the carotid arteries, here, means the victim will rapidly lose consciousness as blood supply to the brain is cut off. But strangling can also put pressure on the nerves of the neck, which then can affect the parasympathetic nervous system. This controls the bodily processes we don’t really think about, like digestion. One of the main nerves in this system is the vagal nerve and you can die instantly from neck pressure, which, via a complicated mechanism, instructs the vagal nerve to simply stop the heart beating. It’s a reflex reaction.’

‘Is that how Anthony died, then?’ asked the police officer, peering at the inside of Anthony’s neck.

‘His head and neck are congested and there are petechial haemorrhages in his eyes. That suggests asphyxia, or certainly not an instant death.’ I leaned over the body. ‘A very famous pathologist called Professor Keith Simpson records the example of a soldier at a dance who, lightly and affectionately, tweaked his partner’s neck – and then saw her fall down dead. He’d tweaked her parasympathetic nervous system. Ever since then, defendants in strangling cases have tried to argue that they had no intention to kill, they simply took hold of the victim’s throat, and the victim’s vagal reflex caused them to expire for almost no apparent reason.’

‘But Theresa Lazenby used a tie,’ one of the detectives pointed out, a little reluctantly I thought. How had she won over these hardnosed men so effectively?

‘Looking at the injury, I’d say she used the tie and held it there for quite a while,’ I confirmed. ‘So if that’s her defence, she’s on rocky ground.’

‘Her defence is that he was trying to kill her,’ said the detective.

‘Poor kid,’ agreed his colleague.

PC Northern, although not participating in this conversation, was still in the room and I’d like to think it was thanks to my reassuring patter that he’d managed to stay so long. He plunged outside only when the mortuary assistant arrived to cut the skull so that I could remove the brain. During this noisy procedure, in which a special saw is used, even the two experienced detectives looked away. Although the SOCO, for whom this was an everyday event, chatted with me over the roar of the saw, it was impossible not to acknowledge, at some deep, instinctive level, the smell of heated bone.

When I had finished the post-mortem, the police officers went back to the station to brief their colleagues and to sign off duty.

‘And I’ll tell you what we need after that. A pint. Or three. Fancy joining us at the Duck and Ball, Doc?’

I would have enjoyed seeing PC Northern come back to life with a pint but, of course, for Jen’s sake, I had to decline. So I headed south. But all the way I had a sense that something wasn’t right. I felt uncomfortable. It was like putting your shoes on the wrong feet or your shirt inside out. The Anthony Pearson case was nagging me. Something to do with the girlfriend who had confessed to killing him. Something the police officers had said about her. But whatever it was floated away like thistledown whenever I came close to grasping it. No doubt all would become clearer tomorrow when I wrote up the post-mortem report. And there was no time to think about it now, I could see my own front door. Portal of delusion.

I deluded myself that it was possible to detach my emotions totally from the evidence I daily encountered of man’s inhumanity to man. To feel nothing beyond scientific curiosity when confronted by death’s manifestation of the madness, the folly, the sadness, the hopelessness, the utter vulnerability of mankind. To be blokeish, the way my colleagues seemed to be. Invincible at work, untouched by the mortuary’s vanity fair laying bare all it means to be human, untroubled by any complexity in the concepts of right and wrong. And then, in another one of those Clark Kent moments, to walk through my own front door and turn back into the warm, loving, emotionally supportive, wholly engaged husband and father I thought I was underneath my work persona. So. Deep breath. Stop thinking about what Theresa Lazenby had done to Anthony Pearson and how. Just stop. Key. Door handle. Step. Smile. Be jovial. Ask questions. Cook. Smile. Read stories. Smile. Over supper, talk to Jen about her day, about the work she must do tonight. Don’t think about Anthony Pearson, that thin trickle of blood from the side of his mouth, the red, ragged line of the ligature. That’s OK then.

The next day at the hospital I took the post-mortem notes out of my briefcase. A smell – broken branches, winter woodland – briefly wafted out with them. The smell of the mortuary.

I handwrote my report for Pam to type. It concluded that Anthony Pearson had no natural illness and gave as cause of death ‘Ligature strangulation’. I noted that

the position and distribution of the bruising of the neck suggests that the assailant was behind the deceased while pressure was applied, and that the ligature was not crossed behind the neck.

I still could not decide what was bothering me about the case but once the report was submitted I quickly forgot about it. I assumed that the Crown Prosecution Service would be contacting me eventually to give evidence at the trial of Theresa Lazenby, and then I would get the file out and start thinking about it again. For the time being, I was too busy.