Dr Richard Shepherd on a career immersed in crisis, his unravelling and why Brits are so bad at death
August 27, 2021. Series 4. Episode 32
Dr Richard Shepherd (Dick) is an Expert Forensic Pathologist who has conducted over 20,000 post-mortems throughout his illustrious career. Many of these have been in the aftermath of some of the world’s most shocking disasters of recent times – including 9/11, the Clapham rail disaster, 7/7 and the death of Princess Diana.
But in 2016 Dick suddenly struggled to separate his work and homelife, something he’d always prided himself on being able to do. It started with a panic attack whilst flying a light aircraft over the town of his first high profile assignment, Hungerford. And it culminated with the simple chink of ice in his wife’s gin and tonic – the moment which, as he says, snapped his links with reality and sent him back to the mortuary at the Bali bombings.
Dick is brutally honest during our conversation, about his inability at that moment to carry on, and the dramatic unravelling that followed which led him to consider suicide. Thankfully, with the support of his wife, herself a doctor, and the help of counsellors, Dick made a full recovery and was able to return to his work. Now aged 69, his passion for pathology is as strong as ever.
Dick has written two insightful and brilliant books which I urge you to read before the summer ends. They provide a detailed account of what it is to be pathologist and the critical role it plays for us all. Including the ‘inconvenient truths found during a post-mortem’, as Dick puts it, that have ensured justice has been done and answers provided to those who have lost loved ones.
Richard’s Crisis Cures:
1. FLYING – It just has nothing to do with my day-to-day life. To climb into my little plane and take off into a blue sky over the coast to France for lunch. Intellectually it is interesting to learn but it’s the freedom and it is a very good clearer of minds.
2. MUSIC – I love music of all types. I’m very broad-church. If I’m very stressed it’s Marriage of Figaro and Cosi Fan Tutti – Mozart. When I’m a bit grumpier, it’s the other end of the spectrum – and there’s always, Pink Floyd – Another Brick in the Wall.
3. Reading – I’m not very good because I usually fall asleep. Holidays are when I read most. 100 years of solitude by Gabriel García Márquez. It’s a tremendous story – I can keep going back to it.
The Seven Ages of Death by Dr Richard Shepherd is published on September 2nd, available from: https://amzn.to/3dcVw8R
The Unnatural Causes tour is starting on October 5th – find events at: https://drrichardshepherd.com/events
Unnatural Causes – https://amzn.to/3QCilAF
Dick Shepherd is a man who has lived his professional life – over four decades, at the sharp end of some of Britain’s most dramatic and disturbing crises. His work has helped solve some of the worst individual crimes of modern times, including Harold Shipman and Robert Napper.
Whilst this interview is not for the faint hearted, I can tell you that it’s utterly compelling, largely because of the clarity and frankly at times, humour that Richard brings in telling his incredible story. Richard’s work and the breakdown it caused has given him a perspective that very few others have – on death of course but also what it is to survive crisis – both professionally and personally.
This is a conversation about crisis at its most visceral and therefore, meaningful. It’s one about death – but one ultimately, I found to be really life enhancing and I hope you do too.
Stream/Buy ‘Allies’ by Some Velvet Morning: https://ampl.ink/qp6bm
Some Velvet Morning Website: www.somevelvetmorning.co.uk
Host – Andy Coulson
Producer – Louise Difford
00:00:00.00 Intro music
00:00:19.04 Andy Coulson:
Hello and welcome to Crisis What Crisis? I’m Andy Coulson, former newspaper editor, Downing Street Director of Communications and one time inmate of HMP Belmarsh. Over the last six years I’ve put all of my experience, the good and the bad, to use as a strategic advisor to business leaders and I can tell you that the bad has been just as useful as the good. And that got me thinking that there are plenty of great podcasts out there where you can hear stories of success but there far fewer where you can benefit from the experiences of those whose lives have properly unravelled.
00:00:49.14 Andy Coulson:
So, on this podcast you’ll hear from the embattled and stoic, the shamed, courageous, ruined, damaged, unlucky and lucky survivors of crisis. All talking in the hope that they might serve as a useful guide to anyone facing down their own demons and challenges. Crisis What Crisis? is generously supported by Myndstream, a brilliant company who harness the power of music for personal wellbeing and improving human performance. Just search for Myndstream, that’s mind with a Y, on Spotify and you’ll find some great playlists.
00:01:21.06 Andy Coulson:
My guest today, for this bonus episode, is a man who has lived his professional life over four decades at the sharp end of some of Britain’s most dramatic and disturbing crises. In his role as a forensic pathologist, Dr Richard Shepherd has undertaken over twenty thousand post mortems and was fully immersed in the Hungerford mass murders, Marchioness disaster, 7/7, 9/11 and the Bali bombings. His work has helped solve some of the worst individual crimes of modern times including Harold Shipman and Robert Napper. His best-selling first book, Unnatural Causes, tells the story of his work and the toll it took on his own life leaving him deeply impacted by PTSD and a depression that almost drove him to suicide.
00:02:07.06 Andy Coulson:
So, this is not a conversation for the faint hearted but I can tell you it is utterly compelling largely because of the clarity and frankly, at times, humour that Richard brings in telling his incredible story. Richard’s work and the breakdown it caused has given him a perspective that very few others have on death, of course, but also on what it is to survive crisis both professionally and personally. This is a conversation about crisis at its most visceral and therefore meaningful. A conversation about death which I found to be rally life-enhancing and I hope you do too. My thanks to Richard for joining me and you’ll find links to his autobiography and his brilliant new book The Seven Ages of Death in our notes for this episode. If you enjoy it please give us a rating and a review on Apple Podcasts or reach out to us @crisiswhatcrisispodcast on Instagram and Facebook.
00:03:05.00 Andy Coulson:
Dr Richard Shepherd, Dick, welcome to Crisis What Crisis? And thanks so much for joining us.
00:03:10.23 Dr Richard Shepherd:
No, my pleasure.
00:03:12.20 Andy Coulson:
I’ve been so looking forward to chatting to you today. During the course of this podcast we’ve explored crisis from a range of different perspectives, if you like, people who’ve survived all manner of different types of crisis. But you’ve lived a professional life where every day, every professional day, you have been immersed in crisis. We’ll talk about, if we may, the impact that that’s had on you a bit later?
00:03:39.08 Dr Richard Shepherd:
00:03:39.13 Andy Coulson:
But reading your books, and they are utterly compelling, it’s hard not to draw the conclusion that part of you was, maybe part of you still is, addicted to crisis. Is that unfair?
00:03:54.22 Dr Richard Shepherd:
No, I’m very interested you choose that because now having written the second book and looked at it and I talk so much about solving puzzles. But on the other hand you could say resolving crises. And that’s, is it just the same side of a coin? Or is it two opposite sides of a coin? My life was spent going into crises, I mean small crises, domestic stabbings, road traffic accidents, sudden natural deaths. You know these are crises, they are so huge to the family but as a professional coming in you have to come in with a calm overview and do your best and try and resolve it as best as you can for that family. And that family is so much in crisis you have to do your bit to understand the medical side, I can’t do everything, I can do the medical side, and to take them through that and hopefully send them away better prepared for the grieving that they’re going to have to do. Yes, so there’s the personal crises but then you do things like World Trade Centre which are major international crises which are totally different.
00:05:11.02 Andy Coulson:
Yes this is the thing I’d like to start with really. Because you’ve been intimately involved with some of the biggest cases, disasters as you describe. Mass murders, terrorist attacks, individual cases of real horror. You’ve carried out more than twenty thousand post mortems. You’ve seen the absolute worst of what mankind is capable of and the impact it has, as you say, on those families that are left behind. Your job, I suppose, is to sort of learn from the dead, in a way, but what have you learned about the resilience of the living from those relatives that you describe, with whom you are sharing the worst moments of their lives?
00:05:52.12 Dr Richard Shepherd:
I think I’ve learnt that, as with so many things, that some people are phenomenally resilient and some people have an inability to cope with anything more in their lives. And sometimes it’s because when I’m talking to them this is the last of a whole series of events, unpredictable series of events and then suddenly there’s a death in the family and this just takes them beyond that pail. And I can really relate to that. But people are, when you’re talking to people about the death of their relative, I’m constantly trying to judge how much information they are wanting me to give them.
00:06:30.18 Dr Richard Shepherd:
Some people will want every little detail. Some people really want broad brushstrokes. But talking to relatives is, I see, very much part of my job and getting them to understand… sorry getting them, that sounds very hard, helping them to understand what has happened. Because I know, because my mum died when I was nine, she went into hospital, she never came home, nobody really told me about it, I never went to her funeral and it became a sort of gap in the family rather than something that was faced up and dealt with.
00:07:11.19 Dr Richard Shepherd:
And I’m conscious that that caused me real problems not having that understanding. And I don’t want other people to find themselves in that same position of guessing what might have happened. Because we know in medicine and I’m sure this is shown up again by psychology, if you leave people to guess they will always guess worst. They will never guess, oh it would have been a nice easy death, it would have been very gently, they wouldn’t have felt any pain, you know? It’s always, it would have been agonising and slow and terrible. And sometimes it is and that’s the truth and you have to face that. But often it’s not. And we can help them to get through to the reality because that’s the bedrock of their grieving.
00:08:01.02 Andy Coulson:
You mentioned the loss of your mum. You were nine, she died, I think from heart disease?
00:08:06.20 Dr Richard Shepherd:
Yes, that’s right.
00:08:08.03 Andy Coulson:
And you analyse that in a fascinating way in the book. It’s that loss but also you’re stumbling across Simpson’s Forensic Medicine as a child those two things kind of lead you towards pathology. Give me a little bit more of a flavour of why you chose that life when, as a medic, there were so many options open to you presumably?
00:08:45.13 Dr Richard Shepherd:
00:08:46.08 Andy Coulson:
Do you remember the kind of moment when you thought, you know what, actually yes, this is where I want to be? This is where I can make a difference.
00:08:54.15 Dr Richard Shepherd:
Well that moment was actually when I was thirteen, that moment was in the toilets at the Watford Boys’ Grammar School, when I first saw this book. And the first seven words of that book are, ‘What to do with a dead body.’ And from then, you know, goodness, I was hooked. Now, I think my dad was quite clever. He used this lever of me wanting to do this as the thing to get me to study and to work and to do O’levels and A’levels. But it was the thing that kept me focused when I was working to get the exams to get to medical school.
00:09:34.05 Dr Richard Shepherd:
But when I got to medical school it wasn’t a fixed entity because of course I came across all sorts of new things in medical school. Surgery, I came across. Actually the other thing that absolutely fascinated me was obstetrics and gynaecology. And here’s something very different and as a psychologist said, that’s really interesting because you spent a life dealing with the dead and yet the other alternative in your binary choice in your career is dealing with the birth and the start and the regeneration.
00:10:03.09 Dr Richard Shepherd:
So I tried all of these careers. Each time I came along we had attachments for two weeks, three weeks, six months whatever and I loved them all, some more than others. I never really got on with psychiatry I have to say, which is interesting, but I loved them all. But each time the pendulum swang back through forensic pathology and when it passed by the bells rang loudest.
00:10:30.18 Andy Coulson:
But there is that binary moment as well, isn’t there, with forensic pathology where the moment comes, when you are stood in front of a dead body and your job now is, you know, the scalpel is in your hand and your job is to start the analysis? And I suspect for that group of students who were thinking maybe, this is what I’m going to do, that’s the moment isn’t it? Where you discover actually whether or not you’re capable?
00:11:00.15 Dr Richard Shepherd:
Yes, that was quite a serious moment because as a young medical student you know it’s coming. It’s not sort of day one, it’s probably week two or three. And the tension is building and then you go into the room and you sit down and there’s lots of bodies prepared for the dissection covered in white sheets and it’s all there and then it’s up to you. And yeah, there’s a moment where you take a deep breath and you wonder whether you’re going to be able to do it. And I did. And in the end it wasn’t a problem. But are there not lots of points in life that we all have, different points, that actually you know you take a deep breath and you say yes I can do it or you say no thank you very much…
00:11:51.09 Andy Coulson:
But that is an extreme one though isn’t it?
00:11:54.13 Dr Richard Shepherd:
Yeah, I mean, handling and looking at and dissecting another human being does, I think take you into a different space in your mind and in the world because it is such a horrendously destructive thing to do and yet, it is so fascinating and exhilarating and stimulating at the same time.
00:12:22.09 Andy Coulson:
And so fundamentally important.
00:12:24.13 Dr Richard Shepherd:
Exactly. And it has to be done, or it had to be done then for medical practice to understand what was going on. So it was there but it was more than… a lot of people did it because they had to but I did it in the end because it was… We all have the same muscles in the same place supplied by the same nerves and the same arteries and veins. You know, how has this happened? It is just phenomenal.
00:12:50.24 Andy Coulson:
Yes, your fascination in it is, I can see it as I’m talking to you now, people listening to this can’t unfortunately see how much it means to you and how engaged you are in it. Look, quite early in your career, 1987, you were called to attend the scene of a mass murder in Hungerford. Michael Ryan had shot and killed sixteen people and indeed himself. Most of those people were going about their normal lives getting in and out of cars, mowing lawns etc. Nothing like that had ever happened, I think, in the UK before.
00:13:30.08 Dr Richard Shepherd:
00:13:31.04 Andy Coulson:
A real sense of horror that you suddenly find yourself immersed in, thrown into really. The town is shut down and you’re driven in to start your work. Tell us just a little bit about that day because you were witnessing something so visceral. How did you find your focus? That is the epitome of a scene of crisis, how did you find your focus? What’s the voice in your head saying at that moment?
00:14:03.11 Dr Richard Shepherd:
I think the voice in my head is saying this is such an important thing for Hungerford, the town. It was the first time we’d had a spree killer in the United Kingdom. Now, I’d been fortunate because I used to go to international meetings and sadly, as we know particularly around schools, they have lots of spree killers in the States. So I’d been able to talk to my American colleagues, my intentional colleagues. So I had some idea of how to manage these things, or how they managed them, and what might need to be done and how it might be managed in the UK. So in a sense I was prepared, that was part of my training and my peripheral experience.
00:14:52.18 Dr Richard Shepherd:
Now, I’d heard about Hungerford as I drove home in the car, it was on the news headlines. And then my pager went off, in the days before mobile phones and I knew the code for Thames Valley Police, so I knew it was them. Got home and was actually, after a quick phone call with Thames Valley to arrange to go to Hungerford that evening, I was straight into family life. We had two young kids of six and four, or whatever they were at that time, my wife was a medical student, I was involved in kids for two or three hours and maybe I think that was a good thing. Because that just took a little bit of the pressure off.
00:15:31.09 Dr Richard Shepherd:
The police didn’t want me early, they wanted me when things were settled, so there was no pressure there. So when the kids were in bed I was able to get into the car and drive out to Hungerford and that was a sort of two hour drive which is always good time for me, that settling time, that transition time from being a dad whose just read bedtime stories to a six year old and a four year old, to an expert forensic pathologist whose going to go into a town with thirteen or fourteen dead people that I was going to have to manage.
00:16:02.11 Dr Richard Shepherd:
Each case was unique, each case was individual, each case had to be managed properly. And you know…
00:16:09.08 Andy Coulson:
And there was also this suggestion that Ryan himself perhaps hadn’t killed himself. That indeed special forces somehow had got there first. So you’re tasked with establishing that fact as a fact. And you’re led into the classroom where his body is to analyse that.
00:16:33.06 Dr Richard Shepherd:
You know and everyone was trying to understand it on that day. But yeah, going into that room, his body was popped in the corner and the police quietly disappearing out of the door and shutting it, leaving me on my own, having told me that he might have a bomb on him, I felt was…
00:16:48.11 Andy Coulson:
Extraordinary. So tell me about that moment.
00:16:52.03 Dr Richard Shepherd:
00:16:53.03 Andy Coulson:
That moment, what’s in your head?
00:16:54.13 Dr Richard Shepherd:
Well, what’s in my head is this smells like a classroom in a school because classrooms in schools have a very particular chalk, sweat, I don’t know what it is… child… And my sense of smell was locked into that and then through that came the smell of discharge of a weapon and the slight smell of blood. And then it was focused down on Ryan, carefully walking across the room. I’m not sure what I’d have done if he’d have moved, I think I would probably have run out the door very fast. But it was focused on him. I could see the gun; I could see the gun in his lap. It hadn’t moved, I knew it hadn’t moved for the last four hours or so. So I wasn’t expecting him to suddenly lift it and fire it.
00:17:45.08 Dr Richard Shepherd:
But I had to look at him to understand where he had shot himself and how he had shot himself. And without moving him because of the possibility of there being a bomb on him. I was able to do that and then trace the entry on his right temple, because it had classic features of a burning that was typical of a gun and he had a gun in his right hand, exit wound in his left temple and then I could look across the classroom and in the noticeboard in the far side, embedded in someone’s bit of artwork, was the bullet that had gone across, through his head and across the classroom and embedded in there.
00:18:22.03 Dr Richard Shepherd:
So I was able to go out and say it’s a suicide, you can go and make that announcement now, there is no… they knew there was no involvement of special forces but he’s now been examined and that’s the case. And from there we had to manage his body because that was most important and then just work our way round the town, quickly assessing each one and making a decisions about how to recover the body back to the mortuary.
00:18:51.16 Andy Coulson:
Goodness. Thirty years later, or there or thereabouts as I understand it. You are flying your light aircraft, you love to fly, we’ll talk about that a little bit later as well, and you look down and you realise that you are flying over Hungerford. And you begin to unravel. First signs, it turns out, of a fairly slow moving but very definite breakdown.
00:19:26.14 Dr Richard Shepherd:
00:19:28.18 Andy Coulson:
You get a grip of yourself, obviously, you land your plane.
00:19:32.06 Dr Richard Shepherd:
Yeah, it’s not a good place to actually…
00:19:35.08 Andy Coulson:
Indeed, you sort of reflect on it but sort of bury again, as I understand it. But much later, it is the beginning but it is later that you begin to realise actually there’s something going on here that is a real problem for you. Can you talk to me a little bit about that process and that kind of realisation in the first instance?
00:19:59.20 Dr Richard Shepherd:
I mean, humans are infinitely able to deny the bloody obvious. Especially when it’s about themselves. You know, we all do it, we all know it, we all know we do it. And so having had that funny turn, very bizarre turn, never experienced anything like that before, landed, did my job, flew home again, sat down in the evening and just thought, oh I’m fine. There’s nothing to it. But, as you say, it had started the chain and it was, how long later, maybe month or two months later, there’d been a few ripples but nothing much. It was putting the ice from a supermarket bag of ice, and that’s crucial that it was from a supermarket bag of ice, into my wife’s gin and tonic, that chink of the ice was the thing that effectively just snapped the links with reality and I was just unable then to carry on.
00:21:02.14 Andy Coulson:
And that was the link to another scene, frankly, of horror that you’d been immersed in. And that was the Bali bombings.
00:21:09.18 Dr Richard Shepherd:
That was the link to the mortuary at the Bali Bombings where Bali was a very poor country and they didn’t have refrigeration, they couldn’t bring it in because it was containerised and there weren’t the containers. So they had just got bags of ice from the supermarket and they’d used those bags of ice to put on the bodies, on the ground. And it was that link, you know, people would say what’s it like seeing dead bodies, or injured bodies, or fragmented bodies? It wasn’t that, it was a bag of ice that actually was the key that split me and really took me completely away from myself and reality into a very distressing and unhappy place for quite a few weeks.
00:21:58.05 Andy Coulson:
And this was PTSD?
00:21:59.19 Dr Richard Shepherd:
This was PTSD yes.
00:22:02.07 Andy Coulson:
And were you diagnosed quite swiftly or were you resistant?
00:22:07.17 Dr Richard Shepherd:
No, I was very, very lucky in that my wife, who’s also a doctor, I’m afraid, as wives and good partners often do, if I can put it this way, took absolutely no crap at all. I was taken, if not the next day, then the day after, to a psychiatric emergency department and I was seen there and that team were just absolutely fantastic. I have such admiration for their skill and ability to manage me, to help my family and then to treat me and to help me through the really hyper-acute phase which lasted for a week or ten days. And then support me for the next few months afterwards.
00:22:56.00 Andy Coulson:
Can I ask you, if it’s not too insensitive, how dark did it get for you?
00:23:00.02 Dr Richard Shepherd:
Oh, immediately after that night with the ice cubes, I was thinking about how I was going to kill myself. And I knew how I was going to do it. And there were… one of the questions that is always asked is, ‘Have you thought about it?’ ‘Yes.’ ‘Have you made any plans?’ ‘Yes.’ ‘Have you actually planned to do it?’ ‘Yes I had’. And one of the absolutely brilliant mental health nurses who came round to see me every day for ten days or two weeks said, ‘You know the thing that scares me Dick, a lot of people talk about it but you actually know how to do it. You know you’ve seen it, you know what…’
00:23:43.10 Andy Coulson:
You’d planned? You’d started to make a plan?
00:23:45.16 Dr Richard Shepherd:
I had planned. I was well on the way and these guys, my wife and family wrapped themselves around me and helped me through that and then gave me the will to cope and to work through it and to talk about it and to discuss it. And you know, there was help from a great drug called Sertraline as well which was fantastically useful for me. So all of the modalities, you know, professional and personal came together and I was just so lucky. You know, if I hadn’t had them, if I, for whatever reason had been on my own or that support hadn’t been there, I’m sure I would have gone through with it. It was that clear and certain in my mind.
00:24:29.04 Andy Coulson:
What was the plan, if I can ask such an insensitive question?
00:24:33.03 Dr Richard Shepherd:
Well, my plan was to drive into a lorry coming in the opposite direction on a dual carriageway.
00:24:41.07 Andy Coulson:
Goodness. And in your state of mind at that time that was an entirely logical way to end your life?
00:24:50.13 Dr Richard Shepherd:
Absolutely. And you know, once again, these great mental health guys said, ‘What do you think that would do to the lorry driver?’
00:25:01.09 Andy Coulson:
00:25:01.11 Dr Richard Shepherd:
And suddenly they took it away from being my issue, it’s someone else’s. And that was you know, ah, they are just so fantastically clever these guys.
00:25:13.08 Andy Coulson:
Yes, yes. But I know also that there’s a, if I’ve understood the timing correctly there was also this issue, and I’m really interested in talking to you about the other aspect of your job which of course takes you into courtrooms frequently. The accumulation of your work, you know, the horrors as we’re beginning to discuss that you’d experienced, I assume had just built up over a long period of time. Along with just the day to day of your job in itself must have been so mentally challenging. But then, as I understand it, there was this extra layer as well. Your integrity was being questioned. A GMC enquiry, we should say very clearly, misplaced, wrong, you were totally exonerated but the process was a very long running one, eighteen months. So you’d done all this work and now your integrity is under question. I assume this was another layer of agony for you at that time?
00:26:10.02 Dr Richard Shepherd:
Yeah. It is something I think every doctor fears, is a GMC investigation. And we know that a significant number of doctors, it terminates their career because they simply can’t cope with the stress and strains. But for me it was another issue that was running along that had to be managed. And it takes away, you know, your self-esteem is so important and when someone is kicking away at that stool that’s underneath you it’s very, very hard to keep going.
00:26:45.18 Andy Coulson:
Yes. And the key message here is very obviously get the help. Spot the signs, get the help and society is not very good at training us to spot the signs is it? Because actually what we’re taught is, you know, suck it up. Particularly if it’s your job. Particularly for someone like yourself who is thrown into these situations. I know that you’ve got very strong views on the lack of support for colleagues. There’s one story that you mention in the book, which we’ll touch on very quickly, but in the aftermath of 9/11 you found yourself in New York working with American colleagues. One of those colleagues was so distressed by the process of identifying bodies and body parts, that she then wrote her name, every time she took flight, she would write her name on each of her limbs.
00:27:37.04 Dr Richard Shepherd:
00:27:36.22 Andy Coulson:
…in case the plane crashed and in case her, you know… I mean that is just… if that’s not, I mean, your story of course is, but sitting alongside that the idea that someone would be driven to that kind of logic, if you like.
00:27:52.05 Dr Richard Shepherd:
I mean, 9/11 changed so many people’s lives. I mean, I’m very pleased… that lady stopped flying, not surprisingly for quite a while but is now back. You know, she sought help, got help and now manages it. But for so many of us that was… a bit like Hungerford in the UK, 9/11 was something that no one had seen before. How do you manage 3.000 deaths and 27,000 fragments of humans that you’ve got to try and somehow fit back together? I mean, we have to manage the process, it’s our job. But sometimes, you know, you have to accept that you’ve got to have the back up and the support and that’s what’s frustrated me in the UK that I’ve not been able to convince the powers that be that pathologists should have that.
00:28:51.05 Dr Richard Shepherd:
And the reason, very quickly, is that we are nine tenths self-employed. So nine tenths of the pathologists, forensic pathologists in the United Kingdom are self-employed. So we have no employer and therefore there is no responsibility for them to support us. And that’s where the Home Office dives out of the door and says, ‘Well we don’t employ you; we just regulate you. Therefore we do not have to provide you with this support.’
00:29:19.01 Andy Coulson:
Goodness, that’s a campaign that needs to be run.
00:29:22.01 Dr Richard Shepherd:
Well, it’s running, we’re working on it. Some great, lovely colleagues up in Glasgow have done some research with the psychology department up there. There’s a lot of support for it to happen but you won’t be surprised to hear that the bottom line is money.
00:29:41.17 Andy Coulson:
The politics of pathology have changed over the course of your career as well. Funding, much more difficult now for forensic pathology research. Also you mentioned in your book the ability for proper consultation among experts before a prosecution or a trial. The fact that there’s so little time, no time in fact, now spent in really trying to establish the facts before CPS make their decision or a trial gets underway. So that’s a big shift and a damaging one, isn’t it?
00:30:18.00 Dr Richard Shepherd:
Well, remember it used to be the police that would make the decisions, initially, to charge and then the CPS would come along and try and sweep everything together afterwards. They’ve tried to make it a more logical process and I do think that when it first happened lots of enthusiasm was present. There was great enthusiasm within the lawyers to join the CPS to get involved in this. And then they’ve run into a bureaucratic swamp as all these big departments do. There’s paperwork and there’s documents and there’s pressure and there’s not enough staff and this, that and the other. And the process bogs down.
00:31:05.23 Dr Richard Shepherd:
So at first the change was good but slowly, slowly it slid into this morass where it’s just taking too long. But the immediate response to can the experts talk, and I’m talking about experts for the defence and the prosecution, now we should be able to talk together, the law says we can talk together, why won’t you let us? Because they, well, they feel it can be done later. And as a result, really good decisions are sometimes delayed until so late on that people waiting to stand trial who probably shouldn’t do, don’t hear for months and months that in fact there’s no evidence to support their prosecution and the case faults.
00:31:53.20 Andy Coulson:
00:31:54.05 Dr Richard Shepherd:
It happens, not just in medicine, you know, it happens throughout the legal system and the wheels have to turn. But they do really need to start turning more efficiently.
00:32:03.10 Andy Coulson:
Yes and not least, we touched on mental health earlier, but the impact that that can have on people’s mental health is pretty terrible.
00:32:09.08 Dr Richard Shepherd:
Absolutely. It rips people apart.
00:32:12.21 Andy Coulson:
Indeed, but a huge part of your job is in court itself, you know, giving evidence for the prosecution or for the defence. You talk brilliantly about how quite often these big cases are subject to all kinds of, as in any situation that involves human beings, is subject to all kinds of game play. You know egos, agendas. And the pathologist is often the person stuck right in the middle and under attack.
00:32:40.06 Dr Richard Shepherd:
00:32:40.22 Andy Coulson:
Quite often, I understand, you don’t even get given the verdict at the end of the case. You have to go and find that out for yourself.
00:32:50.07 Dr Richard Shepherd:
00:32:51.01 Andy Coulson:
I mean that is a, sorry to interrupt you, that is a… on one case you could say, well that’s just a day at work. It’s not just a day at work. That’s you in a witness box under attack. It’s a real mini-moment of crisis. How did you cope with those moments?
00:33:09.15 Dr Richard Shepherd:
Well I think in a sense because they are a bit… I always say it’s a bit like entering a dance competition. You know, you sort of know the moves but you’re not quite sure whether you’re going to do a tango or a foxtrot. So you have to wait and listen to the mood music start up and then you go, oh right, okay we’re into a foxtrot here, this is nice and slow. And then, of course that barrister sits down and the next one is playing a tango or something faster.
00:33:41.05 Dr Richard Shepherd:
You know, the legal system in this country has so many good bits about it but so many bits that really are jarring. And it is hard to stand in a witness box and be challenged by someone who actually has no particular knowledge and who you are pretty certain has not been advised to ask you the questions that they are asking you but they’re just, in a sense, taking them off the shelf as standard, not quite, but you know, ‘my client wasn’t there so how can you prove he was?’ That’s sort of question. And as a pathologist you have to smile sweetly. If experts lose their rag in the witness box the barristers know that they have won.
00:34:30.13 Andy Coulson:
It’s more than that though, isn’t it? Because you’re not someone who is being brought in to analyse the direction of a bullet as perhaps some forensic experts would. You’re also the guy who may well have been holding the knife over the body of the victim and who has, spent some time with that body trying to fully understand what on earth happened. A, just to make sure that the truth is discovered, that justice is brought to bear but also, as you said earlier, for the family. So it’s a much more personal thing for you, isn’t it? When your judgement is being questioned in that way?
00:35:13.21 Dr Richard Shepherd:
Yes, I mean, I think because we’re used to the adversarial system, we’re used to a colleague giving evidence and saying, ‘Well, yeah, we both agree that so and so was stabbed twice but I think this was a really unfortunate accident whereas he thinks it was clearly a murder.’ So I’m used to that sort of challenge. And you’re quite happy in a sense, to deal with it. If you’re a good professional you will have thought of all of the possible arguments before you even complete your report. And they should have been dealt with in your report before it’s sent in. But we’re used to the challenge because that is how the adversarial system works. But it can sort of be done nicely and not nicely, if I can put it that way. And I would have to say that the harder I’m kicked, the more firm and more resilient I think I become.
00:36:15.19 Andy Coulson:
Yeah, it’s just this idea that you’ve spent so much of your time, not to be morbid about it, but that is the fact of your job, dealing with the dead, learning from the dead, as I mentioned earlier. But then having to switch to the nonsense of the living. You know, all that sort of career driven, game playing superficial, self-centredness… all that sort of nonsense.
00:36:41.02 Dr Richard Shepherd:
00:36:41.05 Andy Coulson:
To be able to switch between those two things is another skill.
00:36:45.15 Dr Richard Shepherd:
It is and because the games that are being played. And I don’t know if you’ve read the book, The Secret Barrister or whether you’ve interviewed him, her or whoever.
00:36:57.00 Andy Coulson:
00:36:58.15 Dr Richard Shepherd:
But I thought it was a fantastic book. There’s also another book called The Devil’s Advocate written by a High Court Judge that basically says, ‘listen the law is not there to find the truth and if you think it’s there to find the truth don’t do law. It is there to tell a story. Your job as a barrister is to tell a story. And we’ve put two stories in front of the jury and we let them decide.’ Now, it works pretty well most of the time but not…
00:37:28.08 Andy Coulson:
It’s the best system we’ve found so far.
00:37:30.05 Dr Richard Shepherd:
Well, yes I think it probably is. But we all have to accept it is not perfect, it is not perfect and there is no doubt that it gets it wrong. But so my job is to not look at the barristers and one of the things I learnt very early on from a very difficult barrister is never to look at them. I never, ever look at the barrister, I look at the jury because the jury are the important people in court.
00:37:58.10 Andy Coulson:
Yes, indeed. This fight for the truth, though, goes to the absolute core of what your job is all about, right? I mean, that’s really what you are, that’s what you’re doing. And there have been cases where it’s your fight for the truth, it’s your stubbornness and determination to stick with what you believe to be the correct version of the truth that has brought some astonishing moments. I mean, you have, on a number of occasions, been the embodiment of the inconvenient truth in the room, running against preconceived ideas of the police and others. Can we talk about, there’s a case in your new book about the young man who dies of a head injury after falling off a wall?
00:38:46.02 Dr Richard Shepherd:
00:38:46.07 Andy Coulson:
Could you just talk us through that example because I think it captures that idea of you running against the grain.
00:38:55.13 Dr Richard Shepherd:
Yes, I mean, very quickly the new book looks at life and death through the seven ages. So I’m looking at people who’ve died from unnatural causes and natural causes and each of those things. This, we’re looking at a man who if I remember correctly is in his twenties, something like that, worked in the City, just become a new dad, everything really going for him. And he went out with his brother and some mates one night, had a few jars and they ended up doing parkour. Now, I have to say I didn’t know what parkour was until this. But this is this… you saw it at the beginning of a James Bond film and if I was clever I’d tell you which Bond film, but they just run over buildings. Up buildings, down buildings, across rooves. Stunning, amazing stuff but not for the faint hearted. Anyway, he falls off the wall, fractures his skull and dies.
00:39:49.22 Dr Richard Shepherd:
Tragic accident except that people say that his brother who was running behind him, pushed him off the wall. So we have a potential murder. And so we have a brother in the cells and we have one brother in the mortuary. And it was one of those cases where the more I did the post mortem the more I felt that something was wrong. You know there is that… I talk about examinations and post mortems essentially involving all five senses but they also involve that little bit of something at the back of your mind. That little niggle that says, mmm what’s wrong here?
00:40:34.23 Dr Richard Shepherd:
And in the end the key to this case was his legs. His calves were of different sizes. And it was one of those, why are these legs, what’s wrong with his legs? And the police were just saying, ‘Well clearly his brother pushed him off, they’ve got lots of background of niggles between the two brothers.’ The bottom line is that the niggle, niggle, niggle… we went off and we did some more extra research and we showed that this lad was suffering from a muscular dystrophy, a congenitally inherited disease which, when we looked back at his life, it was beginning to affect him. He was losing his ability at the football team. He’d been dropped from the team. You know, he probably knew his legs weren’t as good as they once were.
00:41:27.23 Andy Coulson:
00:41:29.08 Dr Richard Shepherd:
And that gave a very, very…
00:41:31.13 Andy Coulson:
Where did that come from though, from your perspective? A body is brought in whose clearly fallen off a wall and fractured his skull. What leads you to think, oh I wonder if it’s…?
00:41:42.06 Dr Richard Shepherd:
Well, I won’t claim that I thought it was muscular dystrophy that night but what I knew was that his legs were odd. And you know, so much of pathology is that little bell tinkling at the back your mind going, that’s not right, that’s not quite right, why’s that not quite right. What else is wrong? And then the next day I went along and talked to colleagues in the hospital and said, ‘What do you think?’ And they won’t ‘Well, let’s do these tests and let’s check this and let’s check that’. But of course it opened up a whole can of worms for that family because it’s an inherited disease.
00:42:18.02 Andy Coulson:
Right, I see. So on the one hand it kind of resolved what would have been a terrible emotional trauma, the idea that one brother would kill another. There was another element to this as well, as I understand it, that you got to the truth thanks to a sort to £600 test in the event. And that was a £600 test, as I understand it, that the system, let’s not pick out individuals, but that the system were pretty resistant about paying. ‘Don’t be ridiculous this guy’s been pushed off a wall, why on earth would we spend six hundred quid?’ And that is fascinating to me that someone’s freedom really, can come down to one test in that way.
00:42:58.09 Dr Richard Shepherd:
Yeah, well in this case it certainly did. And we would have got to doing this test because I knew where I had to get to. We had to do this test one way or another. Now, I would have to say when I go back to the start of my career, you know, the holistic approach to the health service was much greater. You know, post Thatcher we’re now in who pays for it? There’s a cost. Who’s going to pay for it? And if you’re not going to pay for it we’re not going to do it. Now, I don’t want to go down that political line but there was a time when I simply would have gone to the lab and said, ‘I think it might be this, could you do the tests to help me?’ We’ve lost that smooth professional to professional flow.
00:43:47.22 Andy Coulson:
And the net result is that we have a system that is less reliable. I guess what I’m really doing here is making the case for the fundamental importance of what you do for a living and what your colleagues do for a living because you are the people who are driving to get to the truth. And not by the way to get to the truth of some case involving financial impropriety or whatever, you’re trying to get to the truth of what happened to someone who might have been murdered.
00:44:19.02 Dr Richard Shepherd:
Yeah. That’s certainly true, I mean, the key thing here was that we would have got there but it would have been another six or nine months maybe. We were able to get it done quicker and get the brother released and start talking to the family much faster than would have happened otherwise. But it’s true of every death. You know, one of my colleagues says, ‘Do you want a cause of death or do you want the cause of death?’ Now, a lot of people say, ‘Just do it please, it’s so disgusting what you do, just give me a cause of death and we can tuck it all under the carpet and move on.’ But so much depends on getting it right and getting the right thing. Even if it’s hard for the family and I’m sorry that it often has been, it is important that we pick up the fact that this guy has been using Spice. You know, it really is relevant. And you don’t like it but society has got to know what’s going on.
00:45:16.23 Andy Coulson:
Because how else do you move forward? Tell us how you’d cope day to day in a mortuary? It’s your place of work so cope is probably the wrong word. But it’s a true centre of crisis. How are those brilliant people that you work with handling those situations day to day? I suspect, we often hear on this podcast how important humour is…
00:45:41.15 Dr Richard Shepherd:
Yes, it is.
00:45:43.06 Andy Coulson:
I suspect, even for you guys, that in an environment that I know is completely covered in respect and governed by respect for the work that you do but humour must have its place.
00:45:56.16 Dr Richard Shepherd:
Oh, absolutely. I mean, we have what’s called a dirty side and a clean side. And between the two is some changing rooms where you get into your scrubs and you put on your wellies and you go through, we call it the horse dip, the sheep dip, you have to paddle through a pond of disinfectant water. and that’s really the divide. So when we’re on clean side, when we’re outside, things are much more relaxed. I mean, people will talk about golf, they’ll talk about their families, they’ll talk about girlfriends, you know, there is laughter. And most importantly there are cups of tea and chocolate biscuits, I mean that is the thing that makes the world go round.
00:46:36.13 Andy Coulson:
00:46:36.15 Dr Richard Shepherd:
There is no doubt, no doubt about it.
00:46:37.17 Andy Coulson:
The greatest crisis cure.
00:46:39.15 Dr Richard Shepherd:
Absolutely. And really good friends and colleagues, you know, that’s the other thing. I can think of some really, really fantastic people who are just tremendous at the work that they do day after day after day managing bereaved relatives, helping the bereaved relatives and talking to the bereaved relatives, absolutely fantastic. And then we cross over to the dirty side and really the professional shields come up, literally, you know, with Covid all the gowns and the masks and whatever.
00:47:15.03 Dr Richard Shepherd:
Health and safety is critical but so is mind health and safety and helping people and watching your colleagues to make sure they’re not suffering. Generally, I’m afraid, sadness is there, bereavement suites are there, but for us it’s a place of work you know? And we are there to do a job, to do a job to the best of our ability with respect but it is the job, it is looking and solving puzzles that we do on our side.
00:47:43.05 Andy Coulson:
Yes, and the detachment is obviously critical for you. But as you’ve already explained with implications for your own health and for the health of your colleagues. But talking about it in the way that you’ve done, obviously, with your books but I know you’re going on tour soon as well to give your perspective on this on your life but also on the broader challenge of pathology. Do you see the tour as therapeutic? Do you find talking about it is therapeutic?
00:48:23.09 Dr Richard Shepherd:
I think it’s so important that people do talk about death. Now, so often now I hear the use of the word passed. ‘He’s passed’, now, I don’t say that’s wrong but I think it’s just hiding what’s happened. I guess it’s a shortening of passed on and it seems to me to be slightly American, that seems to be the phraseology that I’m hearing from across the pond. But what’s wrong with saying someone’s died? You know? They haven’t done anything wrong, you know. Not by dying they haven’t done anything wrong. So why are we hiding it?
00:49:05.00 Dr Richard Shepherd:
And then we sort of hide the process and we hide away from it. And talking to people whose relatives have died seems to be becoming a harder process as well because we don’t do it very often, thank goodness. Although Covid has changed that, it’s changed everything, everything has been stood on its head. You know not being with your relatives when they die. Few people at funerals, the whole process of a celebration of a life has altered. But even before that it had. I felt that there was this, is this the right word, a dumbing down of death? You know, it’s just hiding it away, we don’t want to talk about it, oh terrible.
00:49:45.12 Andy Coulson:
I am in total agreement with you. And you see that, it’s really interesting, you see that as getting worse actually. Because in so many other ways, our emotions are more public than they’ve ever been and social media is kind of driving that with everyone has to tell everyone what they’re thinking and feeling at any moment. And in your book you refer to Facebook as the devil’s window. I think you’re quoting someone else but I love that.
00:50:12.15 Dr Richard Shepherd:
The police call it the devil’s window because…
00:50:17.07 Andy Coulson:
But your analysis though, is despite that, actually under the surface, we’re not talking about the things that matter, we’re not actually kind of being grown up about death and being celebratory, when appropriate of course, it’s not always appropriate is it?
00:50:36.16 Dr Richard Shepherd:
I mean, death of anyone is an awful event but it is an event that we are all going to have to suffer, of our relatives, but suffer also ourselves. So it shouldn’t be seen as a failure. It is sad when someone is no longer there to hold your hand, to chat about the news, to exchange stores. That’s sad. But they’ve had a life.
00:51:02.18 Andy Coulson:
Let’s talk quickly about the sort of changes that you’ve seen form a human perspective during the course of your career, you know, the bodies that you see now are now more ornate, I suspect, than ever before, thanks to the tattoo industry. I assume you’ve noticed the rise in obesity is very marked and clear.
00:51:24.00 Dr Richard Shepherd:
00:51:25.09 Andy Coulson:
Yeah, what else?
00:51:28.01 Dr Richard Shepherd:
I think obesity is the thing that is the most striking and tattoos are now almost so ubiquitous. To see someone without a tattoo almost brings notice whereas before having tattoos did so. They’re also a point of interest sometimes at the post mortem when the tattoos… it’s almost as if the girlfriends have been changed. The tattoo has been done and the one above has been obliterated above as they move down the girlfriends. So it’s a social marker. I don’t have any tattoos. I wouldn’t want a tattoo because I know in thirty years’ time they will be rather grey and wishy-washy and not very pleasant. But that’s my choice, others go a different way. I think the other things are the piercings and the body art and the decorations and the augmentations of bodies. You know, all of these things change.
00:52:35.02 Andy Coulson:
And the causes of deaths, obviously during the time of your career, one imagines a significant uptick in deaths as a result of drug abuse.
00:52:48.15 Dr Richard Shepherd:
Yes, sadly it’s just the drugs that change it seems. You know, when I started out there were barbiturates. Then there was Distalgesic and now we’re into the opiates and the synthetic cannabinoids, the spice type drugs. The sad thing, there is nothing I think sadder than seeing a young twenty year old, eighteen year old, twenty year old, twenty-five year old dead because they took drugs. And life is and can be very hard. But you know one sense is that this is an utter tragedy for them and their family. And it benefits… I don’t know how society is going to manage that because too many people benefit from it.
00:53:41.19 Andy Coulson:
Yeah, more positively? As we come to the end of the conversation, what positive trends do you see for us as human beings, as someone who is there absolutely at the frontline, to be able to judge it?
00:54:04.16 Dr Richard Shepherd:
Well I think I was getting more optimistic until we had Covid and then Covid has dampened that optimism considerably because it has clearly shifted the whole of medicine throughout the world in a way that is going to affect our children and probably our children’s children. And so there is that concern. Sorry, I will try and get to a positive.
00:54:30.06 Andy Coulson:
I’m going to drag you, kicking and screaming.
00:54:33.20 Dr Richard Shepherd:
But when I look at the surgical procedures that can be performed now, life-saving procedures once again, just jumping back to my mum with her heart disease. If she could have had a valve replacement back then. They hadn’t been invented so it wasn’t as though they were there and she couldn’t have it, they had not been invented until five or six years after she died. She would have gone on to live a longer life. She wouldn’t have lived until she was ninety, I’m sure, but she would have gone on and lived a much longer life.
00:55:05.00 Dr Richard Shepherd:
And the medical and the surgical procedures and treatments that we have now, the increasing knowledge that people have about their own bodies. A lot of people ignore it but people are taking notice about diet and about exercise and things of that sort. And that’s got to be a good thing. But I’m afraid the death rates just keep rising and it is sad that so many people don’t feel there is any benefit in taking care and looking after and cherishing themselves and their families. And I think that’s very sad.
00:55:45.17 Andy Coulson:
00:55:46.19 Dr Richard Shepherd:
That was he uptick was it? I’m sorry.
00:55:49.07 Andy Coulson:
That was the attempted uptick. Dick, before we move on to your crisis cures, I just want to say thank you really for your time today but also for the work that you do. You know, we’ve touched on it in this conversation but it’s not just a case that someone’s got to do it, it’s not that at all, is it? It’s absolutely fundamental to us all that this work continues in the way that you’ve been doing for so many years. It’s the toughest of jobs but thank god that there are people like you who do it.
00:56:27.10 Dr Richard Shepherd:
Thank you for your thanks but I am so lucky to have had a career that I discovered when I was thirteen and I am now sixty-nine and I have thoroughly enjoyed, not every moment of it, but it has been a very fulfilling, exciting and satisfying career.
00:56:49.05 Andy Coulson:
Good, let’s talk about your crisis cures. So these are three things that you’ve leaned on during tough times in your life. Let’s start with the one that we touched on earlier because I know that flying, for you, is incredibly important. Tell me why?
00:57:09.21 Dr Richard Shepherd:
It’s so different, it’s got nothing to do with my day to day life. To climb into my little plane, it’s one that I share, I don’t own one myself, I belong to a group and we share the costs and the expenses and the fun. But just to climb into that and to be able to take off into a blue sky and fly down the coast of England. To fly over to France, go and have a meal in a cafe in a French restaurant in the evening and then fly back the next day, it is intellectually quite interesting because there’s lots of stuff you have to read and to do and take exams in, so I suppose there is that bit that ticks it. But it is the freedom, it is the fact that I can get in and I can go off and I can enjoy myself and have…
00:58:05.00 Andy Coulson:
You can’t think about anything else?
00:58:07.05 Dr Richard Shepherd:
No, actually it is a very good clearer of mind actually, it really is. You know, when you take off and you think oh, I’ve got to get this thing back down on the ground somehow so it’s important.
00:58:18.05 Andy Coulson:
Yeah, okay, give me your second crisis cure please?
00:58:22.10 Dr Richard Shepherd:
Music I think is where I go to. I love music, I love music of all types. I’m very broad church but if I’m very stressed I do like a couple of the Mozart operas Marriage of Figaro and Così fan tutte but there’s a particular song that I love from Così fan tutte, just the end of Act 1, I mean the story I just think is tremendously typically Mozartian but when the people are going off and it’s May the winds be gentle. And it’s the most beautiful bit of music and I’ve seen it performed lots of times. I saw the Jonathan Miller production of Così fan tutte in Seattle. I mean, I don’t often drop names but it was one of those moments, really it just filled my life, it was just tremendous. At the other end of the spectrum is when I’m a bit grumpier and I need just a bit of winding up then there’s always Brick in the Wall by Pink Floyd which really, really gets me going.
00:59:23.24 Andy Coulson:
Very good, you have one more.
00:59:28.05 Dr Richard Shepherd:
Reading, I’m not very good at reading partly because I usually fall asleep. So apologies for the time that I read but I love the book One Hundred Years of Solitude by Gabriel García Márquez. It is a fabulous book, conceptually and the way it’s written and put together. Following this family over seven generations through a hundred years it’s just a tremendous story that’s always taken me page turning from one to the next. The stories of this family are so utterly wonderful and I can keep going back to that book and finding such interest. Not a lot of forensic interest, I have to say, some of the books I enjoy the forensic interest. But this one is just a fantastic story brilliantly told.
01:00:20.19 Andy Coulson:
Superb. Dick, thank you so much for your time today.
01:00:25.23 Dr Richard Shepherd:
Not at all, my pleasure.
01:00:26.05 Andy Coulson:
It’s been a fascinating conversation and as I say I can’t thank you enough for your time, can’t thank you enough for your work.
01:00:33.01 Dr Richard Shepherd:
Well, thank you Andy, it’s been a great pleasure talking to you.
01:00:59.19 End of transcription