The Cradle in the Grave (17 page)

It's one of the staples of fiction: the doctor with the God complex, conceited enough to imagine he can draw a murder to the police's attention, explain how it was committed (injection of potassium between the toes) and still elude detection as the culprit. He never does, for that would deprive the lead sleuth of the opportunity to say, ‘You've developed a God complex, doctor. You get a kick out of choosing who lives and who dies.'

In fiction, it makes for another predictable evening in front of the television. In real life, it's considerably more frightening. Harold Shipman, the GP who murdered hundreds of his patients, died without admitting his guilt or offering any explanation for his crimes. He was a contemporary bogeyman, an unassuming monster who moved among ordinary people undetected, passing himself off as one of them.

Following hot on his heels in the monster stakes is Dr Judith Duffy. Last week [adjust if necessary] Dr Duffy was struck off after a GMC hearing found her guilty of misconduct. Despite never having murdered anybody, Dr Duffy was responsible for ruining the lives of dozens of innocent women whose only crime was to be in the wrong place at the wrong time when a child died: Helen Yardley, Lorna Keast, Joanne Bew, Sarah Jaggard, Dorne Llewellyn . . . the list goes on and on.

Here's a horror story to rival the most terrifying tale any author of penny-dreadfuls could dream up. Dr Duffy doesn't make an appearance until later, but bear with me. In August 1998, Ray (Rachel) Hines, a middle-class physiotherapist from Notting Hill, London, gave birth to a baby girl, Marcella. Ray's husband Angus, who works for
London on Sunday
, saw no need to amend his lifestyle. He continued to work long hours and go out drinking with colleagues; meanwhile Ray, having temporarily given up the work she loved in order to stay at home with a baby who never slept for more than an hour at a time, became progressively more exhausted. So far, so familiar. Mothers everywhere will be nodding as they read this, muttering rude comments about men under their breath.

Most women believe themselves to be the equals of their male partners until the advent of the first baby, at which point most – even in this day and age, astonishingly – accept that the days of equality are over. The men continue to go out into the world, and come home insisting they need a good night's sleep in order to perform well the next day. The trouble is, there's a baby to be looked after, so someone has to put their career on hold, if not abandon it altogether. Someone has to summon up the energy, after a punishing day without a break, to cook, clean and iron. Someone must relinquish their freedom and identity for the greater good of the family unit. Those someones are invariably women.

This is what happened to Ray Hines, but fortunately for Ray, or perhaps unfortunately, she is not most women. Having had the privilege of meeting her more than once, I can tell you that Ray is exceptional. Before tragedy and injustice devastated her life, Ray was one of the UK's most successful businesswomen, co-founder of the marketleading PhysioFit franchise. I once asked her to tell me how this came about. She said, ‘I had a bad back as a teenager'. Referred to an incompetent physiotherapist who sat reading a magazine while Ray walked on a machine, Ray decided to do something about the standard of physiotherapy provision in the UK and made a career out of it. That's the sort of woman she is. Most of us would have asked our GPs to refer us to a better physiotherapist, and left it at that.

Ray decided she wasn't willing to be the sacrificial lamb of the family. When Marcella was two weeks old, Ray left home without telling Angus where she was going. For nine days, she stayed away, phoning home regularly but refusing to say where she was or when she'd be back. Her hope was that when she returned, Angus – who would presumably be struggling to cope alone – would have realised the error of his ways, enabling the couple to go forward on a more equal footing.

No such luck. Ray came back to find Angus's mother living in her house, attending to all things domestic with great flair and enthusiasm. Angus would for ever after be able to say, ‘My mum coped, so why can't you?' That's why Ray lied to Angus, initially, about the reason for her nine-day absence: she felt humiliated by her failed plan, and told him she had no idea why she'd walked out and couldn't remember where she'd been for the nine days she wasn't at home. Angus rejected that answer as unsatisfactory and wouldn't stop badgering her, so she ran up to their bedroom and locked the door. When Angus and his mother started to berate her through the door, she opened the window and climbed out onto a rather precarious ledge, to escape their harsh voices.

She lit a cigarette and thought about her options. She didn't think Angus would change for the better; if anything she thought he might get worse. She wondered, fleetingly, if she ought to disappear for good. Angus, his mother and Marcella would manage fine without her. She loved Marcella, but she wasn't prepared to live out the rest of her life as the family slave, and she wondered if this made her a bad mother, since most of her good-mother friends seemed to welcome slavery, or at least tolerate it with reasonably good humour. Not for one second did she think about jumping off that ledge.

Fast-forward three weeks. 12 November 1998, 9 p.m. Angus is out with friends from work. Ray has given Marcella her last feed of the day and settled her in her Moses basket. Life is, generally, better. Marcella is sleeping well and therefore so is Ray. Angus has suggested that Ray should go back to work as soon as possible, which is also what she wants, and they've agreed that Marcella will start at a local nursery when she's six months old. Angus regularly jokes that this will be brilliant for Marcella, and names the children of several of their friends who have been ‘spoilt to the point of vileness' by having their mothers at their beck and call for the first five years of their lives.

Ray goes upstairs to her bedroom, and lets out a howl when she sees Marcella. Her face is blue and she's not breathing. Ray summons an ambulance, which arrives three minutes later, but it's too late. Ray and Angus are distraught.

Enter one Judith Duffy, a perinatal and paediatric pathologist and Consultant Senior Lecturer in Infant Health and Developmental Physiology at the University of Westminster. Duffy performs the post-mortem on Marcella and finds nothing to suggest she did not die naturally. There is one fractured rib and some bruising, but Duffy says both were probably caused by attempts at resuscitation. The ambulance staff agree. Marcella is a victim of Sudden Infant Death Syndrome (SIDS), which means that no explanation for her death can be found.

Fast-forward four years. Ray and Angus have another baby, Nathaniel. One morning, when Nathaniel is twelve weeks old, Ray wakes to find Angus's side of the bed empty, and light streaming in through the curtains. She is terrified. Nathaniel always wakes her up before it's light, so something must be wrong. She runs to his Moses basket and the nightmare begins all over again: he is blue, not breathing. Ray calls an ambulance. Again, it's too late.

Again, the post-mortem is performed by Dr Judith Duffy, who finds swollen brain tissue and evidence of subdural bleeding. She concludes that Nathaniel must have been shaken, even after consultation with an eminent colleague, Dr Russell Meredew, who disagrees. Crucially, Meredew points out that there is no tearing of the nerves in the brain, as there would have been if Nathaniel had been shaken. Dr Duffy tells Dr Meredew—OBE, incidentally, and winner of the Sir James Spence Medal for his contribution to extending paediatric knowledge—that he doesn't know what he's talking about. She says she has no doubt that Ray Hines shook Nathaniel to death, and smothered Marcella.

There is no alternative now but for the police to become involved, and in due course Ray is charged with the murders of her two children. Her trial begins in March 2004.

But wait a moment, I hear you say. Didn't Dr Duffy perform a post-mortem on Marcella and find nothing suspicious? Yes indeed. Her answer to this, in court, is that she examined the evidence again and revised her opinion. She argues that even if the fractured rib was caused by efforts to resuscitate Marcella, the bruising cannot have been, since Ray admits she was too scared to attempt any sort of resuscitation, and Marcella was already ‘cyanosed' by the time the ambulance arrived. This means that there would not have been sufficient blood pressure to cause bruising when medics pressed down on Marcella's chest to try and get her heart beating again.

Again, Russell Meredew disagrees. He explains that it is possible for bruises to appear when blood pressure is almost down to nothing, or even – though this is rare – after death. He has seen many instances of the former and one or two of the latter. He also points out that Myocarditis, a viral inflammation of the heart muscle, is a more likely cause than shaking for Nathaniel's brain swelling and subdural haemorrhage.

It's almost impossible for any fair-minded person to comprehend what happened next, or rather what didn't happen. Without the death of Nathaniel, Dr Duffy would not have become suspicious about Marcella's death. Two things had made her think Nathaniel Hines hadn't died naturally: subdural bleeding and swollen brain tissue. Once Dr Meredew had explained that both could result from a naturally occurring virus, why wasn't that the end of the murder trial? Why didn't the prosecution realise their case had fallen apart? Why didn't Justice Elizabeth Geilow throw it out of court?

Inconceivable though it is, Russell Meredew – a man I'd trust to carry me across an enemy minefield – later confided to me that at the point when Dr Duffy told him she'd changed her mind about the cause of Marcella's death, she hadn't looked again at the file. ‘She can't have reviewed the details – she'd come to me straight from Nathaniel's post-mortem. It's hard not to conclude that she suspected foul play in the case of Nathaniel, and decided that meant Marcella couldn't have died naturally.' Meredew added that he didn't doubt that Dr Duffy had at some point dug out Marcella's file and had another look at it, but, as he brilliantly put it, ‘If you go searching for flying pigs and there's a pale pink sky, what conclusion are you going to draw: a beautiful sunset or flying pigs as far as the eye can see?'

The jury, of course, would have been familiar with Dr Duffy's name. She was the expert who, at Helen Yardley's trial for the murder of her two sons in 1996, said that for crib death to strike the same family twice was ‘so unlikely it borders on impossible' – a memorable sound-bite indeed. I believe Ray Hines' jury remembered it, and thought that it meant Ray couldn't be innocent of murder, just as eleven out of twelve jurors in 1996 had concluded it meant Helen Yardley was guilty.

Russell Meredew did his best to save Ray. He called Dr Duffy's assertion that Marcella Hines was smothered and Nathaniel shaken to death ‘a nonsense', explaining that smothering is ‘covert homicide', whereas shaking is usually linked to losing one's temper. Smotherers are devious but controlled, so it's unlikely that any mother would smother one baby then shake the next, even assuming she were murderously inclined.

The court heard that there was an extended family history of similar tragedies in Angus Hines' family. Angus's nephew was stillborn, and his grandmother lost a baby to SIDS. His mother suffers from a disease called Lupus, where the body eats itself from within. Asked to explain what all this meant, Dr Meredew was unambiguous: ‘It's highly probable that the defendant's husband's family contains a genetic auto-immune disorder. That would explain the stillbirth, the SUDIs (sudden unexpected death in infancy), Lupus – all things you'd expect if there was an auto-immune malfunction.'

Was the jury listening? Or were they all thinking about ‘so unlikely it borders on impossible'? Did they take against Ray because she wasn't a good witness? She contradicted herself several times, denied things she'd previously said to the police, and was accused by the prosecution of lying.

What no one knew was that Ray's lawyers had advised her to lie. She was betrayed by the very people whose job it was to protect her. Her defence team decided that the true story of why she left Angus and Marcella alone for nine days, and the smoking on the window ledge episode, would make her appear unsympathetic to the jury; they would think she was a feminist agitator. Instead, Ray was encouraged to pretend that she had been suffering from post-natal depression, didn't know why she'd left or where she'd gone when she was away, didn't know why she'd come back, had no memory of climbing out on to the window ledge. Not only was it illegal and immoral for Ray's lawyers to give her this advice (unsurprisingly, they now deny they did so), it was also a fatal miscalculation.

Ray was found guilty of two counts of murder and sentenced to life in prison. Her lawyers sought leave to appeal, citing Russell Meredew's claim that Dr Duffy couldn't have looked again at Marcella's medical notes at the point at which she'd told him she'd changed her mind and now suspected Marcella was murdered. But this was impossible to prove. It was Dr Meredew's word against Dr Duffy's. Leave to appeal was denied.

Then, in June 2004, two months after Ray was convicted, there was a breakthrough: a volunteer working for the organisation Helen Yardley and I set up together, JIPAC (Justice for Innocent Parents and Carers), spoke to somebody who worked with Dr Duffy – let's call him Dr Anonymous. He produced a copy of an email Dr Duffy had sent him in which she lamented her own idiocy in having allowed her arm to be twisted over Marcella Hines' post-mortem. Desmond Dearden, the coroner on whose desk Marcella's file landed, knew Angus Hines personally, and told Duffy they were a nice family. Astonishingly, he seems to have semi-blackmailed her into ignoring her suspicions and recording instead that Marcella Hines had died of natural causes. Here is an extract from Duffy's email to Dr Anonymous: