Dr Richard Shepherd: Lessons from 23,000 Postmortems- including Hungerford, Hillsborough and Princess Diana

0:02This is a Global Player original podcast.

0:11Hello and welcome to Full Disclosure, a podcast project designed to let me spend more time than I would ever get on the radio with interesting people. Dr Richard Shepherd, welcome. It's a tough introduction this, but you'll be used to it. I've not interviewed you before. You are Britain's leading, have been Britain's leading forensic pathologist. I read here 23 ,000 post-mortems. Yeah, over a career of 40 years. Yes, I appreciate it. Not sort of rushing them off. But latterly on a mission also to remove some of the mystique that surrounds your profession. Yeah, I think there is this great interest in crime, in violent crime.

0:53and there's a lot of false ideas have been built up. What happens, what we do when we're investigating it and how it is involved within society. And really, I mean, Silent Witness is an absolutely brilliant programme. But it is fiction and they tell brilliant stories, but it's not the truth. And I'm quite keen, I've spent my career saying that I really want to tell the truth to the families because that's what enables them to get on with grieving. You can lie to them and make it easy, but when they find out you've lied, they can cause them a lot of problems. So truth and, you know, people are interested and so to tell them what we really do is good.

1:38And over the course of that 40-year career, the status, for want of a better word, of the job has, because of popular media, not just Silent Witness, but lots of other things as well, presumably it's changed quite a lot. I mean, the levels of interest and the levels of young people keen to go down the same path have exploded. Yes and no, interestingly, because I think when we look back to when I started, we had Keith Simpson, we had a little bit before him, of course we had Sir Bernard Spilsbury, then we had Keith Simpson. And actually the role of the expert witness in the criminal justice system has changed significantly over the time.

2:13We've been, probably correctly, because these people used to go, it is because I say it is. you know and everyone went yes right end of story now we're challenged now we're made to explain and help people to understand and that's got to be a good thing so that that it's the two parts i mean there's more than two but but there is the the science and then there is the explaining often in court yes yeah and and the science it has changed a bit i mean postmortems really haven't changed for 400 years plus well the human body yeah the human body hasn't changed a lot in 400 years and yes i'm sorry i didn't want to spring that on you um but it and so how we look at it hasn't changed but we're just now moving into modern modalities like ct scans and things of that sort which are good but you know ct scans have their own problems and different problems and so the process hasn't really changed very much over that time.

3:14I didn't know that. You've explained it in a way that makes it inevitable that it hasn't really changed that much but actually it's not an area of science where technology has played a huge part in recent years. No, bits alter. We can do more because we bring in, we're very parasitic. We bring in other techniques and we use them but the fundamental process is just the same. We should begin at the beginning, which is 1952 when you were born in West London. But I think you moved out, the family moved out quite quickly to Watford. Yeah. I mean, there was an early tragedy, which we will come to shortly.

3:54But until that moment, you, your brother, your parents had a... I mean, I'm going to do that thing everyone who's ever interviewed you does. I was like, you seem like a really cheerful bloke. How did you end up being a pathologist? But you had a happy childhood. I had, yes. That assumes pathologists are not happy, but we'll move on. Well, of course you are. I'm the stupid one here. It's a lazy presumption. It was a really normal childhood. I remember happy sunny days in my childhood. What did your dad do? My dad was a local government accountant. Okay. And so he'd come from Manchester with my mum, and he'd worked really hard in night school to get the qualifications.

4:38to to pull himself up to to he realized education was crucial and he'd done that himself and he'd achieved you know became a chartered accountant and did i think you know extremely well and and and he had expectations for you and your brother he yes we have a sister as well but yes that that's for all three of us yeah yeah he was he was very kid education crucial what kind of kid were you what kind of boy were you uh i think i was sort of compliant and relatively well behaved i'm sure i i can't remember too many disasters but a few a few um times when i did things clearly wrong my dad was a little bit into corporal punishment as most normal at the time it's hard to explain to the younger generation but it didn't it doesn't mean that he was a particular but it was mainly not you know you've let yourself down you've let your family down but really just just think what you did was that good and that was that was there but there was a belt at the end of the day if things if things didn't get better and you performed well at primary school and I mean you would of that generation where grammar school would be a very big challenge on the horizon it was 11 plus time so yeah I mean I without really realizing it yeah I did okay got into the local grammar school which was still pretended to be a small minor public school you know the masters wore gowns and carried canes with them and beat boys you enjoyed learning yes i well i found it found it relatively easy and i think you know when when you are the sponge and it's relatively easy yes of course it's um it soaks in it it didn't become harder but when i began to focus then i worked for different reasons i worked towards a goal initially it was just soaking in because people put things in front of me and i picked up on them uh then there came a point where i needed to do it what where did the focus come from what was well the focus the focus came actually when i decided i wanted to be a forensic pathologist how old were you then about 14 or 15 no 13 14 you didn't want to play in goal for west bromwich albion no well i grew up in watford It could be an odd choice.

6:54But it's a very odd ambition for a 14-year-old boy, linked, I think you have explained, to the loss of your mother a few years previously. Well, that was certainly... She died when I was nine. She died from a natural disease process. But, of course, I hadn't realized she was ill. So her death to me was sudden and pretty traumatic. Because she'd had rheumatic fever as a child. She'd had rheumatic fever as a child, and that affected her heart, something you don't see in a Western civilization. now because it's treated with antibiotics and the problems don't occur so you know that was yeah for me that was was very hard that sudden appearance of death in the family would she have been aware of the fragility of her own existence oh yes so and your and your dad would have known that she was living on a bit of a knife edge as a consequence of the damage to her absolutely but they correctly chose not to tell you and your brother well i know i know i think they knew because they my brother's five years older than me my sister's 10 so they were significantly older they they knew sister of course most because she was what 19 she was off at college uh my brother a bit but you know i i just knew that mum used to go to bed and have sleep a lot you know nothing more than that and i what did she live longer than the doctors expected did i i really i really don't know okay i really don't know um when she died it was just just after christmas and she actually spent christmas in the royal brompton hospital now to me in retrospect says here is someone who was really ill because normally we try and especially then as well you try and get people home and i can remember the echoing wards and seeing her in in the bed with the big oxygen cylinder gosh um you know and that must have been that's been terrible for her realizing that that was the progression she'd had two major heart operations in the days when it was really unusual to have open heart operations this was out at um hillingdon hospital you know the people used to be anesthetized and these were they were put in a bath of ice to chill the body down to give it the chance of surviving longer so she'd survived two of those and and when when it came it was for you a complete bolt from the there was no farewells or no preparations no none none whatsoever it just was was remember my dad coming home um having been in the hospital all day and just saying interesting you you think you remember the words exactly i'm pretty sure he said you had a good mother and it was the change intense gosh that was important so it's a nine is a funny age isn't it because it younger than that and you may not have had much memory older than that and it probably would have been more traumatic because you would have had more memories but nine is a yeah it's a curious pivot point yes it it i think my brother as he was five years older me felt it worse that's kind of what than i did um but um i think he had more memories but equally he had more difficulties in processing it whereas i think for a nine-year-old there's an element of huh okay you know it's not good that's the way the world turns this is life let's let's go and play with my friend john next door but some seed of mystery was sown so some idea of wanting to understand how this stuff can happen that had started but the key thing was when when when my friend brought a book about forensic pathology into school as a sort of unofficial show and tell yes and perhaps building on this interest about death and why and how people die this book which was full of pictures of people who died you know was just a sort of uh oh this is this is very interesting this explains a lot but equally it says to me doctors can work with the police to solve crimes now this is this is really really interesting doctors can be in there to solve crimes solve crimes and that was that was the key that was the hook i think i mean based on you know my mum's death was there somewhere but it was it was that hook that really caught me simpson's forensic medicine simpson's forensic medicine yes third edition i then wrote the 12th edition later on that's pretty cool it's nice that's a A nice little bit of symmetry, career-wise.

11:18Absolutely. Why do you think pathology then and not detective work? I mean, if solving the crime was the abiding impact. I think maybe linking back to what you're saying about my dad, you know, education. I mean, two boys. I mean, this was 1955, 56. So my sister was the eldest, so she was going to go off to teacher training college. University, I don't know. I don't think it was really considered, although clearly in retrospect she could have done anything. And then my brother and I were either going to be a doctor or a lawyer. That was the drive in the family. And I think my brother was sort of hinting at law, so I was going to do medicine.

12:03And then this came along and really caught me. The hook was there. There was a willing fish waiting to be caught, if you see what I mean. Of course I did. And I just swallowed this hook, line and sinker. yeah that's what I want to do and that's a lovely thing to have at 14 I mean I suppose you could have grown out of it or you could have moved on or you could have focused on something else but it's actually quite nice and you use the word focus and goal quite early on in this conversation they're really healthy things to have or helpful absolutely I mean you know my dad was quite sensible about this so you know he he used this desire to keep me keep me working keep me doing my homework keep me learning but it you know it was a sort of a willing victim um you know if i wanted to play football i could play football but there was a time you said right you got to come in and do you do your work can we talk about your dad a bit because he must have i mean i know from reading about your life that he he stepped up to the plate when it came to providing to being both parents for a long time he he was he was in a sense way above way in advance of his time about being a really good single parent and continuing his job in local government and trying to maintain that.

13:13We had au pairs at the time my mum died, but I think he felt he couldn't continue having a young au pair in the house at the same time. But yeah, so he was... So he'd do the cooking, the shopping, the childcare, all of the help with the homework. He was terribly organised, though, I mean, as an accountant. There were lists. Before spreadsheets existed, he was doing spreadsheets. Yes, absolutely. We still have some of them at home. The shopping rota went on a sort of three-week loop, as did the menu. And again, because of your age and that curiously malleable prepubescent brain, this is just normal.

13:50This is how my life is. I'm not sitting here feeling sorry for myself or marvelling at how different my life is to John next door. This is how the shepherds roll. Yeah, and my sister had gone off to college. so it was you know that my dad and two boys um and my brother was the rebellious one so i you know i i could sort of sit slightly in the backwash and take the benefits of him being rebellious and hide when he was got things went too bad

14:20can you remember the first time you told him that you wanted to be a pathologist it would have been later on i think when i began to realize how the system worked how i could achieve what i wanted to achieve and very interestingly well it's not for my dad perhaps typically he said well your mum had a post-mortem would you like to read the report how old were you then mid mid to late teens i mean sort of moving up to sort of six six form levels so 17 18 so that was a bit oh you know this is interesting because he said well you know it happened um i was in in those days he was asked if the hospital could do it because there was a mystery about because well for education she'd had these operations they wanted to understand he said yes because he was all for that and then he had this report full of full of long words that he thought i could begin to help explain to him which i couldn't then but i began to obviously later on and you did come back to it and help him understand some of the stuff and it was uh i i've never gone back to it i i saw it and then it went from my life that report now i know i know how i could get a copy of it right uh by going back to the hospital and asking them to look in their records uh but i don't i don't want to do that i don't want to go down that route but it was it was very interesting and that is an extraordinary response isn't it for for a father i mean look the appeal of medicine notwithstanding, he'd have been within his rights to say, a what?

15:59A pathologist? Go and be a real doctor, my boy. You're 14. Well, I didn't have any history of sort of cutting up earthworms and things. I think that would make you a serial killer. Well, I think... More likely than a pathologist. Well, you notice that I'm not admitting to cutting up these things. But yeah, that would have been odd. There's the usual biology things at school. But no, but this was, I think, typical of him. He would take something at face value and say, is this going to be beneficial? Would it help? If it will, then right, let's be grown up and do it sensibly. And that perhaps is a trait you have inherited a bit because other boys, and this would be why your friend, I think he was the local doctor's son, wasn't he?

16:43This is why he brought it into school. It could have been pornography. He was trying to shock and titillate and excite. and you're looking at pictures who've been people who've been strangled stabbed electrocuted and you are not freaked out by it yeah you are absolutely intrigued yes it and and when i took the i borrowed the book i'm trying to remember whether i i borrowed it officially or unofficially willingly from him i just simply said i'm bigger than you i'm going to take it no i think i borrowed it and took it home you know when my dad saw it he said well this is really interesting let's you read some bits and we can talk about it and and murder is is crucial to this process it's not just death it's murder in particular it was particularly murder and the solving of those those crimes that were the once again they were the lead in that was the path i followed to a much bigger area in pathology where do you think that came from why do you think the fascination with murder.

17:40I think it's just crime, isn't it? Did you read Sherlock Holmes and stuff like that? Yes. But not excessively? Not particularly. You didn't have a massive interest in murder before this or during this process. It was this book that just... But I think there was a lot more about murders. I mean, we would have the Times delivered to the House and there would be the court page, not court as in royalty but court as in court's page. and there would be the reports you know things like the the prosecution and the defense reports of serious trials were were there much more officially much more like hansard than you get nowadays with of course even my father was a newspaper journalist and court reporting was a crucial part of the of the arsenal i was at eisleworth crown court not long ago i was on a jury i wasn't um gosh that must have been interesting i wasn't in the diet i didn't i get selected but that's a that's a conversation for another day um and the room was there reserved for the court reporters and of course there aren't any anymore so it was actually part of the daily diet was quite detailed information coming and people had a real post-victorian appetite for it didn't they so it was there you see this this silent witness thing wasn't on television because that wasn't there but it was it was always there and then you go back to jack the ripper and the penny dreadfuls and the pictures and the stories that used to be told and distributed then so it's always been there.

19:03Crippen in particular was a soap opera almost for people wasn't it? This is of course why you so politely dismissed my original suggestion that the enthusiasm the public have for your world is a relatively recent development. It's nothing of the sort. It's just changed. It's morphed over the years. Yes and you are now set upon that path towards science so you need you need biology and chemistry and you need at good A-levels and you know what you want to do with them. You didn't I send struggle particularly with the academics? well there was there was a introducing a slight complexity here my father remarried and it wasn't a happy remarriage i'm sorry to hear that um he deserved happiness yes uh i mean yes and maybe that's you know an interesting thing about when i married i married someone who had three kids and was determined that i was going to be a really good stepdad but that's that's an that's a sideline so uh no so that mustn't happen and that was around a levels so in fact the a levels didn't didn't go well right um and i ended up applying through clearings um to to get into medical school and was very lucky indeed for that saint george's wanted a second row you know you've alluded to your size once already and when we were talking earlier about school i nearly said i didn't know that you played rugby but i very nearly said surely you also played rugby well but i suppose these days possibly basketball but not no no not in not in not in not those days no so it was i was very lucky saint george's needed it was the rugby that got you in well up to a point always always difficult to know but certainly it didn't do you any harm it was you know they used to say you know if they you walked into the interview they threw a rugby ball at you you know if if you caught it you're in you're in if you threw it back you got honors you know love it but medical school and rugby go together of course like a horse and carers in these in this era they used they used to and it was it was it was really useful and i'm very grateful that i got through however i got through the second row is not traditionally the most creative of rugby players i might no comment on that one um let's back up slightly because you would have had your first experience of dissection when you were doing your a levels i think or Possibly even your O-levels.

21:20Yeah, I can't remember. But yes, I mean, the usual dogfish and things of that sort. And clearly it was something that you were supremely comfortable with. Did a schoolmate when you were 15 say that you already had the stomach of a surgeon? What did he mean? Or sturgeon, was it? Sturgeon. What did they mean? I think because these things were steeped in formalin, you know, and the smell was formalin and not anything else. And, you know, it just didn't seem to bother me. So you get to St. George's. Yep. Do you tell, I'm not quite sure what the etiquette is at medical school. Do you share ambitions with teachers or with peers on where your specialty, where you want your specialty to be?

22:01And certainly with peers. I mean, teachers could be a little iffy. Yes. Because we were in the days, my first consultant was a man called Sir John Batten, who was physician to Her Majesty the Queen. you know and that was on inst george's hyde park corner with it which is now the lanes for a hotel of course so that was my walking to do the clinical work wonderful place but that was the sort of the the type of person you're dealing with he was he was a wonderful man uh a true polymath but you know others wouldn't have been so tolerant but you know you you plow through and you get there but they wouldn't have been so tolerant because the first thing we think of when we think of medicine is helping people to get better is that why it would be yes possibly but i think in those days pathology was was much more part of hospital life um pathology if someone died in hospital it was expected that a post-mortem would be performed and it will be used as a learning thing for the clinical staff and it would be used as a teaching component for the medical students and all the medical students have to get involved in in the in the um they would have to have to go i mean every every lunchtime there would be a post-mortem presentation so you'd go and have lunch and then you'd trundle along to the mortuary and what about the the non-academic side of things you're away from home now away from an unhappy home you're throwing did you throw yourself into life in london i think the school was on hybe park corner at the time so you were pretty central yeah we we i start off at university college so i was down gower street uh and that was that was great i mean right in the middle of right in the middle of london yeah pretty pretty much i would i involved in the medical society i used to do the disco it was uh it was good fun because we used to get free drinks so rugby rugby discos yeah yes rugby discos rugby discos nurses and books and then it's not bad focus but the first part of the course was then called second mb which was 15 months and you learned all the basics anatomy biochemistry physiology that was only in 15 months right and then you took an exam so there was a year of growing up which is i think i i personally think it's so important for university people to have time to go away to grow up and then three months of hell when learning but you know we jumped i jumped all the all the obstacles as i went along i mean this is an obvious question and i apologize because it's also a bit crass but but But when did you confront your first cadaver?

24:32Also, is that the right word to you? Body, cadaver, I mean, autopsy, post-mortem. These words are interchangeable. I mean, we tend to use body. Okay. Corpse. I mean, but there's all sorts of things that can be used. I would have seen that when I was at, in doing my preclinical year at university college, I would have gone to the post-mortem demonstrations at lunchtime. And they could sometimes be flamboyant, I think. Oh, yes, sometimes they could. But at the same time, I was learning anatomy by dissecting a body as well. So we had the two sides working together. I can't help wondering how ironic it would have been if the very first time that you encountered a body, you actually did find that you didn't have the stomach for it, having been so settled on it for so long, best part of a decade by now.

25:26Yeah. But that wasn't the case, clearly. Well, there was another moment when I was training as a pathologist and I was no longer just viewing a post-mortem. I was actually doing it. And that first case that I did myself, that was a huge jump because there was that realization that if I can't manage this, I've got some very serious thinking to move around. What element of it do you mean when you say if I can't manage? Well, it's actually holding the knife and putting knife to skin and doing that superficially mutilating component of the investigation. Because there is that change that you're causing damage.

26:10You can justify doing it because there is a beneficial outcome. Of course. But actually doing that. As a surgeon, you use a knife and you can justify it because you're going to help make someone better. It's a little harder, perhaps. so there was that moment when it was just that little bit harder what do you think and again i apologize that you've answered this question i doubt over dinner tables and interview scenarios a million times but what what what do you think the trick is or the secret is to disassociation in these moments you see i i don't think it's special to me all all doctors have to dissociate you know when you're in a and e someone comes in from a road traffic accident you know you can't spend time fretting about how their family might be feeling or how they're feeling you get in you treat and the trick i always think is coming back from the dissociative state to the caring state yeah and sometimes you see people who lose the ability to make that return so they forget the humanity of the patient whether alive or dead yeah absolutely they become entirely focused on the practicalities the science and don't think about that person as a person their family is part of the integral group you have to do that and there were times when i've had to stop stop the car on the way home from a case and in a sense just make myself stop and think a bit and physically sort of move myself between states yes that's really interesting it It reminds me also of some of the stories one hears about consultants in particular developing slightly narcissistic tendencies, which speaks directly to what you've just described.

27:56I do think that it is very easy if people are saying, oh, gosh, you're wonderful. And, you know, you begin to believe it. And we've had some consultants do terrible things. Yes. Are there key moments here? Are there milestones in this development? I mean, did you, I think I read, for example, that there were brief wobbles on what you would specialise in. The child took the opposite end of the generational spectrum. No, I mean, I think we did all of it. I mean, there have been changes in paediatric pathology. And it is now its own subject. Quite rightly so, because a child is not just a small adult.

28:37A child is a special thing. But you never thought, maybe I'll do something else in the course of your studies? Oh, no, not, no. Presumably a lot of your peers did. They'd wobble around a bit, jump around a bit. Oh, yes. When you qualify, you then have to go off and do, we used to call it a house year. Now it's called a foundation year. Now it's two years. It used to be one. When I got to the end of that, then I could apply for a post as a pathologist. Right. And I couldn't get one. there weren't any available but one was coming up in three or four months time um in the joyful thing of those days the consultant said well it's your shepherd when you want it just you know but we've got to wait for Goggins to to move on so I went off and did obstetrics oh okay so that way you knew you were you were you were killing time yeah well yes but surprisingly I loved obstetrics and that generated a not a not a real wobble but just a reassessment am i going down the right track because this working with live people doing something like obstetrics was really good why surprisingly i'm not sure just because i think i was so so focused on doing this that i really thought it was going to be a bit you say it was marking time and suddenly you're going oh this is this is actually quite interesting although i was talking once an astrologer said to me are but on the astrologers wheel or what i'm quite sure what they actually call it birth and death are right next door to each other so she said it didn't surprise me at all that you could have gone either way how interesting isn't it and this is where once you get your placement as a pathologist you you start shadowing people originally you the first bit is you're watching people do and again you've mentioned some of the big names from the past two in particular including the bloke who wrote the the book that changed your life it's quite how do you explain that to somebody who is not squeamish but surprised to discover the performative element of an autopsy

30:44um i think you have to observe it's not the autopsy in a sense it's not that little band of narrow medical dissection it is the peripheral things it is relating to the police officers relating to the forensic scientists relating to the exhibits officers understanding how the photography works understanding how the scene works understanding how courts work and all of these things are very peripheral that you won't learn doing the medical pathology bit so that's why you tag along you get the experience you see how those bits are done because it's not a solitary pursuit at all it's something that those of us on the outside wouldn't properly clock until we speak to somebody like you it is it is you're describing communication skills now you're describing the ability to draw people in to tell a story and to send people away with considerably more knowledge than they had before enough knowledge to reach a conclusion about whether someone in that side of the court is guilty or yeah absolutely and this is This is why explaining complicated medicine to those 12 people on the jury is crucial.

31:52Now, you can stand up, you can do it in long medical words, and they'll be blank and they won't really understand. But that's no good when they go to the jury room. They're going to send someone away for life. They've got to understand it well enough to use it. And that's the communication you've got to achieve. So someone could be brilliant on the table, the operating table, but absolutely bloody awesome. Oh, yeah. Explaining. Absolutely. And there were plenty of them around. I was trying to pick a few, some, many, lots. What have we touched on so far from your past and your childhood and your early days as a student that explains why you were soon to discover that you also had a gift for that side of the...

32:39equation? I'm not sure. I mean, I didn't do amateur dramatics at school. I've never done amateur dramatics outside school or anything else. But I loved lecturing. Talking to the students was great. Individual tutorials. I love that communication with them. And watching them, watching the dawning of knowledge in their eyes was fantastic. And it never really freaked me. it used to freak a lot of my colleagues to do it they really didn't like it whereas i did and that is public speaking in any sphere in a way some people it makes their palms sweat other people take to it like a duck to the water and you were in the second category i think so yes so it seems to work prior to graduation you are um looking over the shoulder of various mentors and asking lots of questions but mostly at this stage looking for hidden signs of disease and things like that rather than solving crimes well it's both both were already both were going on i mean less less with the crime yeah because of my interest i became a bit of a leech to the so if you heard someone was coming in yes if i knew there was a case you know you'd pop into the mortuary first thing in the morning say anything interesting happening today and they say oh well we think we probably got a shooting at two o 'clock and i go all right okay well oh look i found myself in the mortuary at two o 'clock so but it is that that was so much of medicine at that time i wasn't unusual you know that the people who wanted to do surgery would find themselves in the surgical operating theaters at that time um so 77 you graduate i think 24 years old um a lot of changes I think this is where you begin to settle down as well, isn't it?

34:26Yes. You meet your future wife. House officer, which means you still have to do a little bit of everything. But when you're working as a house officer, that's when you start drifting towards the pathology suite. Yes. In the ways that you just described. I had more flexibility then. Yes, we do six months doing medicine in the sense of a physician and six months as a surgeon, and then you are off free. And at 78, you go on to the postgraduate training program to become a pathologist. You've described, you've mentioned your wife and you've described her seeing the man behind the profession. I've been conscious of that, not that line necessarily, but that idea since you sat down or since we shook hands outside there, seeing the man behind the profession.

35:12But you haven't struck me so far as someone who worries particularly about that. So I was interested to see that that's one of the ways in which you've described your marriage. How interesting. I wonder quite what I meant when I wrote it, if you know what I mean. But I think she, wives can be a wonderful sounding board. I mean, if you can't confess to weakness or fear to anyone else, you confess it perhaps to your nearest nurse, your partner or your wife. If you're lucky. If you're lucky, yes, absolutely. And, you know, there are probably phases in marriage where you can and phases in marriage where you can't.

35:50maybe they simply pick it up because you're coming home and slamming the door and not talking to anyone you know they don't you don't actually say it but they detect it because they love you yes yes possibly but also maybe they're just in a relationship with you they've known you the longest they can just see the signs that you hide from anyone else that's always a possibility and i mean for someone who lost their mom at the age of nine it's odd that i'm thinking of the word lucky a few times in this conversation because you were lucky that your father had and this is you mentioned him being ahead of his time in in the context of single parenthood but he had emotional literacy that was he he he spoke to you about vulnerability i think and he and he he helped you with things that would would probably still be considered as more feminine than masculine yes i he he really did uh and i think that was he he really had it really had an explosive temper But behind that, he was very tolerant and understanding and would rather talk than do anything else.

36:54Let's try and understand what's going on here. And that was very good. What's the curve now then? What's the trajectory for somebody who's been accepted onto the sort of pathology side of medicine? How long is it before you are in that scenario you described earlier with your scalpel in your hand in charge for the first time? and conscious that everything is on you. Well, that comes quite quickly because that's part of the training. So you will be doing that with supervision. There will be someone around. But you're not feeling the weight of responsibility if you've got a supervisor there. Well, I am.

37:28Or you are. Well, I am, but not the full weight. No, okay. If you see what I mean. Of course I do. There is a different weight because you really don't want to screw it up in front of the guy who's your supervisor. So there's that as well. So that's a trajectory of doing more and more, learning about diseases learning about what diseases look like so that the normal medicine and the forensic medicine begins to creep in and creep in and creep in and you're looking i mean the things that in a way it's uh it's about assembling your own mental and physical log book isn't it so that you will recognize things when you see them in the future so you strike me as someone who who would be constantly trying to add to that yes there's the this the pattern recognition component and i remember when my my mentor my forensic mentor a guy called rufus crompton at st george's he had a boxes full of photographs of crime scenes and if it was quiet i would go and sit in his office and just just look at them i mean i knew didn't know the stories but i would just look at these photographs these 10 by 8 metropolitan police color photographs and just try and see what can i see what can i understand and then and that would uh that would go on at the heart of all my work is is to find the truth i was determined to adhere to the truth with its beautiful simplicity and not allow emotion to muddy that simplicity um a bit naive maybe yeah emotion was bound to kick in as we as we as we will discover later but i think i think you also thought that by the time you got your first post-mortem out of the way you wouldn't have to worry about emotional reactions anymore yes yes i'm very innocent really you know well i wonder if i wonder if that helps actually i wonder if you need to come i think i'm very keen picking up on maybe what you said about my dad to try and keep in touch that to to feel it and sometimes it hurts but actually to understand understand what's going on and try and manage it i mean you know that there came a point when my first wife said to me you know i was very cold and unemotional and had shut those doors right down um because you had to to survive you would have felt at the time someone might have argued at the time yeah um and and then you move into the 80s this is where you come under the wing of dr ian west who is another i think the use of the word flamboyant is sounding a bit cliche but sometimes these are the only words that fit aren't they and and he would conduct um post-mortems in in a in a in a very theatrical way i think yes yeah i mean he he was he was a wonderful teacher you know he he really was his his knowledge and expertise were great and he was a very you know very good mentor to have but he was rufus my first one was was a very academic man not not at all uh the showman where ian was very much the showman and how does you then develop when do you start emerging from the shadows of your various mentors when does dr richard shepherd um i think the line you've used is become fluent in the language of pathology but also become distinct from other pathologists you are bringing something to the process that if not unique is distinct from from many others i i think it's a slow process i mean the only thing i could link it to possibly is an actor who goes through rada or something like that and then goes to work in in theater around the country and is learning all the time and they're picking up a bit here and a bit there well that that worked well that didn't work well let's build it here and then gradually as I came to give more evidence at the Old Bailey, realising that that crucial nub of conveying the information, I knew I could get it right, but I then had to communicate it.

41:32And there's a responsibility to the dead person kicking in here that's really quite profound. Yes, and also the accused. I mean, the responsibilities are massive because you can't go in biased and say, God, it was a terrible thing to do. You know, that guy there must be guilty. What a shitbag. No one has ever said to me, and do you see that person in court, Dr. Sheppard? It was him. Happy days. But no one's ever done that. But remembering that the people you're trying to teach in this brief period, have you have to assume no knowledge of this and and yet it's the i'm arguing about the finesse of how a knife was inserted into the body something they've never thought about in their lives i've got to convey that this knife went in this way and i i when i say it i know it and you can sort of believe me when i tell you and and and from that it could only have been inserted in this way by somebody with these attributes or somebody that's right what was the first time in the doc can you remember what was the first case no i can't remember the first case i assume it was a pretty straightforward case and this is how my training would have gone you know i would have been given the simple cases to begin with and then built up but we had spent a lot of time in coroner's courts in the days when i would give evidence in five or six cases in the morning at coroner's cause um and some coroners were quite robust in their treatment of you i remember one where i realized that every time we talked about alcohol no matter how it came up he would always refer it back to driving well the level is 80 milligrams dr shepherd so you know this is three times the limit for driving no matter what they were falling off a building or whatever and i thought well i can speed this up a bit you see so i thought i said you know this this lady had a blood alcohol of 240 that's three times the level for driving he just looked at me and said dr shepherd since the only thing she was in charge of was a chaise longue i hardly think that's relevant and when i and i thought oh and when i went out of court he said to me don't steal my lines because you know he wanted his role he wanted his role and it's a bit of a pas de deux yes that is his dance you know you know a little bit of the questions and you have to lead slowly so that I learned a lot from dealing with coroners.

43:56And you do now begin to realize the dreams that brought you into the profession. I think you had an early-ish case of establishing foul play in what had looked like a routine heart attack, which meant that someone got their collar felt. Yes. Oh, absolutely. I mean, but that in a sense is our role in dealing with these inverted commas routine cases. We are there as an arbiter for the public to see the things that don't work, that are worrying. I understand why you can't remember the first time you were in the dock because it would all have blurred into one. No, in the witness. In the witness box.

44:33You'd remember the first. Clearly, I remember very clearly the first person. Can you remember the first time you sent someone to jail? Your evidence essentially sent someone to jail. No. I think it would be fair to say that I never look at the accused. Because it's not my job at all to convict them or to find them not good. But these are the things people outside find surprising. But the more you explain it, and this is why your live shows and your tours are so compelling, the more you explain it, the more perfect sense it all begins to make. Yeah, I mean, it is keeping that separation. Of course it is.

45:09I have to say, sometimes it can be really hard not to look at them. Yes. But I think that's not my role. I look at the jury. I don't even look at the barristers. And I only look at the judge if I have to. And then we come to what we would call, for want of a better word, the biggies. The cases that are in the public consciousness. And the cases that were infamous in many cases. The first of which I think was Michael Ryan. Yeah, Hungerford. Yes. So funnily enough, my dad was on that story. So my dad would have been outside the school with his notebook when you went in, not knowing whether it would be booby-trapped after this man for people who don't know, who'd killed 16 people in the town, had then taken his own life.

45:54But you are going in alone with your bag of tricks to the classroom where he has shot himself. Yes. And the last words are, don't move him much, Doc. And I said, I think, just told me you might be booby-tapped. And I said, I won't, don't worry. Yeah, that was a very, very, very formative moment because that was the first really, really obviously big case. Yes. You know, there was no doubt about it. This was going to be massive that I had to deal with. And that, I mean, because you weren't going to solve a crime on this case because the guilty man was lying dead in front of you. but there was something satisfying about the knowledge that it was a big case or different.

46:41Oh, yes. I mean, like the actor, I wanted to move up. Ian had done, Ian West had done so many of the IRA bombings and the IRA shootings. He had become quite famous in that way. And I wasn't jealous because, in a sense, you knew it was going to come. but to to go in to do something like hungerford you know it's going to be big and actually we knew michael ryan had been involved but we didn't know that somebody else hadn't been involved of course there was always unlikely but it was always that possibility so there is that component of the crime that you need to think about to establish positively that it was just him and and i suppose a lot of the other mass fatalities that you found yourself covering are also not really matters of proving who did it so there's the Clapham Junction rail crash there's Hillsborough, there's the Marchioness all of these horrific events were not mysteries that needed solving in the most obvious sense No, but there's always subtext particularly in the individual of talking then to that family and saying this is what happened to your loved one.

48:05We know what happened overall in the Martian essay. We know what happened. But can we help them understand what happened to their particular child? In their final moments. In their final moments. Sometimes you can and sometimes you can't. And once again we come back to the truth here. If you can't, say so. There is no point pretending that they would have died within seconds when actually you simply can't be certain that that's the case. And so the truth can sometimes be I don't know as well as I can tell you exactly what happened in this safe.