As Sarah turned to summon her first witness, he caught her eye, smiled, and slowly shook his head.
14. Pathologist
Sarah’s first witness, Terry Bateson, described how he and DS Litherland had examined David’s flat, finding Shelley’s clothes strewn all over the living room floor, and, in the bloodstained bathroom, a kitchen knife covered in Shelley’s blood. He was followed by the pathologist, Arnold Tuchman, who limped briskly to the witness stand and repeated the oath from memory, without glancing at the card the usher held up for him. A skinny, white-haired man, he gripped the stand with both hands and turned his attention to Sarah, who stood waiting. The wire-rimmed spectacles magnified the size of his eyes as they focussed on her, and she had a brief, unsettling sense of what it must be like to be a worm spotted by a thrush.
‘Would you give the court your name and qualifications, please?’
‘My name is Dr Arnold Tuchman. I am a consultant forensic pathologist.’
‘And you have been practising forensic pathology for how long?’
‘Thirty nine years, young lady.’
Sarah smiled gently, accepting the words as a compliment rather than the put down the crusty old man probably intended. Age was relative, after all; this man had begun practising pathology a year before she was born.
‘So you are highly experienced, doctor. And you performed a post mortem examination on Shelley Walters, I understand. Could you summarize your findings for this court?’
‘Certainly. The deceased was a young healthy woman about twenty years old. She had suffered severe loss of blood due to cuts on her wrists, particularly the right wrist, where the ulnar artery was pierced. Her lungs contained traces of bloody water, and there were the residues of pink froth in her mouth and throat, which is common in cases of drowning. In addition I noticed a number of subcutaneous bruises around her head and neck, as well as a circular bruise, presumably the mark of a tourniquet, around her right arm.’
‘Thank you, doctor. So what, precisely, was the cause of her death?’
‘She died of heart failure, caused by the severe blood loss from the ulnar artery in her right wrist, combined with the trauma caused by partial drowning.’
‘You cannot say which of these factors was the principal cause?’
‘Not really. As I understand it, she was still alive when the ambulance crew arrived and applied a tourniquet to stop the bleeding. At the hospital, every attempt was made to revive her, including blood transfusions and electrotherapy. Unfortunately these failed. The trauma was too great. Her heart simply stopped.’
‘So, to be quite clear, you cannot say whether she died from drowning or blood loss?’
‘No. She died from both.’
‘Very well, let us examine the cuts to her wrists. If the jury would look at photographs one and two.’ The usher distributed booklets of photographs to the jury, whose faces paled at the pictures inside. ‘Could you describe these injuries for us, Dr Tuchman?’
‘Certainly. The cuts to the left wrist, as you see, are relatively superficial. Several flexor tendons and veins have been severed, but there is no damage to any major blood vessel. The wrist was probably bent backwards as the cuts were made, which would cause the radial artery - the artery that is normally injured by attempted suicides - to slip into the shelter of the radius. This is a common difficulty which people encounter when trying to kill themselves, or indeed others, in this way.’
Sarah watched the jury, who had never faced photographs like this before. Several jurors were peering so intently at their booklet that she wondered if they heard a word the old man said.
‘The injuries to the right wrist, however, are much more severe. In particular the ulnar artery - not the radial - has been pierced. This injury would have led to immediate and severe haemorrhage which, as I say, was one of the main causes of death. It would certainly have killed her had the bleeding not been checked by the tourniquet.’
‘Are you able to say how much blood she had lost before that happened, doctor?’
‘I’m afraid not, no. She received blood transfusions at the hospital, you see. So it’s impossible to say how much of the blood in the body was hers.’
‘What can you tell us about the state of her lungs?’
‘Well, both lungs contained water. In addition to this there were traces of a pink bloody froth in her airways and around her mouth. This is a classic indicator of drowning.’
‘So why is it not possible to say whether she drowned or bled to death?’
‘Because both injuries occurred at more or less the same time, and both were unsuccessfully treated by the hospital.’ The elderly pathologist glared at Sarah as if she were a persistent but not very intelligent pupil. ‘One of the things I have learned over the past forty years, young lady, is that the cause of death isn’t always as clear cut as lawyers might like it to be. In this case, both factors obviously contributed, that’s as much as I can say. The young woman was already in a near terminal state when the ambulance came; it was probably too late to revive her.’
‘Very well.’ Sarah was amused by his manner. It didn’t worry her; what he said suited her case quite well. ‘As you may be aware, Dr Tuchman, Mr Kidd claims that this is suicide. Shelley Walters inflicted these injuries upon herself, he says, while he was out of the flat. In your expert opinion, are these injuries consistent with that explanation?’
‘They are more consistent with murder, in my view. But suicide is not completely impossible.’ The big eyes behind the wire rimmed spectacles met Sarah’s unflinchingly, a faint smile flickering across his lined old face. ‘Although I regret to say that I cannot be absolutely certain. The longer you work in my field, the more you find that is true. But in order to maintain that this was suicide, you would have to find a convincing explanation for a number of factors which do not fit in with that theory.’
He’s enjoying this, the patronizing old coot! Sarah thought. Beside her, Savendra was scribbling down the last answer industriously.
‘And those factors are?’
‘Well, for one thing, the fatal cut was to the victim’s right wrist, not the left. A right-handed person would naturally cut her left wrist first, and more effectively, than the right.’
‘Could you explain that please, doctor?’
‘Certainly.’ The elderly pathologist fished in the breast pocket of his jacket and, to a murmur of interest from the jury, drew out a pocket scalpel, its blade shining clear in the lamplight. He laid his left hand on the hand on the witness stand in front of him, palm upwards. ‘A right-handed person would take the knife in his right hand, like this, and cut from the outside of his left wrist, near the base of the thumb, across to the inside, like so. But the wrist has many tendons, so you would have to dig the knife in deep, and drag it across with some force. Not a pleasant business, which is why many suicides who kill themselves in this way are drunk, by the way. To deaden the pain.’
‘Was this girl drunk?’
‘Not really. A little alcohol in her blood - a small glass of wine or beer, that’s all. But think of the results of such a cut. You decide to kill yourself, you’re right handed, as this girl was, so you cut your left wrist, like so. Then to complete the job, you pick up the knife in your left hand, which is already damaged and bleeding, and try to slit the right wrist. You’re using the hand you don’t normally use, remember. Which cut do you think is going to be the deeper?’
By now the doctor was facing the jury, as though delivering a lecture. Sarah saw several heads nodding earnestly as they took it in. Before a juror felt drawn to raise a hand to answer, like a student, Sarah said: ‘I take it you mean the cut on the left wrist will be deeper, Dr Tuchman?’
‘Obviously,’ he said, looking at her as though she were a halfwit. ‘Whereas if someone else cut her wrist, the opposite is more likely to be case, don’t you see? Come here, young woman, let me demonstrate.’
This way of being ordered around by a witness wasn’t one she recalled being covered at the Inns of Court School, but Sarah was in favour of livening up court proceedings whereever possible. With a quick glance at the judge to ensure he did not disapprove, she left the table in the well of the court and advanced towards the witness stand. The pathologist, to her amusement, handed her the scalpel. It was a deadly little instrument, she saw; quite enough to cause instant death if misused. She held it in her right hand.
‘Right, now, imagine I’m sitting in a bath facing you when you come in.’ The pathologist held out his two hands, wrists upwards, in front of him. ‘Now, catch hold of one of my wrists, young woman, and pretend to cut it, if you would. Gently, without drawing too much blood.’
There was a murmur of appreciative laughter from the jurors. Reaching forward with her left hand, Sarah grabbed the old man’s bony right wrist, bending the palm back slightly to expose the network of veins and tendons, and drew the wicked little blade through the air above it, from the base of the thumb inwards. The pathologist chuckled appreciatively.
‘Very good. You notice how you naturally chose my right wrist to cut, not the left. Now, do the same with the other one.’
Sarah reached across his body to seize his left wrist. The action was a little more awkward, felt less natural. When she drew the scalpel through the air above it, she hesitated, before moving it from the outside inwards, as before.
‘You weren’t sure which way to cut then, were you?’ said the doctor. ‘You could just as well have cut from the inside out. But I think the jurors could see another thing. You are right-handed, so you felt more confident cutting my right wrist than my left. So the damage you were likely to inflict would be deeper, more potentially fatal, on the right than the left.’
Sarah handed back the scalpel and walked back to her table. ‘And how does that relate to the wounds suffered by Shelley Walters, Dr Tuchman?’
‘Very closely. Both wrists were cut from the outside to the inside of the arm, but the cut to the right wrist is deeper - the knife has gone in much further and pierced the ulnar artery - the one nearer the little finger - whereas on the left wrist both arteries remained undamaged. On the left only veins were cut; if she had made a fist or applied pressure the bleeding would have stopped. Whereas on the right the bleeding was far more serious. It was the cut to her right wrist which killed her, not the left.’
The crotchety old pathologist, Sarah thought gratefully, was proving a star witness - one whose evidence the jury would not easily forget.
‘And what would have been the result if she had cut her own wrists?’
‘Then, presuming she was right handed, I would expect the opposite to be true. The left wrist would be badly damaged, the right wrist much less so, if at all.’
‘Very well, is there any further evidence which leads you to suspect that this is murder, rather than suicide?’
‘Yes. There is the lack of tentative cuts.’
‘Tentative cuts?’Sarah frowned. ‘Perhaps you could explain these to the jury, as well.’
‘Well, when a person cuts their own wrists, they don’t usually know exactly how to do it. It hurts, it’s difficult to succeed the first time. So in many suicides we see a number of shallow, experimental or tentative cuts, next to the final cut which does all the damage. Whereas in a murder, such tentative cuts are much less common.’
‘Did you find any such tentative cuts in this case?’
‘None at all.’ The pathologist gave a thin, triumphant smile.
‘Very well. Let’s move on to the bruising, if we may. Subcutaneous bruising around the head and the neck, you say in your report. Would you explain that to the jury, please.’
‘It means that the bruising was less obvious on the surface of the skin than on the layers beneath. When I peeled back the skin from her skull, I found places where it had been gripped tightly against the bones. You can see this in photographs four and five.’
Several jurors turned away from their booklets in disgust. Sarah understood their reaction, but felt more concern for Shelley’s parents. Pathologists, particularly those who had been working for nearly forty years, were not renowned for the sensitivity of their explanations. But there was nothing Sarah could do to minimize their pain. The Walters could leave, of course; but if she had been in their position, she imagined, the obsessive need to know every dreadful detail would overcome her disgust.
‘What do these injuries suggest to you?’
‘This sort of bruising is common in situations where a person has been held down against their will, particularly in drowning incidents, when the desire to escape is overwhelming and the assailant has to exert great force to subdue the victim. So it looks to me as though someone held her head underwater.’
‘So in your view these bruises are further evidence of a violent assault?’
‘That is the most probable explanation, yes.’
‘Very well.’ Sarah studied the jury quietly before asking her next question. Most of them were staring at the photographs or the pathologist, mesmerized by horror and disgust. ‘But we have still not established whether this poor young woman was half drowned first, before someone cut her wrists, or whether it was the other way around. Can you help us with that, Dr Tuchman?’
‘On balance it seems to me more likely that the murderer attempted to drown her first, and then cut her wrists afterwards.’