Lucy Letby: the handover notes
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Crime & Punishment
Lucy Letby Edition
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I’ve read the [New Yorker] article[1] and now the retrial is over I can write about it. And while there’s no doubting the author, who says she obtained full transcripts of the ten-month trial at huge cost, has researched the case thoroughly, it contains errors and cherry-picks evidence, omitting large parts of the prosecution case which was pivotal in reaching a conviction.
For example, it makes no mention of the 250 confidential “trophy” handover notes, blood test results and resuscitation notes relating to the babies police found at Letby’s home; it does not try to explain the Facebook searches that she made for the parents of her victims, years after she harmed their children.
It was alleged — strictly speaking, it is alleged that it was alleged[2] — that Ms. Letby took handover sheets home with her and kept them as “trophies” of her grisly deeds. In her judgment on Ms Letby’s appeal, President of the King’s Bench Division Dame Victoria Sharp said the following:
[Ms. Letby] retained and took home a large number of handover sheets as “trophies” of her crimes. These handover sheets were confidential documents and should not have been removed from the unit. Over 200 were found hidden under the applicant’s bed. [3]
It wasn’t alleged
Let me first explain my “allegation” pedantry. It has so entered the commonplace that Ms Letby “collected trophies” that even the President of the King’s Bench repeated it without so much as a pausing, whilst recapping issues from the trial.
But, during the trial, it was not alleged, by anyone, that Ms. Letby kept the handover notes “as trophies”. She had 257 handover sheets, sure, in a shoebox labelled “keep”. But no-one claimed them to be trophies. As far as the transcripts reveal, no variation of the word “trophy” was uttered over the course of the ten-month trial. Not in opening, not in evidence, not in cross examination, and not in closing.[4]
The Crown Prosecutor did not really make much of the handover notes at all. Mr Johnson KC said:
I’m not going to spend a lot of your time looking at Lucy Letby’s notes. There are more important things in this case.
Later, on day 2 of his summing up, Mr Johnson KC said:
I want to start — I’m not going to deal in great detail with these jottings. I’ll start with Exhibit 15, which is the handover sheet of Baby P] and [Baby O].
Lucy Letby suggested that she took this home deliberately to rely on it as an aide-memoire when writing up the drugs on her following shift. But when you look at page 2, which shows the back of this document, the only drug you will see recorded on that sheet is caffeine. So Lucy Letby’s explanation is not true.
Why is she not prepared to tell you the true reason?
It can’t be because it helps her, can it? We suggest that the handover sheets are capable of informing you of her unhealthy interest in some of these children.
Whether directly, as in the case of [Baby M] for example, or indirectly, as in the case of [Baby G], for example, whose handover sheet would have been a very useful reminder of how to spell her mother’s French name when conducting a covert Facebook search.
And when determining or considering Lucy Letby’s credibility, her believability generally, we encourage you to think about these things. First, her claim that her collection of handover sheets, acquired over years and retained through multiple house moves, was simply a consequence of her tendency to collect paper.
Second, her assertion that they were stored confidentially, her inconsistent assertions about owning a shredder and whether or not students receive handover sheets. Third, her assertion that the word “keep” written on the side of the shredder box at her parents’ house referred to the shredder rather than the handover sheets that were in the box.
And fourthly, her assertion that documents containing sensitive information about dead babies were, to use her word, insignificant.
None of that stands up to any sensible analysis. And as I say, if she’s not telling the truth about that, is the true explanation one that’s going to help her in the context of the allegations being made in this case? You can safely conclude the answer to that question is no.
The Crown presented the handover sheets not to allege Ms. Letby “kept trophies” but, based on her explanations for keeping them, as evidence of her dishonesty. Mr. Johnson KC didn’t believe her explanations. He thought the sheets were somehow suspicious, but he did not offer a sensible theory for why. His best guess was that they would help her perform a covert Facebook search. He didn’t buy Ms. Letby’s explanation that she “has difficulty throwing things away”.[5] But it’s a far more plausible explanation than “Facebook spellchecker”, which doesn’t even make sense, let alone “serial killer trophy hunter”.
If there are two alternative explanations, one having a fair chance of happening at random, and one being an remote “outlier”, then unless you have better evidence, don’t plump for the outlier.
We’re back to our old friend confirmation bias, and how it leads to base rate neglect.
Squirrelling useless bits and bobs away is not especially unusual behaviour. One does not need to be mentally ill to do it.[6] Mrs. Contrarian does it.[7] Furthermore, staff taking handover notes home does not seem to have been especially unusual behaviour, either. It seems to have been a perennial problem at the Countess of Chester Hospital.
All the same, it is not “best practice”. It requires explanation.
But rather than starting, as the Crown seems to have, with the hypothesis “this means serial murder” and working backwards, the right starting place is to ask this question.
“This is odd behaviour. What could explain this? Is this the sort of thing a person who was not a murderer might do?”
Given how rare healthcare serial murders are, you should only ask, “is this cogent evidence of serial murder?” if you have answered, firmly, “no” to that starting question.
Let’s say we had answered, “No” to that starting question.
Even so, is this behaviour cogent evidence of serial murder? It is even “consistent with” it? Does it map to Mr. Johnson’s theory about spell-checking?
It doesn’t, really. For one thing, the 257 sheets spanned Ms. Letby’s whole career. Fewer than one per cent related to victims of the alleged crimes.[8] How were they going to help her spell her Facebook searches? What would they be “trophies” of?
Serial killer trophies?
The Crown may not have formally advanced the “trophies” line, but is it fair anyway? I am not — promise — a serial murderer, so I am not well placed to say, but ride with me a while: a shoebox full of your own scribbled notes seems an odd serial killer trophy. Doesn’t it? The internet tells us:
Serial killers may take “trophies” as souvenirs or keepsakes from their victims or as a way of remembering to maintain a sense of control over their victims.
But in this way, as in so many others, Ms. Letby thumbs her nose at what is expected of a self-respecting psychopathic killer.
The literature says the most common trophies are underwear or hair. Ed “Leatherface” Gein made furniture and suits out of his victims. Some, such as Jack the Ripper, Charles Albright, Stanley Baker, Jeffrey Dahmer, Alex Mengel and Dennis Nilsen kept severed body parts. Others took jewellery, driver’s licences and personal effects. One took a library card. But all took things that, in some way or another, belonged to or personified the victim and signified her control and possession of things in the world. These were trophies of conquest: of deprivation of that control.
So what about your own scribbled handover sheets, which you made yourself, had in your bag anyway, and were never in the victim’s control? As trophies these seem — well, a bit beige, don’t they?
But, look: ok. Let’s go with these handover sheets as potential serial killer trophies. Clearly, they might, also, not be. It could be an accident: it could be sloppiness. (Nurses online are ferociously divided: some say it would be unthinkable to take so much as an annotated lunch ticket off the ward. Others claim to pull sheaves of the things out of their smocks each day before putting the wash on.)
It certainly seems precedented: in 2013, it happened often enough at the Countess of Chester Hospital to make the local paper.
So for now, let us give Ms. Letby the benefit of the doubt and allow that, in itself, this might denote behaviour that is merely sloppy, or even within the Overton window of normalcy.
Are there some other filters we might apply to this trove of sheets to bump up the inferential likelihood of evil?
There are.
One is the subject matter of the sheets. If they all relate to victims, and only victims, then, hello: that seems a bit more fishy. Handover sheets about random shifts from five years previously on which nothing much happened don’t seem especially emblematic of anything. But a tightly curated set, matching, and restricted to, the 25 episodes set out on the charge sheet? That might tell us something.
So let us look: we have the evidence. What does it tell us?
Not that.
Sure: some do relate to victims. We do not know whether they relate to specific shifts on which collapses occurred, but it seems reasonable to suppose that, if they did, the Crown would be all over that fact in its summing up. It was not. But literally ninety-nine percent of these sheets had nothing to do with any suspicious event.
The best explanation for those?
Letby says she has difficulty throwing things away.
See also
References
- ↑ Rachel Aviv’s, New Yorker investigation of 13 May 2024.
- ↑ Lucy Letby: initials of babies noted in diary on dates of alleged attacks, court told, The Guardian, 17 April 2023.
- ↑ Letby v R [ 2024] EWCA Crim 748, at Para 27. Judgment here.
- ↑ One my fellow pundshop Poirots has accumulated a near-complete record of the trial transcripts and kindly searched for “Trophy”, “Trophies”, “trophy”, “trophies” across the whole database for me. There were no hits.
- ↑ Recap: Lucy Letby trial, May 18, Chester Standard, May 18 2023.
- ↑ With that said, up to 6% of the US population have a diagnosable “hoarding disorder” according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Ed. So, even an undiagnosed psychiatric hoarding condition would be orders of magnitude more likely than this being “serial killer trophy collecting”.
- ↑ I make no insinuations about Mrs. C’s mental health, but she did marry me.
- ↑ Just 21 of the 257 handover sheets related to victims with which she was charged at all, let alone “critical shifts”.