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When he prevented paramedics from resuscitating one of his victims, 81-year-old Hilda Hibbert, and said with anguish, "You don't want her bringing back as a cabbage," they took this as compassion, not guessing that it was really the fear of discovery.

So why did he do it? Apart from the forging of one will for $617,600, which eventually led to his unmasking when the real heir smelled a rat, he didn't get any material benefits from the murders. Psychiatrists had a field day trying to answer the question.

"He felt guilty that he had not been able to ease his mother's death with morphine when he was a teenager, so he set out to repeat her death and this time be in control of it," opined forensic psychologist Ian Stephen.

"He was a necrophile -- obsessed not with having sex with the dead, but with the act of inducing death and controlling the moment," mused psychiatrist Richard Badcock.

"He was driven by the thrill of having the ultimate power over someone's life and death. He also had an obsessive-compulsive disorder. He developed this ritualistic act to kill and then felt compelled to repeat the act over and over," was the view of psychologist Alan Wise.

All the experts agreed that he craved supreme authority, and it is easy to understand how a British doctor with delusions of omnipotence could get carried away with his power over patients. There, the family doctor is still regarded as almost omniscient.

House calls are still part of the ailing National Health Service and, in a country that has virtually abandoned organized religion (fewer than half the proportion of the population that goes to church in the United States goes in Britain), the family doctor has replaced the priest as the figure of authority.

"A consultation with a doctor is similar to a confession in church," wrote Fred Kavalier, a general practitioner, in the Independent. "In these days of increasing complaints against doctors it may seem bizarre, but there are many patients who want their doctors to be nothing less than God-like. It is easy for a doctor to obtain lethal drugs. If a patient is elderly, everyone feels it is more humane to avoid involving the coroner. It was easy for Dr. Shipman cleanly and quietly to commit murder."

Britain is moving only slowly toward the American model of "mini-clinics" replacing the old-style family doctor. Medical practice is strikingly casual compared to North American procedure: When you go to a doctor in Britain neither your weight, blood pressure nor any of the other basic information that is standard pre-consultative procedure in the United States is ever taken.

In the latest twists to the Shipman saga, the convicted doctor decided to launch an appeal against his sentence, claiming that the press coverage prejudiced his trial. If by any chance he succeeds, the prosecution says it has enough evidence to try him immediately on 23 more charges of murder. And, at last, the British Medical Association has struck him off the list of doctors allowed to practice.

While the scale of his crimes may be unique, Harold Shipman is merely the latest in a long line of British medical murderers. They are ensconced in British folklore, celebrated at Madame Tussaud's waxworks and as familiar to every schoolchild as Snow White's stepmother.

Back in the 1850s, another doctor, William Palmer of Rugeley, poisoned a dozen of his relatives and patients. And Jack the Ripper, most famous of all British murderers who got away with it, was strongly suspected of being a doctor, so anatomically perfect was his disembowelment of his prostitute victims in London's East End.

Dr. Hawley Harvey Crippen, who murdered his wife in 1910 (and fled to the U.S., only to be caught by the first criminological use of wireless telegraphy), is still a household name. And, in the 1960s, Dr. John Bodkin Adams stood trial for murdering his patients and forging their wills, just like Shipman, and was acquitted for lack of evidence.

Like Palmer and Adams, Shipman was unctuously pious. He decreed in the will he forged for Kathleen Grundy that some of her money should go to an old people's home and to establish a fund for the support of women who gave birth on the anniversary of her death. The rest was to go to her kindly doctor "for all the care he has given," as he phrased her grateful thanks to him.

As the hysteria mounts in the British press, a spokesman for the National Health Service admitted: "The service is underfunded and has too little capacity. There are too few doctors and nurses. We are trying to change that, but it takes time."

As for policing doctors, the secretary of the British Medical Association, Dr. Mac Armstrong, says that the present regulatory system is the worst of all worlds. "The General Medical Council has lost the confidence of the medical profession, and doctors worry that it no longer has the confidence of patients." It seems to be a case for St. Mark's words: "Physician, heal thyself."

However, a new public opinion poll by Market and Opinion Research International found that 87 percent of Britons would still trust their doctor to tell the truth. And how many would trust journalists, presumably including those who were stirring the trouble pot? Just 15 percent. Perhaps we should also be saying "Media, heal thyself."
salon.com | March 23, 2000

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