After the child known as Baby C died, his mother had his tiny handprints and footprints made into a pendant to wear round her neck. It had comforted her to keep them close, she told the court. But even that was taken away from her when Lucy Letby, the nurse convicted of being Britain’s worst child serial killer, was arrested: it was Letby who helped the unsuspecting mother make the prints.
She was one of several parents whose victim statements to the court are quoted movingly and at length in Jonathan Coffey and Judith Moritz’s diligent, absorbing book. The mother of triplets, two of whom died so soon after birth she only had one photo of them together; the father driven to suicide; the parents whose now seven-year-old son Letby had tried to kill, who were so scarred and distrusting that they wanted him homeschooled so he was never put in anyone else’s care again.
Yet it feels a little jarring that these accounts appear over 200 pages into the book. Of course, its primary subject is a murderer and the disputes over her guilt, not the victims, and of course the authors are focused on stress-testing the evidence. But there’s something uncomfortable about opening with a breathless description of how it felt to watch the trial – how reporters “craved colour and pounced on every detail”, how Letby “broke the fourth wall” when she testified, as if it was all some made-for-Netflix drama – rather than how it feels to lose your child.
That, however, is the way the Letby case was treated from the start: as drama, spectacle, a juicy true-crime serial (the Daily Mail even turned its trial reporting into a podcast). Like the police search last year for Nicola Bulley, or the disappearance of Madeleine McCann in 2007, it unleashed an army of amateur online sleuths convinced they knew better than the jurors who sat through months of testimony.
But while this thriving cottage industry must be incredibly distressing for the families, the Facebook #justiceforlucy brigade aren’t the only ones troubled by the verdict. Some leading clinicians not involved in the trial have expressed doubts to this newspaper and others about the safety of her conviction, while former colleagues at the Countess of Chester hospital remain torn. So, it emerges, are this book’s authors. Moritz, who covered the trial for the BBC, felt the prosecution proved its case; Coffey, who produced Moritz’s Panorama documentary on it, has questions.
And in some ways, who doesn’t? “Nice Lucy” seemed so blandly ordinary, with her salsa classes and soft toys lined up on her bed: as the criminologist Professor David Wilson tells the authors, she doesn’t fit the usual profile of a healthcare serial killer. Perhaps that wouldn’t matter if the evidence was overwhelming. But nobody caught her red-handed – though she was seen behaving oddly around a struggling baby on at least two occasions – or established a motive for murder. And while paediatricians on the unit fought hard to have their suspicions about her taken seriously, potentially valuable postmortem evidence may have been missed because nobody ensured an immediate investigation into the deaths of babies she had cared for. Even the now infamous “I AM EVIL I DID THIS” note found in her diary remains ambiguous. A confession, or a conscientious nurse beating herself up for imagined inadequacies after being taken off a job she loved?
But if she isn’t a typical murderer, then her curiously emotionless demeanour following incidents that left other staff distraught doesn’t seem typical for a nurse, and nor does she behave like a typical victim of a miscarriage of justice. None of her family, and only one old friend, would speak to Coffey and Moritz. More puzzlingly, the authors suggest Letby was the one who vetoed calling expert witnesses in her defence. (The great mystery of the trial was that, while her lawyers found a neonatologist sceptical of the prosecution’s case, he wasn’t asked to testify.) Something doesn’t add up, which makes the titular promise to unmask the real Letby all the more intriguing.
The book is a commendably layperson-friendly but thorough dissection of both the medical evidence given in court, and subsequent challenges to it from outside. Helpfully, it also explains in detail how the police and prosecutors built a case against Letby following an unusually large number of baby deaths on the unit between summer 2015 and 2016.
One by one, the authors tackle her supporters’ arguments: that the prosecution relied too heavily on the statistical oddity of a spike in deaths, or on the fact that death seemed to follow this one nurse around (a misunderstanding of how the case was constructed, their analysis suggests). What about the defence’s argument that these already sick babies might have died from poor care in a demonstrably understaffed, overstretched unit? Unusually, Coffey and Moritz argue, these deaths often involved seemingly stable babies collapsing suddenly without explanation: if sloppy care was at fault, you’d expect to be able to identify a fatal mistake. Nor can staff shortages explain why tests on three babies indicated dangerously high levels of insulin that couldn’t have occurred naturally, and must therefore have been injected. That indicates a poisoner at work. (Though Letby’s supporters say those tests aren’t considered reliable enough for court, apparently that’s because they can produce false negatives: if anything, they could err in a poisoner’s favour.)
Yet the book doesn’t shy away from the fact that the case against Letby remains uncomfortably circumstantial and theoretical, boiling down to fine scientific judgments that sometimes (including in Baby C’s case) shifted over time. Setting aside the insulin cases, the prosecution claimed several of the babies were harmed by air embolisms – essentially caused by someone injecting air into them – and the authors note that Letby took a training course warning of the dangers of accidentally causing embolisms shortly before Baby A died. But the embolism theory is contested and Coffey and Moritz admit that the science often “felt like a fog”. In one case where the original pathologist and the prosecution’s pathologist had disagreed about a baby’s cause of death, a third pathologist was asked by the authors to review the notes and settle the matter – but ended up disagreeing with both of the others.
If qualified experts can honestly disagree, how authoritative is the science? What does “beyond reasonable doubt” mean in a case reliant on what Coffey and Moritz call a constellation of evidence, which looks overwhelming taken together but less so taken piece by piece? “The more one learns about Lucy Letby,” they write, “the more difficult the case is to understand.” It’s a frustrating admission in some ways – what happened to the great unmasking? – but it has the ring of truth. Like the murderous GP Harold Shipman, who died without confessing or explaining, Letby fascinates because she remains so unknowable; a blank page on which anyone can write. Rigorous as it is, one suspects this book won’t be the last word.
• Unmasking Lucy Letby: the Untold Story of the Killer Nurse by Jonathan Coffey and Judith Moritz is published by Seven Dials. To support the Guardian and the Observer order your copy at guardianbookshop.com. Delivery charges may apply.
