Reading the exploits of Sherlock Holmes fired his schoolboy imagination and convinced him to aim at a career in medicine and forensic science.
The son of a Belfast shipyard worker, Professor Jack Crane, Northern Ireland’s state pathologist, won a book prize at the end of his first year at the city’s prestigious Methodist College.
“The prize was worth 13 shillings and six pence [67.5p in today’s currency] and after perusing the shelves of Mullan’s bookshop in Royal Avenue, I found that the case book of Sherlock Holmes came to that value,” Professor Crane recalls.
“Reading that book fired my enthusiasm for science and medicine and the detection of crime using medical knowledge. When I reached sixth form I was torn between doing pure science with a view to doing forensic science or medicine and a career in forensic pathology. At medical school there were lots of interesting subjects but I always retained that fascination for forensic pathology.”
Now aged 54, he joined the state pathologist’s department in 1980 as a registrar, later becoming a consultant and then being appointed department head in January, 1990.
His career in the department has seen him investigate some of the most horrendous terrorist atrocities — events like the Enniskillen Poppy Day bombing, the Omagh bombing and the Shankill bombing. Those killings are undoubtedly seared into his mind, but he talks about them with the reserve of his medical training. “It is not that you don't have compassion, but you have to deal with it dispassionately,” he says.
However, the mask slips a little when he talks about the death of young people. “It is not necessarily the scale of death that you deal with. Sometimes I am more moved by the futility involved when lives are lost.”
He adds: “Here in Northern Ireland we have had a lot of young people taking their own lives. If I carry out a post-mortem on say a 17-year-old who has taken his or her life, I find that such a tragedy and such a waste of a young life. I try to imagine how the family must feel. It is awful that a young person feels that is the only course of action they can take to resolve their problems.”
The large increase in the numbers of young people taking their own lives is a tragic development he has witnessed in recent years. “When I started my medical career you didn't see young people committing suicide,” he says. “People who did that then usually had depression over a period of time. That no longer seems to be the case.”
Professor Crane sees it as part of his wider role to flag up issues as the rising incidence of teenage suicides. “I believe as pathologists we have a role to prevent deaths and highlight issues that society needs to confront and deal with. If we see an increase in the number of young people taking their own lives we should bring that to public attention.”
Another issue is that of alcoholism among young people. “There has been a very significant increase in the number of people in their 20s and 30s who have died from alcohol abuse,” he explains. “The typical stereotype of an alcoholic being a man in his 50s who has drunk heavily for many years no longer applies. Alcohol dependency is now increasingly common in younger people and among younger women.
“We get very hung up about drugs, but the numbers of people who die from alcohol is hundreds times greater. I have no problem with people drinking, but I think there has to be some degree of responsibility in all of us and it seems to me that if young people can drink until 3am or 4am it is hardly surprising there are problems. Alcohol seems to be freely available no matter what age you are.”
Another issue highlighted by his department in recent times has been the danger of parents bringing babies into bed with them. “This caused us a dilemma. We didn't want to make some parents who had suffered a cot death feel guilty and blame themselves. But we felt that if we could prevent one infant death then we should highlight the danger of bringing babies into bed. We have seen cases where the baby has been suffocated accidentally in such instances and we wanted to highlight that potential problem.”
Although reticent of talking in detail about terrorist atrocities he has investigated, he admits that sometimes he has been affected by the deaths. On Sunday, November 8, 1987, he was driving back to Belfast from Londonderry when he heard on the car radio about the Poppy Day bombing in Enniskillen.
“All sorts of things flashed through my mind. I had family in Enniskillen who could have gone to the Remembrance Day service. I remember travelling down to Enniskillen. I was not sure what I was going to be confronted with. I remember the police taking me down to where the bomb had gone off and standing at that little corner. There was this eerie atmosphere.”
The bombing of Frizzell's fish shop on the Shankill Road on October 23, 1993 also sticks in his mind. “I kept thinking of those ordinary people out shopping when they were killed,” he recalls.
The department's long experience in dealing with deaths caused by bombs and bullets has gained it an international reputation.
Pathologists have built up an enviable database of the types of injuries caused. Professor Crane's expertise in firearms deaths led to him being invited by the United Nations International Criminal Tribunal for Yugoslavia to review cases of war crimes.
He visited Bosnia and Kosovo to exhume bodies from mass graves and investigate how they died.
While he says that pathologists learn to control their emotions when faced with death, they must retain compassion for the relatives. “Often relatives don't fully understand why a loved one has died. If the Coroner's Office says that families have questions I am quite happy to meet them and explain the circumstances in which someone died.
“Understanding what happened is part of the process of grieving. You don't want relatives 10 years later not realising what happened. At the inquest into the deaths of 29 people in the Omagh bombing, a number of relatives wanted to talk to me about how the victims died. They wanted to now, for example, if their loved ones had suffered. I think if I can give them information that is helpful to relatives.”
This empathy with relatives is reflected in the design of the new £4.5m forensic mortuary opened in the grounds of the Royal Victoria Hospital, Belfast in July this year. It replaced dated mortuary facilities at Forster Green Hospital.
The new facility includes a four-table post-mortem examination room, a dedicated suite for investigating homicides or deaths from infectious diseases such as HIV or hepatitis, storage facilities for 56 bodies, police interview rooms and training facilities. There is also a quiet, tastefully furnished room for relatives and a viewing room where they can see — or even sit with — the body of their loved ones.
Professor Crane says programmes such as Silent Witness — albeit heavily dramatised — have created interest in pathology, although most young people entering medicine still prefer to specialise in a healing discipline.
He argues that pathologists should not just work for the prosecution in court cases. “I think they should also work for the defence if called upon. I don't think those who just work for the prosecution have that same degree of balance and impartiality which is important for a pathologist.
“The outcome of any trial is no concern of mine. My job is just to provide assistance to the court. I am not there to ensure that someone is convicted or acquitted. I am there to help the courts by providing impartial, balanced evidence on the cause of death. My view is open to challenge by someone else. That helps to keep us on our toes.”
Professor Crane adds: “The department has always had a reputation for impartiality. That was very important during the Troubles. We had to be free, for example, to say that someone was shot in the back by the security forces. Everything had to be out in the open. That is the way it should always be.”