National treasure Meadow put out to pasture

The thrilling conclusion of one man's quest for truth

by Tristram O'Specious

Previously: From Stonyface Grammar School, Wigan, to the very pinnacle of the paediatric pyramid — Sir Roy Meadow's glorious arithmetical trajectory to that dateline with destiny in Winchester...

It is 16 April 2002 and Winchester Crown Court is bubbling over with excitement as the call goes out for the key prosecution witness to take the stand in the murder trial of Salisbury shop assistant Mrs Angela Cannings, 38.

Professor Roy Meadow: Screaming hysteria This is the setting for Act Two Scene Five of the West End smash hit The Importance of Being Learned a faithful yet entertaining theatrical biography of the eminent paediatrician Sir Roy Meadow, written by the highly talented dramatist and part-time GP Dr Art Grant. Grant, who studied under Sir Roy in the early nineties at Leeds University Hospital, stepped onto the celebrity ladder himself in 2001 when he coined the term "Meadowmania" to denote the state of screaming hysteria that overtakes swooning young mothers when they catch sight of the dazzling professor turning up unexpectedly on their doorstep to admire their baby and whisk it from under their noses out of harm's way.

Three years earlier at the trial of Chester solicitor Sally Clark, Professor Roy Meadow's stock rose to astronomical heights after he demonstrated in open court for the first time that he had solved the riddle behind the embarrassing modern phenomenon of cot death.

How on earth, (went the riddle), in a post-industrial nation such as Britain, let alone in middle-class families with all the advantages, could so many hundreds of children be dying in this inexplicable way?

It just didn't add up. But that — according to Sir Roy — was exactly where his predecessors investigating the killer syndrome had gone so terribly wrong. They should never have tried to add it up in the first place. Multiplication was the key to explaining the unacceptably high numbers of infant stiffs. Multiplication, with a dash of probability theory thrown in. Yet they shied away from it, for this was a skill in short supply amongst conventional paediatricians, who were unlikely to have ever got beyond their twelve times table, if that. It was left to Professor Meadow to plan, launch and bring to fruition the ground-breaking piece of mental arithmetic that identified the true killer and pointed the way towards root and branch reform in the social services that would eventually bring the mortality rate down.

"As a matter of fact," he announced to the spellbound audience at the trial of notorious Chester solicitor Sally Clark, "there's not a great deal of it around. Cot death, I mean. It's been blown up out of all proportion." He narrrowed his eyes and looked directly into the frozen face of the defendant. "Most of it's infanticide. Isn't it, Mrs Clark?"

Ever since that decisive moment guilt-ridden parents had been increasingly caught out and forced to own up to their crimes. Over-enthusiastic slappers and shakers, poisoners, crushers and smotherers masquerading as bereaved parents were exposed by the icy logic of the Meadow formula and were now facing up to a life behind bars.

Meanwhile, new standards of preventative medicine were rolled out nationwide under Sir Roy's exemplary supervision. He set up channels of communication whereby vigilant GPs could report any suspicious incidents of mothers bringing their children to surgery with cuts, bruises, rashes and the like, claiming to be very worried and generally hogging the doctor's attention. These reports never failed to send a chill down the professor's spine. He appeared to go into a trance as he computed the evidence. His secretary tensed, awaiting the outcome. Suddenly, in a moment of blinding clarity Sir Roy jumped up from his desk, grabbed his coat, and was on his way out the door. "Munchausen Syndrome By Proxy!" he yelled. "Get the car ready — let's hope we're not too late!"

Numerical spell

Sadly, these hopes were not always fulfilled, as in the case of Mrs Cannings, whose local surgery woke up to the signs of her erratic behaviour far too late, allowing her to kill and kill again before the professor was alerted. Now her day of reckoning had arrived, and the normally sedate Hampshire court-room was packed to the rafters with an expectant public who had queued up all night for the privilege of watching a living legend weave his numerical spell and utter the damning testimony that would send her down.

The Crown prosecution team assembled for the occasion were an unprepossessing lot, thrown together in haste at the last minute and barely conversant with the facts, but this mattered little. There was a rule of thumb now in opeartion down at the CPS which governed the allocation of resources, enabling numerous kak-handed trainees and dullards to have their day in court without prejudice to the outcome of a case. If the name of Professor Roy Meadow featured in the roll-call of witnesses, (so the saying went), then you could send out the dimmest makeweights, for conviction was already assured.

Indeed it was increasingly recognised that the additional experts on the list, whose testimony would once have been considered an integral part of proving a case beyond reasonable doubt, were themselves only there to make up the numbers. But Sir Roy could handle that. It was his core métier after all.

It was not simply the irrefutable quality of his evidence, but the way he delivered it, with style and eloquence, dipping occasionally into a vast reservoir of erudition that extended well beyond the strict confines of his domain as the needs of the trial demanded. These crucial insights brought essential clarity to controversial issues which the so-called specialists in those fields seemed unable to disentangle. He could pronounce with absolute authority on a whole range of subjects, encompassing such diverse disciplines as the infant respiratory system, toxicology and the feminine psyche without ever needing to have studied them.

Superbly led by his star witness, the prosecuting counsel arrived at the crucial question. "Forgive me Sir Roy, might I be so bold as to ask ... what are the chances of lightning striking twice in the same family? Lightning, that is, in the form of SIDS?" (Sudden Infant Death Syndrome, aka cot death).

"One in seventy three million," the professor informed the court. "And there's a bare twenty million families in Britain, if that."

"So it couldn't possibly happen in this country?"

"Hardly. It does happen in China and India on occasion, perhaps even America."

"No further questions, m'lud."

Surprise attack

The defence attorney shot to her feet. This defied all precedent. Three years ago in Chester the counsel for the defence had simply given up at this point, shrugging the shoulders and grinning apologetically at his client Mrs Clark, who hung her head, knowing that she'd come to the end of the road. There had been no need to depart from that pattern in the two dozen trials since. Until now.

The smartly-dressed ethnic young lady who took to the floor with such apparent confidence had clearly been shockingly briefed. The hearts of the spectators in the gallery went out to her, knowing the fate that lay in store.

"That's quite a number, professor," Ms Pushi Kau suggested. "Such a tiny, tiny possibility you say, so tiny we might as well discount it completely. Do you have any evidence for your claim?"

For an instant Professor Meadow flinched at the surprise attack. Then he smiled his most gracious smile and winked at the jury as if to say: "Let's play along for a bit, see how much rope we can give her."

"Answer my question!" the prickly young woman snapped, almost verging on contempt of court. "Where's the evidence for that statistic you've just quoted?"

The prosecuting counsel half got to his feet to object but Sir Roy nonchalantly waved him down. "Evidence? I shredded it, of course," he gleefully countered, producing a ripple of mirth in the courtroom.

Justice Horatio Clockwatcher, in charge of the proceedings that day, glared at the public gallery until silence was restored.

"Aha! You shredded it did you," the rebarbative advocate sneered, skating ever closer to the edge, the ice literally cracking beneath her feet. "You shredded the evidence, just like that!" And she indulged in a pantomime display of tearing an imaginary document into tiny little pieces and flinging them into the air.

The courtroom was aghast. Sheer disrespect was one thing. The magnanimous Meadow lightly brushed it off, his own dignity correspondingly enhanced. But pure blind ignorance was something else again. Perhaps it wasn't the young lady's field, but surely her foundation year would have covered this most basic tenet of intellectual property rights.

Professor Meadow's pre-eminence on the expert witness circuit, and the prodigious court fees he commanded, flowed from a unique endownment of arithmetical genius that he had channelled into a life-long quest for scientific truth, comprising more than fifty years of hard graft. It was not to be thrown away lightly in some ill-advised nod to "open science". Less scrupulous academics than he, who were constantly on the lookout for shortcuts, would be bound to get hold of the sensitive data, and with only the barest glimmer of comprehension, misuse it for their own ends. If his colleagues even suspected for a moment that he had a copy of his painstaking research hidden away in the bottom drawer of his desk or locked in the safe at home, then what was to stop them hiring a gang of thieves to deliver it into their hands, or even worse, kidnapping the professor and beating him over the head until he spewed out the combination?

"I expect she's one of those 'quota' barristers," a gentleman in the front row explained to his wife, "who don't know their arse from their elbow. You know the sort, those secretaries who wangle themselves onto an all-female short-list and get picked out by lucky dip."

It was an unkind remark. More likely, two generations simply weren't long enough to smooth down the rough edges bequeathed to the legal ingénue by her alien culture of origin. Whatever the reason, the dogged young minx had the bit between her teeth and wouldn't let go. "I would submit, your honour, that seeing as there's no evidence..."

Sir Roy Meadow cut her short. "Evidence shmevidence!" he riposted, finally losing patience with the irritating gadfly and batting away her last impertinent thrust. "It's all up here," he pointed out to the presumptious interrogator, tapping his head for the benefit of the one person in the courtroom who just didn't seem to get it. Then turning to the judge he suggested a way out of the difficulty.

"I know the evidence off by heart, your honour. Would my learned inquisitor accept a recitation?"

"That would be most satisfactory," Justice Clockwatcher ruled. "A very sound notion, it would save a good deal of time. Ms Kau?" he raised his eyes, inviting the hot-tempered advocate to retire to her place.

It was beginning to sink in at last, the enormity of the faux pas that threatened to end her career before it had started. She slinked back to her place, flushing hot with embarrassment.

The judge banged his gavel to silence the court.

Audible whirring

"Now as you all know," the professor began, addressing his professional and lay listeners alike with that absence of condescension for which he was noted, "there's a one in 8544 chance of it happening just once in a given family, so ... if you'll bear with me a moment as I hunt down the relevant times table ..." His forehead frowned in concentration, the whirring of his brain as it navigated the aisles and shelves of half a century of learning was almost audible.

"Wait for it now ... here goes ... eight thousand five hundred and forty-four eight thousand five hundred and forty-fours are ... " (the audience held their breath) "... 72,999,936. As near as dammit 73 million!"

Resounding applause filled the courtroom. The humbled Kau had nowhere to hide, but to her credit she was beginning to catch on to the protocol of Meadow's court. She splayed out her empty hands palms upwards again, this time with a wry smile, indicating the emptiness of her case. Turning to the public benches behind her, she repeated the gesture for the benefit of the Cannings friends and relations, letting them know the game was up.

With normal service resumed after the unexpected delay, the public let rip, giving full vent to their feelings. "Murderess! Murderess!" they chanted from the gallery as the sentence was pronounced.

Taking a leaf out her advocate's book, the convicted Cannings shamelessly flouted convention by showing emotion as she was led away, protesting her innocence to the last, her piercing shrieks audible throughout the building and out in the street. It was very embarrassing. The court officials didn't know where to look, and yet in a way it was a relief, for it removed the last vestige of doubt that they might have had about the verdict. Here for all to see was a classic example of Munchausen Syndrome By Proxy, a woman whose teenage dreams of parading the catwalks in Paris and Rome, of jetting out to LA with her all-girl band for a sell-out gig at the Hollywood Bowl, had gone up in smoke with the advent of motherhood, the loss of her shape and the drudgery of domestic routine. Yet still she craved public attention, hardly waiting for the first one to pop before she laid into it, knocking it about whenever her visitors' backs were turned and pestering the nurses to drop everything and rush to her bedside to have a look.

Finally she broke the ultimate taboo, snuffing the very life out of her own flesh and blood. Friends and family, counsellors and carers rallied round in support. They didn't half make a fuss of her now, a pleasure so exquisite she couldn't wait to do it again. Confronted by Meadow she denied it all. And the more she denied it the better it got, the more of that precious limelight she grabbed.

Here she was now still at it, kicking and screaming as they tried to drag her from the court to begin her sentence, milking her fifteen minutes of fame for all it was worth. Finally they managed to bundle her out into the van and bring the appalling scene to a close.

As for Professor Meadow, one might have thought he could retire at the apex of his career and leave others to carry on the good work. But that would be to underestimate the depth of his dedication to the cause. He had still more to give, setting up a direct helpline for mothers who, shocked out of their complacency by the scenes at Winchester, were determined not to make the same hideous spectacle of themselves. Mothers who swore to put the interests of their children first should they ever begin to suspect that they themselves might be prey to the infamous syndrome.

Howling caravan

Act Three comes to a rousing finale with a howling caravan of women beating a path to Professor Meadow's door, not daring to bring their only surviving child with them, but insisting it be farmed out into the safety of care. Clamouring for attention these desperate mothers have kicked and scratched the nearest policeman they could find until he's been forced to do their bidding and handcuff them for even greater dramatic effect.

Here comes Mrs Trupti Patel, two children already down the pan and a third whom she's vowed never to see again, sobbing incosolably. She frogmarches her way into the office ahead of the constable and throws herself onto the floor at Sir Roy's feet, absolutely gagging to know the worst.

Like so many guilt-ridden parents before her she's come to the one man who offers a glimmer of hope. If she can only hear that famous catchphrase fall from his lips for her benefit alone, experience for a few treasured moments the undivided attention of the legendary professor devoted exclusively to herself, surely the height of any mother's ambition, then maybe, just maybe she can learn to accept her fate.

She has taken the first painful step on the road to redemption. She cries out to receive the balm of self-knowledge encapsulated in the concise formulation developed by Professor Meadow over the years and which has come to be known as Meadow's Quip.

Sir Roy casts a dispassionate eye over the tragic figure writhing on the carpet below his desk. The desperate mother senses the great man's attention focused fully upon her. She stops her convulsions for a moment and looks up at him with mournful eyes.

"Tell me sir, tell me I've got it," she begs. "The quip, you must give me the quip!"

The venerable professor of paediatrics utters a mild "tut, tut". He leans forward, meeting her anguished look with those all-knowing eyes that penetrate deep into her soul. Shaking his head sadly, he pronounces the diagnosis.

"To lose one baby, Mrs Patel, may be regarded as a misfortune. To lose two smacks of Munchausen Syndrome By Proxy."

Epilogue

It is almost time to draw the curtain on the exploits of our most erudite national treasure. The West End audience have been thrilled, charmed and inspired in turn by an evening spent in his company. But before Dr Grant, his worthy disciple, bounces onto the stage with his sterling troupe of thespians to take a well-deserved bow there is one final scene to be played.

London, July 2005. A feverishly awaited trial, since Professor Meadow has indicated it might be his last. There he is in his customary place in the stand. By some curious mix-up he's been billed as the defendant, but this will be sorted out in due course and shouldn't hold up the proceedings.

He has something special up his sleeve today, a valedictory treat lovingly prepared for the delectation of his legions of fans.

"Meadow's Quip! Meadow's Quip!" the delirious audience chants. Many of them have never heard it straight from the horse's mouth and this is their golden chance.

Sir Roy raises his hand and silence reigns.

"No," he says, "I don't do the quip anymore. I didn't mean it, I never meant it to be taken like that."

For a tense few moments there's a dreadful hush. Spectators turn to their neighbour for enlightenment. The penny drops. Hoots of laughter break out.

Is there no end to the man's talents? The fêted scientist and showman has defied all expectations and re-invented himself as a comic, self-deprecating buffoon. It's absolutely priceless!

"I never wanted to give the evidence," he blubbers. "They forced me."

The audience are falling about in the aisles, clutching their sides. If Sir Roy had a place in their hearts before, which he certainly did, he's now taken over the freehold from his Yorkshire rival and close contemporary Alan Bennett.

"Those domineering clerks and barristers — once they get their talons into you they never let you go. I tried to get out of it but they kept forcing me to accept their filthy money and take the stand — you don't know what it's like!" he splutters miserably.

What an act, what a class performer! And still he cranks it up. "Standing over me with their threatening stare, giving me the evil eye, making sure I said what they wanted to hear."

The crowd can't take much more of this. Their stomach muscles are beginning to ache, they need to come up for air.

"It was pure speculation!" he wails, "I never meant it to be taken seriously!"

The courtroom collapses in a final burst of hysterics.

The West End audience go out into the night with smiles on their faces, chuckling as they play back in their mind the hilarious swansong of a remarkable genius. A life-saving hero too, with countless achievements to his name. But most important of all — as every true Briton (of three generations' vintage or more) knows — a very funny man.

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