Scarred by evil, haunted by what-ifs; Murder: A respected doctor is convicted of killing 15 women, and a town searches its soul over how such horrors could have happened.

THE BALTIMORE SUN

HYDE, England -- John Shaw kept the list and kept quiet.

After all, who would take the word of a burly taxi driver over that of a revered doctor? Who would believe that Hyde harbored a Doctor Death, possibly the most prolific serial killer in modern British history?

But by January 1994, Shaw was growing concerned as his steadiest customers, Hyde's elderly women, were dying off. The only link in the chain of death was the name of their doctor, Harold Shipman.

Over the next four years, Shaw wrestled with his conscience and compiled the names of customers who were alive and well one day and dead the next.

He got to 24.

"I was going to go to Shipman myself," he says. "But I was frightened of being wrong."

Now, Shaw is haunted because he was right.

In this old working-class mill town of 35,000 on the outskirts of Manchester, nearly everybody knows somebody who was paid a final house call by Shipman.

Hyde was rocked Monday when a jury found Shipman guilty of killing 15 female patients with injections of diamorphine, the clinical name of heroin. The presiding judge gave Shipman 15 life sentences and recommended he remain behind bars for the rest of his life for killings between March 1995 and June 1998.

Until the guilty verdicts came in, some people here believed in the innocence of the doctor, who set up his own office on the town's modest main street in 1992, after 15 years in a larger practice,

Support for Shipman gave way to the realization that a popular family doctor, whom thousands had trusted with their lives, was a killer.

Nobody knows what sparked the killings or when they began. Nobody is sure how many people Shipman killed during his 28-year career.

Police have investigated 141 cases involving Shipman. Virtually all the cases involve elderly women.

The killings and their aftermath reached into nearly every layer of the community, even to the jail known as Strangeways, where Shipman is being held. Two guards received leaves because Shipman is suspected in their mothers' deaths.

This area of Greater Manchester has been subjected to notorious killings before. The infamous Moors Murderers, Ian Brady and Myra Hindley, who lived in nearby Hattersley, shocked Britain in the 1960s with a crime wave in which they tortured and killed children.

Preying on the elderly

The Shipman case was different.

He preyed on elderly women who lived alone.

He used his position as a respected doctor to persuade relatives of his victims that his decisions in treatment and after death should not be disputed. He had a ready explanation for why he was present or nearby when many of the deaths occurred. He signed the death certificates and provided a quick cause of death -- a stroke here, a coronary thrombosis there. He was insistent that a post-mortem was unnecessary.

If not for clumsily forging the will of his last victim, Shipman might never have been caught.

Some have suggested that he killed for power, to play God. Others say he simply enjoyed it. Detectives ruled out greed as a factor, even though he attempted to forge the will.

People here are wondering how this could have happened.

"There are a lot of ifs," says the Rev. Denis Maher, a Roman Catholic priest at 3,500-member St. Paul's Church. He was a witness at the exhumations of five of his parishioners killed by Shipman.

"If only people had courage to report him," he says. "The ultimate responsibility lies with ourselves. We put doctors in this position, giving them a power and a trust they don't have to earn. When you have so much power, it's bound to be abused."

Shipman doesn't look especially evil or powerful. He is compact and middle-aged, with a gray beard, oversized wire-rim glasses and thinning hair.

A seemingly ordinary life

He lived what seemed an ordinary life in Mottram, sharing with his wife, Primrose, a squat, two-story townhouse on a nondescript street.

But the 54-year-old father of four, who professed his innocence, was adept at hiding his dark side.

Some here have attempted to link the killings to Shipman's witnessing the slow and agonizing death from lung cancer of his 43-year-old mother, Vera. Then 17, this son of a Nottingham truck driver saw his mother given doses of diamorphine to ease her pain.

Others have pointed to his stint as a young doctor in Todmorden, where he became hooked on a painkiller pethidine and forged 70 prescriptions to feed his habit. In 1976, he was fined by a court and left the medical profession for nearly two years.

He arrived in Hyde in the autumn of 1977 and joined a large practice, Donneybrook, where he worked for 15 years. In 1992, he opened his single-doctor practice on Market Street, setting up shop near a pharmacy and boosting his patient list to 3,600.

Shipman made many house calls and said he was there for his patients 24 hours a day.

The beginning

The first of the known killings occurred March 6, 1995, when 81-year-old Maria West, a retired shopkeeper, was killed at her home while a friend was in the next room.

A familiar pattern of death followed.

There was Irene Turner, 67, killed the day after returning from a vacation; Lizzie Adams, 77, a former dance teacher found dead in a chair by a friend while Shipman looked at porcelain figurines in the next room; and Ivy Lomas, 63, the only one of the known victims killed in Shipman's office.

Shaw, the taxi driver, may have been the first to notice what was going on. He recalls growing suspicious after the death in January 1994 of Joan Harding, who was said to have died of a heart attack in Shipman's office. Shipman was not charged with that death, although Harding is on the list of his possible victims.

Shaw and his wife, Kath, kept their suspicions to themselves. Customers died. But who would believe a taxi driver's suspicions?

Shaw looks out the window, points to homes where some of the victims lived and says, "I'm supposed to be over this. But I'll never be over this."

His wife says, "We didn't talk to anyone else. No one would believe it."

In 1998, others caught on. Across the street from Shipman's office, the five doctors at the Brooke Surgery grew concerned about their neighbor because of the number of cremation certificates they were co-signing on Shipman's behalf. The practice is known as "ash for cash" and is built on trust among medical colleagues. Undertakers were suspicious about arranging funerals for so many of Shipman's patients.

"We were starting to think the unthinkable but not speak the unspeakable," says Dr. Raj Patel.

To point a finger at a colleague, especially one as respected as Shipman, would be difficult at best, if not impossible. Patel recalls that Shipman had an impeccable record, especially in treating coronary heart disease. He remembers giving a lecture on dermatology, and Shipman sat in the front row, and knew virtually every answer to a pop quiz.

"Personally, he was a very confident man," Patel says. "Some people call him arrogant. Enormous charisma. A sense of power in him."

It was Dr. Linda Reynolds, now terminally ill with cancer, who helped spearhead the Brooke Surgery's quiet investigation of its neighbor. An outsider to Hyde, she viewed Shipman with fresh eyes. The doctors decided to look at 1997 medical records and discovered that Shipman, with a patient list a third smaller than theirs, had three times more nonhospital deaths.

"We couldn't ignore this. But what could we do?" Patel asks.

They notified the coroner, who alerted the police, who investigated and came up empty.

The doctors at the Brooke Surgery were relieved. They had been wrong. The unthinkable had not occurred.

But the killing continued. Shipman killed three more women, then made a crucial mistake.

The killer slips

Kathleen Grundy, 81, was a charity volunteer and a wealthy widow whose husband was a former mayor. Shipman was her doctor, and he made house calls to check on her. On June 24, 1998, she was discovered dead in a chair in the living room of her cottage, several hours after Shipman had taken a blood sample.

Grundy's daughter, lawyer Angela Woodruff, followed the doctor's trail. What tipped her off was a forged will that left her mother's $630,000 estate to Shipman. Gathering evidence, she meticulously compiled a dossier, which she gave to the police.

This was the only crime that the evidence clearly shows Shipman tried to profit from.

A new investigation was begun. Grundy's body was among 12 exhumed, and toxic levels of drugs were found. Shipman was cornered. Police later discovered that in several cases he had falsified medical evidence logged into his computer.

He never admitted committing the crimes.

In a letter from jail published by the Sun of London, Shipman purportedly wrote in September: "I can see the headlines from the trial: GP [General Practitioner] Murders 15. Are We Safe In Their Hands? No Motive in GP's Murder. Serial Killer.

"You can guess the rest."

The families of the dead, the entire country, are left to pick up the pieces.

"Sadly, nothing that has happened here, or will happen in the future, can bring back my mum and all the other victims," Woodruff said after Shipman's conviction. "We hope that we can now have the space and time to remember my mum as she was, a happy, active, caring, energetic, loving person, whom we miss so much."

The government plans an inquiry into the deaths with the likelihood of greater oversight of doctors' signing death certificates and handling drugs.

"You can legislate against a poor doctor," Patel says. "But you can't legislate against evil."

That's the scar that won't heal soon in Hyde. People here are convinced that sheer evil invaded their town, crept into their homes and took the lives of their most vulnerable.

And hardly anyone noticed.

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