THEwas a winter evening at a hospital outside London and colorectal surgeon David Sellu’s clinic was busy. But when a fellow doctor, an orthopedic surgeon, he asked if he would see one of his patients, Sellu didn't hesitate to say yes. What is how, what time or later, what's to happen to the man whose death would turn him into a criminal serving 15 months in a prison cell.
His new patient was a 66 year-old who had a knee replacement, but was now complaining of abdominal pain. In Did He Save Lives?, the book that documents his story, James Hughes, a retired builder from Northern Ireland, and sitting by his bed about talk about how he was feeling. Sellu, now in his early 70s, speaks quietly and precisely. It is easy to imagine him in the evening nine years ago, pulling up a chair and explaining to him that needs painkillers to get him through the night and an urgent CT scan in the morning.
That scan showed Hughes had a perforated bowel and would need surgery straight away. Sellu tried to book an operating slot, but the earliest he could secure a theater and anesthetist at the hospital, the private Clementine Churchill in Harrow, was for later that evening. At the last minute, however, the anesthetist was delayed with another case. Sellu tried, but failed, to find another anesthetist. Hughes's surgery eventually went ahead, but not until around three hours after the intended slot. During the operation Hughes bled a lot more than expected and turned out, he was also suffering from cirrhosis of the liver. It was clear that he had an uphill battle ahead.
Sadly, it was one he couldn’t win. Hughes died two days later, without ever regaining consciousness. Sellu remembers being told the news by a colleague on the phone. “When something like that happens, you go through a very difficult time. You agonise about whether you could have done anything different – this happens after every death. ”More than a third of people who suffer from a bowel die from it in the UK, however good their care. Nevertheless, it has occurred to him that he might have caused his patient's death – or that anyone would imagine he had.
David Sellu’s official birthdate is November 22, 1946, but that was certainly not the day he was born. He grew up in a village in rural areas of Sierra Leone, the eldest of 10 children. His parents could read or write their lives as if they were living, spent growing rice and tending to small flock of sheep and goats. After having started to teach himself to read, he took his place in the local school – and on the first day. It did not make any difference to Sellu when anyone thought he was born, until 1968 when he needed to apply for a passport.
He did remarkably well academically and had won a scholarship to study medicine at Manchester University. He boarded a plane for the first time in his life and arrived in the UK knowing no one. When he realized that he left his toothbrush at home he went into a shop near his hostel in London to buy another. The shop was Harrods: an attendant kindly pointed him towards another shop called Boots down the road.
Fast forwarding four decades and selling had become a senior consultant specializing in gastrointestinal and colorectal surgery. He and his wife Catherine, whom he had met when he was a registrar and a nurse at Hammersmith Hospital, lived with their family in a large, comfortable home in west London. There were four Sellu children and James, the youngest, decided to follow his father into medicine. Today, James is with his father to meet me, and he takes up the story. "We were living a good life," he says. "We had everything we wanted. I knew my father worked extremely hard – often he already looked at work when I woke up, and still at work when I went to bed. But I heard my parents discussing their patients and I found it inspiring. I wanted to do the same with my life. ”In the autumn of 2009, James got a place to study medicine at his father's old university.
Meanwhile, across in Armagh, a builder with a painful leg was already thinking about having a knee replacement in London, a decision that would lead to his own death, but would have a dramatic effect on the lives of both. James.
The circumstances of Hughes's death meant an inquiry was inevitable and Sell welcomed it. He says, medicine has become increasingly complex. "You have doctors, nurses, managers, laboratories, protocols," he explains. "When something goes wrong, you need to look at the whole system."
Professor Duncan Empey, BMI group medical director of the Churchill Hospital’s parent group, commissioned the report and, to sell surprise, his team had to make mistakes in the past. Says Sellu, was unfair: put any surgeon's work under scrutiny; equally, any mismanagement should have been dealt with at the time. Either way, Sellu says he was never so much criticized during his long career.
The Empey report, to defend itself against charges that its treatment of Hughes had fallen below the standard expected, to a serious degree; but neither the GMC nor, later on, the inquest court, were you aware of another report, the Root Cause Analysis (RCA), carried out by its quality manager. Initially, the GMC decided there was no answer to the case, but said it would be the outcome of further inquiries including the coroner's inquest. On a subsequent occasion, when he was summoned again to the GMC, Sellu noticed something troubling: he was there, like him, who had foreign names.
It was the inquest into Hughes death, in October 2010, that changed everything. Sellon to step outside, and told Sellu's counsel and the court that he believed a crime had been committed. It was not enough to reduce the delays; and it culminated in the consultant being charged, in July 2012, on two counts: gross negligent manslaughter of James Hughes, and perjury in the coroner 's court,
For Sellu and his family, the cloud that had been hanging over their lives for the two years. David and Catherine had their best to keep their children, which meant that he was shocked when he got the news. He remembers how he felt in court, and to see his father in the dock. "I was numb," he says. "I never imagined that we could ever be in that situation."
The case was tried in October and November 2013: "I was not guilty of the charge, but guilty by a majority of 10" – the minimum required to convict – of the manslaughter charge. He was sentenced to two-and-a-half years in prison, and served 15 months – including time in two prisons in Suffolk, many miles from his family, had long journeys across the country to see him. James took breaks from his studies to support his mother and sisters on these trips.
In his book, Sellu describes, movingly, his quiet but determined dignity in appalling conditions. He says, he is like being locked in a toilet with strangers. Recreation, exercise and meaningful work were scarce. To me while away he taught himself Arabic and improved his French.
James delivered what David remembers as "a bombshell". Despite having a merit in his master's degree and completing his medical degree, he had already begun. His father's eyes fill with tears as he remembers hearing the news. “Catherine and I had always encouraged him, always believed medicine was a wonderful career. We were devastated. "
Sellu was released in February 2015. In November 2016, after a campaign led by a fellow doctor, consultant neurologist Jenny Vaughan, her conviction was overturned by three appeal judges on the grounds It emerged that in the RCA report the hospital's identified failings included its lack of an emergency anesthetic rota. The Medical Practitioners Tribunal Service (MPTS) ruled that it was satisfied that the Hughes’s condition had not significantly deteriorated on the afternoon before the operation. Dr Rob Hendry, medical director of the Medical Protection Society, who represented Mr Sellu, said: “The tribunal heard evidence of this case and tested it rigorously. As we have said before, they are best placed to weigh up all the factors affecting a doctor's fitness to practice. By contrast, to criminal court is rarely the best place to hold a doctor's account for what has happened in a complex clinical environment. "
James has not revisited his decision to quit medicine. "When something goes wrong, people look for a scapegoat," he says. "And if you are a black doctor, you’re first in line. I loved the idea of being a doctor and impacting positively on other people's lives, but also of the NHS, and the NHS needs the private sector to survive. And being a black doctor is just too risky. Also, if you end up in court, like my father, you are being tried by people who, with all two respect, haven't got a clue what they're listening to. At one point during my father's trial I noticed one of the jurors looking at a piece of evidence upside down. "
James Sellu now has a job in sales. His father – exonerated, cleared by the GMC – is back working part-time. He is "a stronger person" now, he reflects, "and maybe a more compassionate one. But these days I’m very wary. I know what happened to him and he is your enemies. carry the can for the failures of a complex and under-resourced system.
And yet, remarkably, there’s no hint of anger about him. "When I was in prison I realized this could destroy me," he says. "I knew I couldn't allow it to do that. Many doctors who are investigating for alleged negligence take their own lives, and many people in prison take their own lives. I knew I had to look after my psychological health. "
He always be sad about the choice James made, but he understands it. "I was through, I could see it from James's point of view." He saw how much I sacrificed to a doctor – and I ended up in a prison cell. So yes, I can see why he had second thoughts about following me down the same path. "
Did He Save Lives? A Surgeon's Story by David Sellu is published by Sweetcroft on 4 July at £ 9.99
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